Advanced oxidation protein products (AOPPs) in juvenile overweight and obesity prior to and following weight reduction
Introduction
Obesity is a metabolic disorder associated with an increased risk for developing several detrimental pathologies such as hypertension, dyslipidemia, type 2 diabetes, or cardiovascular disease. In addition to decreased quality of life, the morbidity and mortality rates are elevated in a population of obese subjects [1]. Despite the growing awareness of deleterious effects of obesity, its prevalence is reaching the epidemic proportions [2] also among children [3]. According to the reports of International Obesity Task Force (IOTF), Poland is among the European countries experiencing the most rapid increase in the incidence rates of juvenile overweight and obesity [4].
A significant body of evidence has been gathered, suggesting that obesity might be viewed as a state of chronic oxidative stress, similarly to other inflammation-based diseases. Oxidative stress has been implicated in the development of obesity itself as well as obesity-related disorders [2]. Consequently, accelerated formation of reactive oxygen species [5] and accumulation of oxidatively modified macromolecules have been demonstrated in juvenile overweight and obesity [6], [7], [8]. Therefore, in order to prevent the development of secondary disorders, obesity interventions should focus on oxidative stress attenuation.
Advanced oxidation protein products (AOPPs) are a new marker of oxidative damage, valued for their ease of determination and stability [9]. AOPPs result from the action of chlorinated compounds on proteins, leading to the formation of dityrosine residues and consequently to the protein cross-linking, aggregation and precipitation [10], [11]. Except for being the effect of oxidative imbalance, AOPPs are involved in the further development of oxidative stress and inflammation by the activation of immune cells [10], [11]. Accumulation of AOPPs has been reported in various pathologies [12], [13], [14], also those associated with impaired carbohydrate metabolism [15], [16].
Data on oxidative stress in childhood and adolescent overweight/obesity, and the effect of body mass reduction on oxidative stress markers are scanty. Therefore, the aim of this work was a thorough analysis of the accumulation of AOPPs in juvenile overweight and obesity, their association with obesity-related disorders, and the evaluation of the impact of weight loss and treatment strategy may exert on AOPPs concentration in the course of lifestyle modification and pharmacological treatment with metformin.
Section snippets
Patients
We examined 114 outpatients of the Department of Endocrinology and Diabetology of Children and Adolescents of Wroclaw Medical University diagnosed with overweight (n = 27) or obesity (n = 87) according to the international IOTF criteria proposed by Cole et al. [17]. Only otherwise healthy subjects younger than 17 years old with primary overweight/obesity, who agreed to participate in a lifestyle modification program, were included. The presence of central nervous system diseases, genetic disorders,
Statistical analysis
D'Agostino–Pearson normality test was applied for data distribution analysis and equality of variances was tested with Levene's test. Baseline AOPPs' values were normally distributed following log-transformation and were expressed as geometric means with 95% CI around mean. Differences between mean values were tested using t-test for independent samples or one-way ANOVA. Univariate correlation analysis was conducted with Pearson's or Spearman correlation tests conditioned on data type and
AOPPs in overweight/obesity and related metabolic disorders
There were significant differences in AOPPs with respect to body mass (p < 0.001). The lean children and adolescents had lower AOPPs in comparison with the overweight and obese subjects of their age (Fig. 1). In the combined cohort of lean and overweight/obese individuals, concentrations of AOPPs directly correlated with both BMI and BMI% (r = 0.38, p < 0.0001 and r = 0.36, p < 0.0001, respectively). No correlation between AOPPs and BMI or BMI% was observed when controls and patients were examined
Discussion
To the best of authors' knowledge, this is the first report showing the association between an enhanced formation of AOPPs and abdominal obesity or metabolic syndrome in juvenile overweight and obesity, and the decrease in concentrations of AOPPs associated with body mass reduction and bran-supplemented diet.
There is a paucity of available data on oxidative stress markers in juvenile overweight and obesity. Enhanced formation of AOPPs was reported in the study of Atabek et al. [8], focused,
Acknowledgments
The authors would like to thank Dr. Andrzej Dabrowski from the Department of Mathematics of Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland, for statistical analysis and Dr. Joanna Chrzanowska from the Department of Endocrinology and Diabetology of Children and Adolescents, Wroclaw Medical University, Wroclaw, Poland, for the contribution to the clinical evaluation of study participants.
The personalized body mass reduction program was designed in cooperation with
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