Early changes in adipokines from overweight to obesity in children and adolescents

array:25 ["pii" => "S0021755716300997" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.02.015" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "424" "copyright" => "Sociedade Brasileira de Pediatria" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2016;92:624-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1099 "formatos" => array:3 [ "EPUB" => 102 "HTML" => 637 "PDF" => 360 ] ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2255553616301033" "issn" => "22555536" "doi" => "10.1016/j.jpedp.2016.08.007" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "424" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2016;92:624-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1101 "formatos" => array:3 [ "EPUB" => 108 "HTML" => 665 "PDF" => 328 ] ] "pt" => array:13 [ "idiomaDefecto" => true "cabecera" => "Artigo Original" "titulo" => "Early changes in adipokines from overweight to obesity in children and adolescents" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "624" "paginaFinal" => "630" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Alterações precoces nos níveis de adipocinas de sobrepeso para obesidade em crianças e adolescentes" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 753 "Ancho" => 1595 "Tamanyo" => 93190 ] ] "descripcion" => array:1 [ "pt" => "Níveis plasmáticos de adiponectina, resistina e leptina (pg/ml) em indivíduos magros (n=24), sobrepeso (n=30) e obesos (n=50). * p<0,01 (teste de Kruskal‐Wallis, pós‐teste de Dunn). ** p<0,001 (teste de Kruskal‐Wallis, pós‐teste de Dunn)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rafael Machado Mantovani, Natália Pessoa Rocha, Daniel Massote Magalhães, Izabela Guimarães Barbosa, Antônio Lúcio Teixeira, Ana Cristina Simões e Silva" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Rafael Machado" "apellidos" => "Mantovani" ] 1 => array:2 [ "nombre" => "Natália Pessoa" "apellidos" => "Rocha" ] 2 => array:2 [ "nombre" => "Daniel Massote" "apellidos" => "Magalhães" ] 3 => array:2 [ "nombre" => "Izabela Guimarães" "apellidos" => "Barbosa" ] 4 => array:2 [ "nombre" => "Antônio Lúcio" "apellidos" => "Teixeira" ] 5 => array:2 [ "nombre" => "Ana Cristina" "apellidos" => "Simões e Silva" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0021755716300997" "doi" => "10.1016/j.jped.2016.02.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300997?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301033?idApp=UINPBA000049" "url" => "/22555536/0000009200000006/v1_201611170056/S2255553616301033/v1_201611170056/pt/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S0021755716301036" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.03.009" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "428" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2016;92:631-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1394 "formatos" => array:3 [ "EPUB" => 100 "HTML" => 916 "PDF" => 378 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "631" "paginaFinal" => "637" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Lesão renal aguda em crianças com HIV: estudo comparativo entre pacientes com e sem terapia antirretroviral altamente ativa" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Douglas de Sousa Soares, Malena Gadelha Cavalcante, Samille Maria Vasconcelos Ribeiro, Rayana Café Leitão, Ana Patrícia Freitas Vieira, Roberto da Justa Pires Neto, Geraldo Bezerra da Silva Junior, Elizabeth de Francesco Daher" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Douglas de Sousa" "apellidos" => "Soares" ] 1 => array:2 [ "nombre" => "Malena Gadelha" "apellidos" => "Cavalcante" ] 2 => array:2 [ "nombre" => "Samille Maria Vasconcelos" "apellidos" => "Ribeiro" ] 3 => array:2 [ "nombre" => "Rayana Café" "apellidos" => "Leitão" ] 4 => array:2 [ "nombre" => "Ana Patrícia Freitas" "apellidos" => "Vieira" ] 5 => array:2 [ "nombre" => "Roberto da Justa" "apellidos" => "Pires Neto" ] 6 => array:2 [ "nombre" => "Geraldo Bezerra da" "apellidos" => "Silva Junior" ] 7 => array:2 [ "nombre" => "Elizabeth de Francesco" "apellidos" => "Daher" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2255553616301057" "doi" => "10.1016/j.jpedp.2016.08.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301057?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716301036?idApp=UINPBA000049" "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716301036/v1_201611170050/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0021755716300973" "issn" => "00217557" "doi" => "10.1016/j.jped.2016.02.014" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "423" "copyright" => "Sociedade Brasileira de Pediatria" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "J Pediatr (Rio J). 2016;92:616-23" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1519 "formatos" => array:3 [ "EPUB" => 99 "HTML" => 994 "PDF" => 426 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "616" "paginaFinal" => "623" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Avaliação do método Western Blotting para diagnóstico de toxoplasmose congênita" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1157 "Ancho" => 1527 "Tamanyo" => 82936 ] ] "descripcion" => array:1 [ "en" => "Distribution of the most frequent Toxoplasma gondii proteins recognized by IgG antibodies in the serum of children with congenital toxoplasmosis and children without the disease, according to their molecular weight (kDa) (p>0.05 for all the recognized proteins)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jaqueline Dario Capobiango, Thaís Cabral Monica, Fernanda Pinto Ferreira, Regina Mitsuka-Breganó, Italmar Teodorico Navarro, João Luis Garcia, Edna Maria Vissoci Reiche" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Jaqueline Dario" "apellidos" => "Capobiango" ] 1 => array:2 [ "nombre" => "Thaís Cabral" "apellidos" => "Monica" ] 2 => array:2 [ "nombre" => "Fernanda Pinto" "apellidos" => "Ferreira" ] 3 => array:2 [ "nombre" => "Regina" "apellidos" => "Mitsuka-Breganó" ] 4 => array:2 [ "nombre" => "Italmar Teodorico" "apellidos" => "Navarro" ] 5 => array:2 [ "nombre" => "João Luis" "apellidos" => "Garcia" ] 6 => array:2 [ "nombre" => "Edna Maria Vissoci" "apellidos" => "Reiche" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S225555361630101X" "doi" => "10.1016/j.jpedp.2016.08.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225555361630101X?idApp=UINPBA000049" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300973?idApp=UINPBA000049" "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716300973/v1_201611170050/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Early changes in adipokines from overweight to obesity in children and adolescents" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "624" "paginaFinal" => "630" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rafael Machado Mantovani, Natália Pessoa Rocha, Daniel Massote Magalhães, Izabela Guimarães Barbosa, Antônio Lúcio Teixeira, Ana Cristina Simões e Silva" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Rafael Machado" "apellidos" => "Mantovani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Natália Pessoa" "apellidos" => "Rocha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Daniel Massote" "apellidos" => "Magalhães" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Izabela Guimarães" "apellidos" => "Barbosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Antônio Lúcio" "apellidos" => "Teixeira" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 5 => array:4 [ "nombre" => "Ana Cristina" "apellidos" => "Simões e Silva" "email" => array:1 [ 0 => "acssilva@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte, MG, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Alterações precoces nos níveis de adipocinas de sobrepeso para obesidade em crianças e adolescentes" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 756 "Ancho" => 1595 "Tamanyo" => 79182 ] ] "descripcion" => array:1 [ "en" => "Plasma levels of adiponectin, resistin, and leptin (pg/mL) in lean (n=24), overweight (n=30), and obese subjects (n=50). * p<0.01 (Kruskal–Walis, Dunn's post hoc test). ** p<0.001 (Kruskal–Walis, Dunn's post hoc test)." ] ] ] "textoCompleto" => "IntroductionChildhood obesity is increasing in prevalence and is strongly associated with obesity in adulthood.<a class="elsevierStyleCrossRefs" href="#bib0155">1,2</a> Obese children are at risk of metabolic syndrome, cardiovascular diseases, and increased adult morbidity and mortality.<a class="elsevierStyleCrossRefs" href="#bib0165">3,4</a>Adipokines are hormones secreted by adipose tissue that play a role in metabolic homeostasis.<a class="elsevierStyleCrossRef" href="#bib0175">5</a> Obesity also induces production of inflammatory cytokines and infiltration of immune cells into adipose tissue, determining a state of chronic low-grade inflammation. Metabolic inflammation has been recognized as a unifying mechanism linking obesity to a broad spectrum of conditions, such as atherosclerosis, type 2 diabetes, and systemic vascular complications.<a class="elsevierStyleCrossRefs" href="#bib0175">5–7</a>The current study analyzed plasma levels of adipokines (adiponectin, resistin, and leptin), and soluble tumor necrosis factor receptor type 1 (sTNFR1), insulin sensitivity, and lipid metabolism in overweight and obese children and adolescents in comparison with lean individuals. The authors also assessed the relationships of these molecules with classical metabolic risk factors. Circulating levels of sTNFR1 are regarded as inflammatory markers, reflecting TNF-α activity better than the measurement of TNF-α itself.<a class="elsevierStyleCrossRefs" href="#bib0175">5–9</a> It was hypothesized that adipokines, low-grade inflammation, insulin sensitivity, and lipid metabolism gradually change from lean to overweight and from overweight to obesity.MethodsSubjectsThis cross sectional study had a convenience sample of 104 children and adolescents, aged 6–18 years old. All individuals who fulfilled the inclusion criteria and accepted taking part in the study were recruited from the Pediatric Endocrinology Service and the Pediatric Primary Care Center of the institution for two years. Therefore, 50 obese, 30 overweight, and 24 lean individuals were evaluated.Inclusion criteriaThe criterion for obesity was body mass index (BMI) greater than the 95th percentile for age and sex according to the National Center for Health Statistics (NCHS) standards.<a class="elsevierStyleCrossRef" href="#bib0200">10</a> Overweight was defined as BMI percentiles for age and sex of >85th and <95th. The lean group included subjects with BMI percentiles >10th and <85th for age and sex.Exclusion criteriaSubjects with genetic disorders, secondary obesity, and comorbidities such as diabetes, cardiac, pulmonary and neurological diseases, or acute infections were excluded. Subjects receiving medical therapy were also ineligible. Health status was determined through medical history and either parental report or self-report to rule out chronic or acute diseases.Study protocolAt admission, all subjects underwent clinical examination including weight, height, BMI, blood pressure, abdominal circumference (AC), and pubertal stage evaluation. Weight was obtained to the nearest 0.1kg using calibrated digital scales. Standing height was considered as the average of three measures, in the nearest millimeter, using a fixed stadiometer. AC was obtained with tape measure at just above the uppermost lateral border of the right ileum, at the end of a normal expiration, and was recorded to the nearest millimeter, as recommended by the NCHS.<a class="elsevierStyleCrossRef" href="#bib0205">11</a> Pubertal stage was determined according to Tanner criteria,<a class="elsevierStyleCrossRef" href="#bib0210">12</a> and the patients were classified: (i) pre-pubertal: boys at genital stage I, girls at breast stage I; (ii) early-puberty boys at genital stage II–III, girls at breast stage II–III; (iii) late/post pubertal: boys at genital stage ≥IV, girls at breast stage ≥IV. Systolic and diastolic blood pressures were measured on three different occasions, in the right arm, after a 10-min rest in the supine position using a calibrated sphygmomanometer, and the two values were averaged. Blood pressure measurements were also evaluated following the recommendations of the Fourth Task Force Report.<a class="elsevierStyleCrossRef" href="#bib0215">13</a>Blood samplingAfter informed consent, all subjects were submitted to blood collection for the measurement of fasting glucose, insulin, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, triglycerides, adiponectin, leptin, resistin, and sTNFR1. Blood sampling occurred at one occasion after an overnight fast of 12h through peripheral venous puncture. One sample was taken for fasting glucose, insulin, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides measurements, according to standard recommendations. The second sample was for adiponectin, leptin, resistin, and sTNFR1 measurements. For these measurements, samples were immediately immersed in ice, and processed within 30min after collection. Cells were centrifuged at 700×g for 10min at 4°C; then supernatant plasma was collected and re-spun for another 20min at 1300×g to sediment the platelets. Cell-free plasma was aliquoted into 0.5mL samples and stored at −80°C until measurements.MeasurementsFasting glucose, cholesterol, and triglycerides levels were determined by enzymatic colorimetric assay (Advia Chemistry®; Siemens®; LA, USA), while insulin was measured by chemiluminescence (reference value: <29μIU/mL; (Immulite® 2000, LA, USA). The insulin resistance was estimated by the homeostasis model assessment for insulin resistance (HOMA-IR).<a class="elsevierStyleCrossRef" href="#bib0220">14</a> Plasma levels of adiponectin, leptin, resistin, and sTNFR1 were measured by specific ELISA kits (R&D Systems®, Minneapolis, USA), following the manufacturer's instructions. All samples were assayed in duplicate during a single assay to avoid inter-assay variation. The intra-assay variation was below 3%. The detection limits were 5pg/mL for adiponectin, resistin, and leptin; 10pg/mL for sTNFR1.Statistical analysisStatistical analyses were performed using SPSS software version 19.0 (SPSS Inc, Chicago, USA). Sample size was estimated as at least a total of 96 individuals, considering a power of 0.80 (1−β), a difference of 20% between groups, a significance (α) level of 0.05, and a standard deviation no greater than 25%. All variables were tested for normality of distribution by the Shapiro–Wilk test. Association between dichotomous variables was assessed by chi-squared or Fisher's exact test. Differences among groups were compared using the Kruskal–Wallis test with Dunn's multiple comparison post-test. Spearmann's correlation analyses were performed to examine the relationship between adipokines, sTNFR1 levels, and age, BMI, glucose, insulin, HOMA-IR, HDL-cholesterol, LDL-cholesterol, and triglycerides. The significance level was set at p<0.05.Ethical issuesThe Ethics Committee of the institution approved the study according to the protocol ETIC 0415/06. Informed consent was obtained from subjects and their parents. The research protocol did not interfere with any medical prescriptions and follow-up was guaranteed even in cases of refusal to participate in the study.ResultsAnthropometrical, clinical, and laboratorial characteristics in obese, overweight, and lean groupsSubjects were allocated into three groups: lean (n=24, 54.2% female), overweight (n=30, 80% female), and obese subjects (n=50, 44% female). Anthropometrical, clinical, and laboratorial characteristics are displayed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Lean and obese subjects were comparable regarding age and gender distribution. There was an increased frequency of females in the overweight group in comparison with obese subjects (p=0.02). In the univariate analysis, the groups differed according to Tanner stage, BMI, AC/height, blood pressure classification, and HDL cholesterol levels (p<0.05, <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The obese group had significantly higher BMI, AC/height ratio, and prevalence of hypertension than lean and overweight subjects. HDL cholesterol levels were significantly lower in both the obese and overweight groups than in lean individuals. However, fasting glucose, insulin, HOMA-IR, LDL cholesterol, and triglycerides were comparable in lean, overweight, and obese subjects (p>0.05, <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>As also shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, plasma levels of sTNFR1 were similar in lean and overweight subjects (p>0.05), but were significantly increased in obese subjects (p<0.01 overweight vs. obese and p<0.001 lean vs. obese).<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows plasma levels of adiponectin, resistin, and leptin in obese, overweight, and lean subjects. Adipokines did not differ when overweight were compared to obese subjects (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Adiponectin levels (pg/mL) were decreased in overweight and obese subjects in comparison with lean subjects (5199.18 in lean subjects; 4537.57 in the overweight group; 3467.57 in the obese group [p<0.001 overweight vs. lean and p<0.001 obese vs. lean, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>]). Plasma levels of resistin (pg/mL) were increased in the overweight and obese groups in comparison with lean subjects (1140.38 in the lean group; 1788.51 in the overweight group; 2256.39 in the obese group [p<0.001 overweight vs. lean and p<0.001 obese vs. lean, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>]). The same profile was detected for leptin levels (702.54pg/mL in the lean group; 1933.04pg/mL in the overweight group; 1965.91pg/mL in the obese group [p<0.001 overweight vs. lean and p<0.001 obese vs. lean, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>]).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>In order to evaluate gender influence, this study also compared plasma levels of adipokines in males vs. females for each group (lean, overweight, and obese subjects), as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>. In the lean group, males presented higher levels of adiponectin (5642.81 vs. 4983.64pg/mL in females, p=0.005) and lower concentrations of leptin than females (371.79pg/mL in males vs. 1391.26pg/mL in females, p<0.001). No other marker differed when comparing males and females. No differences were detected in leptin, resistin, and adiponectin levels for the comparisons between male and females in overweight and obese groups (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>To investigate a potential interference of Tanner's stage, the levels of adipokines in pre-pubertal vs. early puberty vs. late puberty were compared for each group (lean, overweight, and obese individuals). No differences were detected in resistin and adiponectin levels for the comparisons between Tanner's stages classification in all groups. Leptin levels exhibited a mild increase according to the progression of Tanner's stage only in the obese group (data not shown).Correlation analysisConsidering all subjects (n=104), plasma levels of adiponectin were negatively correlated with BMI (p<0.001; ρ=−0.402), insulin (p=0.02; ρ=−0.247), HOMA-IR (p=0.02; ρ=−0.263), and triglycerides (p=0.02; ρ=−0.261). Leptin levels were positively correlated with age (p<0.001; ρ=0.425), BMI (p<0.001; ρ=0.577), insulin (p<0.001; ρ=0.500), HOMA-IR (p<0.001; ρ=0.497), triglycerides (p=0.003; ρ=0.325), and negatively correlated with HDL-cholesterol (p=0.03; ρ=−0.240). Resistin concentrations were positively correlated with BMI (p<0.001; ρ=0.469), and negatively correlated with HDL-cholesterol (p=0.02; ρ=−0.247). Plasma levels of sTNFR1 were positively correlated with BMI (p<0.001; ρ=0.338) and negatively correlated with adiponectin levels (p=0.03; p=−0.212).DiscussionThis study showed that circulating levels of adipokines discriminated lean from overweight/obese subjects. Overweight and obese individuals presented similar levels of all the evaluated adipokines. Remarkably, adiponectin levels were decreased while leptin and resistin levels were increased in overweight and obese groups in comparison with lean controls. Traditional metabolic parameters were similar in all groups, while sTNFR1 levels were increased in the obese in comparison with the overweight and lean groups.Fasting plasma glucose, insulin, HOMA-IR, LDL cholesterol, and triglycerides are traditionally used to assess metabolic and cardiovascular risks in obesity,<a class="elsevierStyleCrossRef" href="#bib0225">15</a> and their mean values were comparable among lean, overweight, and obese groups in the present study. On the other hand, sTNFR1 levels were higher in obese individuals than in the lean or overweight groups. Increased levels of sTNFR1 support the general idea of a low-grade inflammatory state in obesity.<a class="elsevierStyleCrossRefs" href="#bib0175">5,8,9</a> Furthermore, adipokines were significantly altered in subjects with overweight and obesity in comparison with lean individuals, suggesting that adipokines might be early markers of changing from lean to overweight/obesity status, even before the occurrence of metabolic alterations. Similarly, other studies have shown that serum levels of leptin and resistin were significantly higher in obese children than in lean children.<a class="elsevierStyleCrossRefs" href="#bib0230">16–18</a> In addition, BMI positively correlated with leptin and resistin, and negatively with adiponectin levels, as previously described.<a class="elsevierStyleCrossRefs" href="#bib0235">17–20</a> In contrast, another study reported similar levels of resistin in obese and lean subjects.<a class="elsevierStyleCrossRef" href="#bib0255">21</a> Nevertheless, when obese children were stratified by insulin resistance values, obese children with insulin resistance had higher resistin levels than children with normal weight or obese children without insulin resistance.<a class="elsevierStyleCrossRef" href="#bib0255">21</a> Corroborating the present data, Adamska et al. reported increased levels of sTNFR1 and reduced levels of adiponectin in overweight and obese adults compared with lean subjects.<a class="elsevierStyleCrossRef" href="#bib0195">9</a> On the other hand, the relation between sTNFR and BMI is controversial. Whereas there was also positive correlation between BMI and sTNFR1 in the present sample, Huang et al. did not detect any association.<a class="elsevierStyleCrossRef" href="#bib0240">18</a> No significant correlation was previously observed among sTNFRs and lipid profile,<a class="elsevierStyleCrossRefs" href="#bib0240">18,22</a> while, in the present study, sTNFR1 was negatively correlated with HDL-cholesterol.There is a paucity of data on the role of adipokines in the transition from lean to overweight and from overweight to obesity, especially in pediatric patients without metabolic syndrome or comorbidities. In comparison with the control group, it was found that circulating levels of adipokines are already changed in overweight subjects, who present a similar profile to the obese group. Similarly, Ko et al. have shown that leptin levels were associated with increased risk of children being overweight.<a class="elsevierStyleCrossRef" href="#bib0235">17</a> Leptin is critical for metabolic regulation by signaling nutritional status to the hypothalamus, which, in turn, produces neuropeptides and neurotransmitters to modulate food intake and energy expenditure.<a class="elsevierStyleCrossRefs" href="#bib0175">5,23</a> Leptin levels positively correlated with insulin, HOMA-IR, and triglycerides; they negatively correlated with HDL cholesterol.<a class="elsevierStyleCrossRef" href="#bib0235">17</a> Johnson et al. found a significant association between leptin levels and increasing fat mass in children.<a class="elsevierStyleCrossRef" href="#bib0270">24</a> Two possible explanations are that resistance to leptin actions at the receptor level might contribute to overweight and that homeostatic alterations precede the occurrence of obesity.<a class="elsevierStyleCrossRefs" href="#bib0275">25,26</a>In the present study, plasma levels of adiponectin negatively correlated with insulin, HOMA-IR, and triglycerides, while leptin concentrations were positively correlated with the same metabolic parameters. Adamska and co-workers showed that insulin sensitivity positively correlated to adiponectin and negatively correlated to sTNFR1 and sTNFR2 levels in obese adults. Soluble TNF receptors and adiponectin also negatively correlated with insulin sensitivity, and these markers have multiple effects on glucose and lipid metabolism in obesity.<a class="elsevierStyleCrossRef" href="#bib0195">9</a> Plasma levels of adiponectin negatively correlated with insulin, HOMA-IR, and triglycerides<a class="elsevierStyleCrossRefs" href="#bib0255">21,27</a> and positively correlated with insulin sensitivity.<a class="elsevierStyleCrossRef" href="#bib0195">9</a> The present results also showed a negative correlation between sTNFR1 and adiponectin levels, supporting the general idea that increased concentrations of adiponectin may compensate low-grade inflammation. Indeed, adiponectin has anti-inflammatory effects that contribute to its protective role against metabolic stress in obesity.<a class="elsevierStyleCrossRefs" href="#bib0175">5,28</a> In this context, increased concentrations of adiponectin may be related to better metabolic profile despite the greater fat mass. However, the majority of studies included obese adults already exhibiting significant changes in metabolic parameters, while the present sample only had pediatric individuals without co-morbidities or metabolic syndrome. Therefore, reduction of adiponectin levels seems to occur later than changes in leptin concentrations, but may come before metabolic alterations in pediatric obesity.Circulating levels of resistin have also been positively associated with body fat mass.<a class="elsevierStyleCrossRefs" href="#bib0295">29,30</a> Accordingly, a study with Mexican children and adolescents found negative correlation between resistin and HDL-cholesterol levels.<a class="elsevierStyleCrossRef" href="#bib0240">18</a> Studies have also associated high resistin levels with increased risk for metabolic and cardiovascular diseases.<a class="elsevierStyleCrossRef" href="#bib0175">5</a> Similarly to adiponectin, the elevation of resistin levels probably precedes co-morbidities related to obesity in pediatric patients.The authors are aware of the limitations of this study. First, the cross sectional design precludes the evaluation of interactions among variables. Second, the sample was relatively small, mostly considering overweight and lean subjects. Third, the use of a convenience sample makes homogeneity among the selected groups very difficult to obtain, since differences in gender and Tanner's stage may change adipokine levels. However, no differences were detected in resistin and adiponectin levels for the comparisons between male and females and between Tanner's stage in the overweight and obese groups. Leptin levels only exhibited a mild elevation according to Tanner's stage in obese group. Nevertheless, other aspects increase the strength of the findings, such as strict inclusion and exclusion criteria, well-established protocol for measurements, and a representative number of obese individuals.In conclusion, the findings suggest that changes in plasma levels of adipokines (leptin, resistin, and adiponectin) may come before alterations in traditional metabolic markers of obesity in pediatric patients. Longitudinal studies with larger samples are necessary to elucidate how adipokines interact with clinical, metabolic, and inflammatory markers in pediatric obesity.FundingThis work was supported by grants from the Research Foundation of the State of Minas Gerais (FAPEMIG) and from the National Council of Scientific and Technological Development (CNPq).Conflicts of interestThe authors declare no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres758952" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec760920" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres758951" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusão" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec760921" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:6 [ 0 => array:3 [ "identificador" => "sec0015" "titulo" => "Subjects" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Inclusion criteria" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Exclusion criteria" ] ] ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Study protocol" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Blood sampling" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Measurements" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "Statistical analysis" ] 5 => array:2 [ "identificador" => "sec0050" "titulo" => "Ethical issues" ] ] ] 6 => array:3 [ "identificador" => "sec0055" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0060" "titulo" => "Anthropometrical, clinical, and laboratorial characteristics in obese, overweight, and lean groups" ] 1 => array:2 [ "identificador" => "sec0065" "titulo" => "Correlation analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-09-11" "fechaAceptado" => "2016-02-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec760920" "palabras" => array:5 [ 0 => "Leptin" 1 => "Adiponectin" 2 => "Resistin" 3 => "Metabolic markers" 4 => "Soluble tumor necrosis factor receptor" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec760921" "palabras" => array:5 [ 0 => "Leptina" 1 => "Adiponectina" 2 => "Resistina" 3 => "Marcadores metabólicos" 4 => "Receptor solúvel de fator de necrose tumoral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveChildhood obesity has been associated with metabolic syndrome and cardiovascular diseases. This study aimed to compare plasma levels of traditional metabolic markers, adipokines and soluble tumor necrosis factor receptor type 1 (sTNFR1) in overweight, obese and lean children. We also assessed the relationships of these molecules with classical metabolic risk factors. MethodsThis study included 104 children and adolescents, which were grouped as: lean (n=24), overweight (n=30), and obese subjects (n=50). They were subjected to anthropometrical, clinical and laboratorial measurements. All measurements were compared between groups. Correlation analyses were also performed to evaluate the association between clinical data, traditional metabolic markers, adipokines and sTNFR1. ResultsFasting glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), LDL-cholesterol and triglycerides were comparable in lean, overweight and obese subjects. Plasma levels of sTNFR1 were similar in lean and overweight subjects, but significantly increased in obese group. Leptin, adiponectin and resistin levels did not differ when overweight were compared to obese subjects. However, all adipokines differed significantly when lean subjects were compared to overweight and obese individuals. Plasma levels of adiponectin were negatively correlated with body mass index (BMI), whereas leptin, resistin and sTNFR1 concentrations positively correlated with BMI. ConclusionOur results showed significant differences in circulating levels of the evaluated markers when lean, overweight and obese individuals were compared, suggesting that these biomarkers may change from lean to overweight and from overweight to obesity." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "ObjetivoA obesidade na infância tem sido associada à síndrome metabólica e a doenças cardiovasculares. O objetivo deste estudo foi comparar níveis plasmáticos de marcadores metabólicos tradicionais, adipocinas e do receptor solúvel de fator de necrose tumoral tipo 1 (sTNFR1) em crianças com sobrepeso, obesas e magras. Também avaliamos as relações dessas moléculas com fatores de risco metabólico clássicos. MétodosEste estudo incluiu 104 crianças e adolescentes, agrupados da seguinte forma: indivíduos magros (n=24), com sobrepeso (n=30) e obesos (n=50). Eles foram submetidos a medições antropométricas, clínicas e laboratoriais. Todas as medições foram comparadas entre os grupos. Também foram realizadas análises de correlação para avaliar a associação entre dados clínicos, marcadores metabólicos tradicionais, adipocinas e sTNFR1. ResultadosGlicemia de jejum, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), colesterol LDL e triglicerídeos foram comparáveis em indivíduos magros, com sobrepeso e obesos. Os níveis plasmáticos de sTNFR1 foram similares em indivíduos magros e com sobrepeso, porém significativamente maiores no grupo obeso. Os níveis de leptina, adiponectina e resistina não diferiram quando indivíduos com sobrepeso foram comparados aos obesos. Contudo, todas as adipocinas diferiram significativamente quando indivíduos magros foram comparados a indivíduos com sobrepeso e obesos. Os níveis plasmáticos de adiponectina estavam negativamente correlacionados ao índice de massa corporal (IMC), ao passo que as concentrações de leptina, resistina e sTNFR1 estavam positivamente correlacionadas ao IMC. ConclusãoNossos resultados mostraram diferenças significativas nos níveis circulantes dos marcadores avaliados ao comparar indivíduos magros, com sobrepeso e obesos, sugerindo que esses biomarcadores poderão mudar de indivíduos magros para indivíduos com sobrepeso e de indivíduos com sobrepeso para obesos." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusão" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Mantovani RM, Rocha NP, Magalhães DM, Barbosa IG, Teixeira AL, Simões e Silva AC. Early changes in adipokines from overweight to obesity in children and adolescents. J Pediatr (Rio J). 2016;92:624–30." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 756 "Ancho" => 1595 "Tamanyo" => 79182 ] ] "descripcion" => array:1 [ "en" => "Plasma levels of adiponectin, resistin, and leptin (pg/mL) in lean (n=24), overweight (n=30), and obese subjects (n=50). * p<0.01 (Kruskal–Walis, Dunn's post hoc test). ** p<0.001 (Kruskal–Walis, Dunn's post hoc test)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2480 "Ancho" => 1490 "Tamanyo" => 208235 ] ] "descripcion" => array:1 [ "en" => "Gender influence on plasma levels of adipokines (pg/mL) in lean (n=24), overweight (n=30), and obese subjects (n=50). A, adiponectin; B, leptin; C, resistin. * p<0.01. ** p<0.001 Mann–Whitney test." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "BMI, body mass index; HDL, high-density lipoprotein; HOMA-IR, homeostasis model assessment for insulin resistance; LDL, low-density lipoprotein; SD, standard deviation; sTNFR, soluble tumor necrosis factor." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristic \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lean (n=24) A \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overweight (n=30) B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Obese (n=50) C \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age in years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.93 (±2.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.28 (±2.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.65 (±2.59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.23<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female gender (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.007<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tanner's stage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-pubertal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Early-puberty \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Late/postpubertal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.39 (±3.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.76 (±2.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.60 (±7.68) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> A<B<C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">AC/height ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.46 (±0.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.56 (±0.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63 (±0.08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> A<B<C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood pressure classification (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.003<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normotensive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pre-hypertensive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertensive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucose (mmol/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85.15 (±8.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.82 (±6.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.08 (±7.73) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.22<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Insulin (μU/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.31 (±30.78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.85 (±12.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.77 (±27.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.14<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HOMA-IR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.18 (±7.69) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.49 (±2.71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.50 (±6.45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.16<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HDL-cholesterol (mg/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.15 (±12.88) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47.38 (±9.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.83 (±10.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.03<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> A=B<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a>; B=C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a>; A>C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LDL-cholesterol (mg/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87.25 (±13.78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">99.32 (±23.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94.22 (±30.41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.39<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglycerides (mg/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.83 (±34.83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71.92 (±31.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.50 (±41.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.16<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">sTNFR1 plasma levels (pg/mL) (±SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">623.75 (±347.14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">624.73 (±191.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">855.14 (±269.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> A=B<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a>; A<C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a>; B<C<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1254060.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Kruskal–Wallis test." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Pearson's chi-squared test." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Dunn post-test." ] ] ] "descripcion" => array:1 [ "en" => "Clinical and laboratory characteristics (mean±SD) for lean, overweight, and obese subjects." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0155" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of severe childhood obesity in England: 2006–2013" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.J. Ells" 1 => "C. Hancock" 2 => "V. Copley" 3 => "E. Mead" 4 => "H. Dinsdale" 5 => "S. Kinra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/archdischild-2014-307036" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2015" "volumen" => "100" "paginaInicial" => "631" "paginaFinal" => "636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25628459" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0160" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obesity: preventing and managing the global epidemic: report of a WHO consultation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "WHO" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "World Health Organ Tech Rep Ser" "fecha" => "2000" "volumen" => "894" "paginaInicial" => "1" "paginaFinal" => "253" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0165" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relation of childhood BMI to adult adiposity: the Bogalusa heart study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.S. Freedman" 1 => "L.K. Khan" 2 => "M.K. Serdula" 3 => "W.H. Dietz" 4 => "S.R. Srinivasan" 5 => "G.S. Berenson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2004-0220" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2005" "volumen" => "115" "paginaInicial" => "22" "paginaFinal" => "27" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15629977" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0170" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High cardiovascular risk in severely obese young children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.M. Van Emmerik" 1 => "C.M. Redners" 2 => "M. van de Veer" 3 => "S. van Buuren" 4 => "O.H. van der Baan-Slootweg" 5 => "J.E. Kist-van Holthe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/archdischild-2012-301877" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2012" "volumen" => "97" "paginaInicial" => "818" "paginaFinal" => "821" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22826539" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0175" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adipocytokines in obesity and metabolic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Cao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/JOE-13-0339" "Revista" => array:6 [ "tituloSerie" => "J Endocrinol" "fecha" => "2014" "volumen" => "220" "paginaInicial" => "T47" "paginaFinal" => "T59" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24403378" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0180" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood obesity: evidence of an association between plasminogen activator inhibitor-1 levels and visceral adiposity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.M. Mantovani" 1 => "D.R. Rios" 2 => "L.C. Moura" 3 => "J.M. Oliveira" 4 => "F.F. Carvalho" 5 => "S.B. Cunha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Endocrinol Metab" "fecha" => "2011" "volumen" => "24" "paginaInicial" => "361" "paginaFinal" => "367" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21823537" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0185" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence and cluster of cardiometabolic biomarkers in overweight and obese school children: results from a large survey in southwest Germany" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Nagel" 1 => "K. Rapp" 2 => "M. Wabitsch" 3 => "G. Büchele" 4 => "A. Kroke" 5 => "I. Zöllner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1373/clinchem.2007.094821" "Revista" => array:6 [ "tituloSerie" => "Clin Chem" "fecha" => "2008" "volumen" => "54" "paginaInicial" => "317" "paginaFinal" => "325" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18089656" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0190" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The potential biological and clinical significance of the soluble tumor necrosis factor receptors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Aderka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cytokine Growth Factor Rev" "fecha" => "1996" "volumen" => "7" "paginaInicial" => "231" "paginaFinal" => "240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8971478" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0195" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationships between serum adiponectin and soluble TNF-α receptors and glucose and lipid oxidation in lean and obese subjects" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Adamska" 1 => "A. Nikołajuk" 2 => "M. Karczewska-Kupczewska" 3 => "I. Kowalska" 4 => "E. Otziomek" 5 => "M. Górska" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00592-010-0252-y" "Revista" => array:6 [ "tituloSerie" => "Acta Diabetol" "fecha" => "2012" "volumen" => "49" "paginaInicial" => "17" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21234613" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0200" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishing a standard definition for child overweight and obesity worldwide: international survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.J. Cole" 1 => "M.C. Bellizzi" 2 => "K.M. Flegal" 3 => "W.H. Dietz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Br Med J" "fecha" => "2000" "volumen" => "320" "paginaInicial" => "1240" "paginaFinal" => "1243" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0205" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available at: <a class="elsevierStyleInterRef" id="intr0010" href="http://www.cdc.gov/nchs/data/nhanes/bm.pdf">http://www.cdc.gov/nchs/data/nhanes/bm.pdf</a> [cited 16.05.15]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anthropometry procedures manual" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National Health and Nutrition Examination Survey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2000" "editorial" => "Centers for Disease Control and Prevention" "editorialLocalizacion" => "Atlanta, GA" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0210" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth and maturation during adolescence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Tanner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nutr Rev" "fecha" => "1981" "volumen" => "39" "paginaInicial" => "43" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7010232" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0215" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents 2004" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2004" "volumen" => "114" "paginaInicial" => "555" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15286277" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0220" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.R. Matthews" 1 => "J.P. Hosker" 2 => "A.S. Rudenski" 3 => "B.A. Naylor" 4 => "D.F. Treacher" 5 => "R.C. Turner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diabetologia" "fecha" => "1985" "volumen" => "28" "paginaInicial" => "412" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3899825" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0225" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.W. Speiser" 1 => "M.C. Rudolf" 2 => "H. Anhalt" 3 => "C. Camacho-Hubner" 4 => "F. Chiarelli" 5 => "A. Eliakim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2004-1389" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2005" "volumen" => "90" "paginaInicial" => "1871" "paginaFinal" => "1887" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15598688" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0230" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lack of association between, insulin resistance, cardiovascular risk factors, and obesity in children: a longitudinal analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Reinehr" 1 => "J. Woelfle" 2 => "C.L. Roth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.metabol.2011.02.005" "Revista" => array:6 [ "tituloSerie" => "Metabolism" "fecha" => "2011" "volumen" => "60" "paginaInicial" => "1349" "paginaFinal" => "1354" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21489579" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0235" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elevated vaspin and leptin levels are associated with obesity in prepubertal Korean children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.J. Ko" 1 => "M. Lee" 2 => "H.S. Park" 3 => "K. Han" 4 => "G.J. Cho" 5 => "T.G. Hwang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Endocr J" "fecha" => "2013" "volumen" => "60" "paginaInicial" => "609" "paginaFinal" => "616" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23318644" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0240" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of six-month lifestyle intervention on adiponectin, resistin and soluble tumor necrosis factor-α receptors in obese adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Huang" 1 => "B.E. Del-Río-Navarro" 2 => "J.A. Pérez-Ontiveros" 3 => "E. Ruiz-Bedolla" 4 => "O.J. Saucedo-Ramírez" 5 => "S. Villafaña" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Endocr J" "fecha" => "2014" "volumen" => "61" "paginaInicial" => "921" "paginaFinal" => "931" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25029953" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0245" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adiponectin and leptin trajectories in Mexican-American children from birth to 9 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Volberg" 1 => "B. Heggeseth" 2 => "K. Harley" 3 => "E. Ruiz-Bedolla" 4 => "O.J. Saucedo-Ramírez" 5 => "S. Villafaña" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0077964" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2013" "volumen" => "8" "paginaInicial" => "e77964" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24205046" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0250" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adiponectin in eutrophic and obese children as a biomarker to predict metabolic syndrome and each of its components" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Klünder-Klünder" 1 => "S. Flores-Huerta" 2 => "R. García-Macedo" 3 => "J. Peralta-Romero" 4 => "M. Cruz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2458-13-88" "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2013" "volumen" => "13" "paginaInicial" => "88" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23363707" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0255" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plasma resistin levels are associated with homocysteine, endothelial activation, and nitrosative stress in obese youths" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Codoñer-Franch" 1 => "S. Tavárez-Alonso" 2 => "M. Porcar-Almela" 3 => "M. Navarro-Solera" 4 => "Á. Arilla-Codoñer" 5 => "E. Alonso-Iglesias" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinbiochem.2014.07.004" "Revista" => array:6 [ "tituloSerie" => "Clin Biochem" "fecha" => "2014" "volumen" => "47" "paginaInicial" => "44" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25020262" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0260" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adipocytokines, body composition, and fitness in children" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Nemet" 1 => "P. Wang" 2 => "T. Funahashi" 3 => "Y. Matsuzawa" 4 => "S. Tanaka" 5 => "L. Engelman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1203/00006450-200301000-00025" "Revista" => array:6 [ "tituloSerie" => "Pediatr Res" "fecha" => "2003" "volumen" => "53" "paginaInicial" => "148" "paginaFinal" => "152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12508095" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0265" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiovascular dysfunction in obesity and new diagnostic imaging techniques: the role of noninvasive image methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.A. Barbosa" 1 => "A.B. Rodrigues" 2 => "C.C. Mota" 3 => "M.M. Barbosa" 4 => "A.C. Simões e Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/VHRM.S17801" "Revista" => array:6 [ "tituloSerie" => "Vasc Health Risk Manag" "fecha" => "2011" "volumen" => "7" "paginaInicial" => "287" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21633726" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0270" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of leptin on changes in body fat during growth in African American and white children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.S. Johnson" 1 => "T.T. Huang" 2 => "R. Figueroa-Colon" 3 => "J.H. Dwyer" 4 => "M.I. Goran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/oby.2001.78" "Revista" => array:6 [ "tituloSerie" => "Obes Res" "fecha" => "2001" "volumen" => "9" "paginaInicial" => "593" "paginaFinal" => "598" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11595775" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0275" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of markers of inflammation, insulin resistance and endothelial dysfunction in children at risk for overweight" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Akinci" 1 => "B. Akinci" 2 => "S. Coskun" 3 => "P. Bayindir" 4 => "Z. Hekimsoy" 5 => "B. Ozmen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hormones (Athens)" "fecha" => "2008" "volumen" => "7" "paginaInicial" => "156" "paginaFinal" => "162" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0280" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metabolic syndrome risk factors in overweight, obese, and extremely obese Brazilian adolescents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.C. Rizzo" 1 => "T.B. Goldberg" 2 => "C.C. Silva" 3 => "C.S. Kurokawa" 4 => "H.R. Nunes" 5 => "J.E. Corrente" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1475-2891-12-19" "Revista" => array:5 [ "tituloSerie" => "Nutr J" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23363783" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0285" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low adiponectin state is associated with metabolic abnormalities in obese children, particularly depending on apolipoprotein E phenotype" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Wardaningsih" 1 => "T. Miida" 2 => "U. Seino" 3 => "Y. Fueki" 4 => "M. Ito" 5 => "K. Nagasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1258/acb.2008.007237" "Revista" => array:6 [ "tituloSerie" => "Ann Clin Biochem" "fecha" => "2008" "volumen" => "45" "paginaInicial" => "496" "paginaFinal" => "503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18753423" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0290" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Circulating pro-inflammatory cytokines and adiponectin in young men with type 2 diabetes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.C. Su" 1 => "D. Pei" 2 => "C.H. Hsieh" 3 => "F.C. Hsiao" 4 => "C.Z. Wu" 5 => "Y.J. Hung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00592-009-0171-y" "Revista" => array:6 [ "tituloSerie" => "Acta Diabetol" "fecha" => "2011" "volumen" => "48" "paginaInicial" => "113" "paginaFinal" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20058158" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0295" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resistin levels are related to fat mass, but not to body mass index in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Ortega" 1 => "P. Riestra" 2 => "P. Navarro" 3 => "T. Gavela-Pérez" 4 => "L. Soriano-Guillén" 5 => "C. Garcés" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.peptides.2013.08.019" "Revista" => array:6 [ "tituloSerie" => "Peptides" "fecha" => "2013" "volumen" => "49" "paginaInicial" => "49" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24012666" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0300" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High serum resistin is associated with an increase in adiposity but not a worsening of insulin resistance in Pima Indians" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Vozarova de Courten" 1 => "M. Degawa-Yamauchi" 2 => "R.V. Considine" 3 => "P.A. Tataranni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Diabetes" "fecha" => "2004" "volumen" => "53" "paginaInicial" => "1279" "paginaFinal" => "1284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15111497" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716300997/v1_201611170050/en/main.assets" "Apartado" => array:4 [ "identificador" => "10179" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009200000006/v1_201611170050/S0021755716300997/v1_201611170050/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300997?idApp=UINPBA000049"]

Statistics

Original article

Alterações precoces nos níveis de adipocinas de sobrepeso para obesidade em crianças e adolescentes

Rafael Machado Mantovania, Natália Pessoa Rochab, Daniel Massote Magalhãesb, Izabela Guimarães Barbosab, Antônio Lúcio Teixeirab,c, Ana Cristina Simões e Silvaa,b,

Corresponding author

acssilva@hotmail.com

Corresponding author.

a Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil

b Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte, MG, Brazil

c Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brazil

Read

3316

Times
was read the article

1429

Total PDF

1887

Total HTML

Share statistics

 array:25 [
  "pii" => "S0021755716300997"
  "issn" => "00217557"
  "doi" => "10.1016/j.jped.2016.02.015"
  "estado" => "S300"
  "fechaPublicacion" => "2016-11-01"
  "aid" => "424"
  "copyright" => "Sociedade Brasileira de Pediatria"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "J Pediatr &#40;Rio J&#41;. 2016;92:624-30"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1099
    "formatos" => array:3 [
      "EPUB" => 102
      "HTML" => 637
      "PDF" => 360
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:19 [
      "pii" => "S2255553616301033"
      "issn" => "22555536"
      "doi" => "10.1016/j.jpedp.2016.08.007"
      "estado" => "S300"
      "fechaPublicacion" => "2016-11-01"
      "aid" => "424"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "J Pediatr &#40;Rio J&#41;. 2016;92:624-30"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1101
        "formatos" => array:3 [
          "EPUB" => 108
          "HTML" => 665
          "PDF" => 328
        ]
      ]
      "pt" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original</span>"
        "titulo" => "Early changes in adipokines from overweight to obesity in children and adolescents"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "624"
            "paginaFinal" => "630"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Altera&#231;&#245;es precoces nos n&#237;veis de adipocinas de sobrepeso para obesidade em crian&#231;as e adolescentes"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 753
                "Ancho" => 1595
                "Tamanyo" => 93190
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">N&#237;veis plasm&#225;ticos de adiponectina&#44; resistina e leptina &#40;pg&#47;ml&#41; em indiv&#237;duos magros &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; sobrepeso &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41; e obesos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; &#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01 &#40;teste de Kruskal&#8208;Wallis&#44; p&#243;s&#8208;teste de Dunn&#41;&#46; &#42;&#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 &#40;teste de Kruskal&#8208;Wallis&#44; p&#243;s&#8208;teste de Dunn&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rafael Machado Mantovani, Nat&#225;lia Pessoa Rocha, Daniel Massote Magalh&#227;es, Izabela Guimar&#227;es Barbosa, Ant&#244;nio L&#250;cio Teixeira, Ana Cristina Sim&#245;es e Silva"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Rafael Machado"
                "apellidos" => "Mantovani"
              ]
              1 => array:2 [
                "nombre" => "Nat&#225;lia Pessoa"
                "apellidos" => "Rocha"
              ]
              2 => array:2 [
                "nombre" => "Daniel Massote"
                "apellidos" => "Magalh&#227;es"
              ]
              3 => array:2 [
                "nombre" => "Izabela Guimar&#227;es"
                "apellidos" => "Barbosa"
              ]
              4 => array:2 [
                "nombre" => "Ant&#244;nio L&#250;cio"
                "apellidos" => "Teixeira"
              ]
              5 => array:2 [
                "nombre" => "Ana Cristina"
                "apellidos" => "Sim&#245;es e Silva"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0021755716300997"
          "doi" => "10.1016/j.jped.2016.02.015"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300997?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301033?idApp=UINPBA000049"
      "url" => "/22555536/0000009200000006/v1_201611170056/S2255553616301033/v1_201611170056/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0021755716301036"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2016.03.009"
    "estado" => "S300"
    "fechaPublicacion" => "2016-11-01"
    "aid" => "428"
    "copyright" => "Sociedade Brasileira de Pediatria"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2016;92:631-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1394
      "formatos" => array:3 [
        "EPUB" => 100
        "HTML" => 916
        "PDF" => 378
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Acute kidney injury in HIV-infected children&#58; comparison of patients according to the use of highly active antiretroviral therapy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "631"
          "paginaFinal" => "637"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Les&#227;o renal aguda em crian&#231;as com HIV&#58; estudo comparativo entre pacientes com e sem terapia antirretroviral altamente ativa"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Douglas de Sousa Soares, Malena Gadelha Cavalcante, Samille Maria Vasconcelos Ribeiro, Rayana Caf&#233; Leit&#227;o, Ana Patr&#237;cia Freitas Vieira, Roberto da Justa Pires Neto, Geraldo Bezerra da Silva Junior, Elizabeth de Francesco Daher"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Douglas de Sousa"
              "apellidos" => "Soares"
            ]
            1 => array:2 [
              "nombre" => "Malena Gadelha"
              "apellidos" => "Cavalcante"
            ]
            2 => array:2 [
              "nombre" => "Samille Maria Vasconcelos"
              "apellidos" => "Ribeiro"
            ]
            3 => array:2 [
              "nombre" => "Rayana Caf&#233;"
              "apellidos" => "Leit&#227;o"
            ]
            4 => array:2 [
              "nombre" => "Ana Patr&#237;cia Freitas"
              "apellidos" => "Vieira"
            ]
            5 => array:2 [
              "nombre" => "Roberto da Justa"
              "apellidos" => "Pires Neto"
            ]
            6 => array:2 [
              "nombre" => "Geraldo Bezerra da"
              "apellidos" => "Silva Junior"
            ]
            7 => array:2 [
              "nombre" => "Elizabeth de Francesco"
              "apellidos" => "Daher"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2255553616301057"
        "doi" => "10.1016/j.jpedp.2016.08.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553616301057?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716301036?idApp=UINPBA000049"
    "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716301036/v1_201611170050/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S0021755716300973"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2016.02.014"
    "estado" => "S300"
    "fechaPublicacion" => "2016-11-01"
    "aid" => "423"
    "copyright" => "Sociedade Brasileira de Pediatria"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2016;92:616-23"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1519
      "formatos" => array:3 [
        "EPUB" => 99
        "HTML" => 994
        "PDF" => 426
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "616"
          "paginaFinal" => "623"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Avalia&#231;&#227;o do m&#233;todo <span class="elsevierStyleItalic">Western Blotting</span> para diagn&#243;stico de toxoplasmose cong&#234;nita"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1157
              "Ancho" => 1527
              "Tamanyo" => 82936
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Distribution of the most frequent <span class="elsevierStyleItalic">Toxoplasma gondii</span> proteins recognized by IgG antibodies in the serum of children with congenital toxoplasmosis and children without the disease&#44; according to their molecular weight &#40;kDa&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05 for all the recognized proteins&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jaqueline Dario Capobiango, Tha&#237;s Cabral Monica, Fernanda Pinto Ferreira, Regina Mitsuka-Bregan&#243;, Italmar Teodorico Navarro, Jo&#227;o Luis Garcia, Edna Maria Vissoci Reiche"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Jaqueline Dario"
              "apellidos" => "Capobiango"
            ]
            1 => array:2 [
              "nombre" => "Tha&#237;s Cabral"
              "apellidos" => "Monica"
            ]
            2 => array:2 [
              "nombre" => "Fernanda Pinto"
              "apellidos" => "Ferreira"
            ]
            3 => array:2 [
              "nombre" => "Regina"
              "apellidos" => "Mitsuka-Bregan&#243;"
            ]
            4 => array:2 [
              "nombre" => "Italmar Teodorico"
              "apellidos" => "Navarro"
            ]
            5 => array:2 [
              "nombre" => "Jo&#227;o Luis"
              "apellidos" => "Garcia"
            ]
            6 => array:2 [
              "nombre" => "Edna Maria Vissoci"
              "apellidos" => "Reiche"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S225555361630101X"
        "doi" => "10.1016/j.jpedp.2016.08.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225555361630101X?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300973?idApp=UINPBA000049"
    "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716300973/v1_201611170050/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Early changes in adipokines from overweight to obesity in children and adolescents"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "624"
        "paginaFinal" => "630"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rafael Machado Mantovani, Nat&#225;lia Pessoa Rocha, Daniel Massote Magalh&#227;es, Izabela Guimar&#227;es Barbosa, Ant&#244;nio L&#250;cio Teixeira, Ana Cristina Sim&#245;es e Silva"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "Rafael Machado"
            "apellidos" => "Mantovani"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Nat&#225;lia Pessoa"
            "apellidos" => "Rocha"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Daniel Massote"
            "apellidos" => "Magalh&#227;es"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Izabela Guimar&#227;es"
            "apellidos" => "Barbosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ant&#244;nio L&#250;cio"
            "apellidos" => "Teixeira"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:4 [
            "nombre" => "Ana Cristina"
            "apellidos" => "Sim&#245;es e Silva"
            "email" => array:1 [
              0 => "acssilva&#64;hotmail&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Universidade Federal de Minas Gerais &#40;UFMG&#41;&#44; Faculdade de Medicina&#44; Departamento de Pediatria&#44; Belo Horizonte&#44; MG&#44; Brazil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universidade Federal de Minas Gerais &#40;UFMG&#41;&#44; Faculdade de Medicina&#44; Laborat&#243;rio Interdisciplinar de Investiga&#231;&#227;o M&#233;dica&#44; Belo Horizonte&#44; MG&#44; Brazil"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Universidade Federal de Minas Gerais &#40;UFMG&#41;&#44; Faculdade de Medicina&#44; Departamento de Cl&#237;nica M&#233;dica&#44; Belo Horizonte&#44; MG&#44; Brazil"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Altera&#231;&#245;es precoces nos n&#237;veis de adipocinas de sobrepeso para obesidade em crian&#231;as e adolescentes"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 756
            "Ancho" => 1595
            "Tamanyo" => 79182
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Plasma levels of adiponectin&#44; resistin&#44; and leptin &#40;pg&#47;mL&#41; in lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; and obese subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; &#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01 &#40;Kruskal&#8211;Walis&#44; Dunn&#39;s <span class="elsevierStyleItalic">post hoc</span> test&#41;&#46; &#42;&#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 &#40;Kruskal&#8211;Walis&#44; Dunn&#39;s <span class="elsevierStyleItalic">post hoc</span> test&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Childhood obesity is increasing in prevalence and is strongly associated with obesity in adulthood&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Obese children are at risk of metabolic syndrome&#44; cardiovascular diseases&#44; and increased adult morbidity and mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Adipokines are hormones secreted by adipose tissue that play a role in metabolic homeostasis&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> Obesity also induces production of inflammatory cytokines and infiltration of immune cells into adipose tissue&#44; determining a state of chronic low-grade inflammation&#46; Metabolic inflammation has been recognized as a unifying mechanism linking obesity to a broad spectrum of conditions&#44; such as atherosclerosis&#44; type 2 diabetes&#44; and systemic vascular complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#8211;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The current study analyzed plasma levels of adipokines &#40;adiponectin&#44; resistin&#44; and leptin&#41;&#44; and soluble tumor necrosis factor receptor type 1 &#40;sTNFR1&#41;&#44; insulin sensitivity&#44; and lipid metabolism in overweight and obese children and adolescents in comparison with lean individuals&#46; The authors also assessed the relationships of these molecules with classical metabolic risk factors&#46; Circulating levels of sTNFR1 are regarded as inflammatory markers&#44; reflecting TNF-&#945; activity better than the measurement of TNF-&#945; itself&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#8211;9</span></a> It was hypothesized that adipokines&#44; low-grade inflammation&#44; insulin sensitivity&#44; and lipid metabolism gradually change from lean to overweight and from overweight to obesity&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">This cross sectional study had a convenience sample of 104 children and adolescents&#44; aged 6&#8211;18 years old&#46; All individuals who fulfilled the inclusion criteria and accepted taking part in the study were recruited from the Pediatric Endocrinology Service and the Pediatric Primary Care Center of the institution for two years&#46; Therefore&#44; 50 obese&#44; 30 overweight&#44; and 24 lean individuals were evaluated&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Inclusion criteria</span><p id="par0025" class="elsevierStylePara elsevierViewall">The criterion for obesity was body mass index &#40;BMI&#41; greater than the 95th percentile for age and sex according to the National Center for Health Statistics &#40;NCHS&#41; standards&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Overweight was defined as BMI percentiles for age and sex of &#62;85th and &#60;95th&#46; The lean group included subjects with BMI percentiles &#62;10th and &#60;85th for age and sex&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Exclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">Subjects with genetic disorders&#44; secondary obesity&#44; and comorbidities such as diabetes&#44; cardiac&#44; pulmonary and neurological diseases&#44; or acute infections were excluded&#46; Subjects receiving medical therapy were also ineligible&#46; Health status was determined through medical history and either parental report or self-report to rule out chronic or acute diseases&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Study protocol</span><p id="par0035" class="elsevierStylePara elsevierViewall">At admission&#44; all subjects underwent clinical examination including weight&#44; height&#44; BMI&#44; blood pressure&#44; abdominal circumference &#40;AC&#41;&#44; and pubertal stage evaluation&#46; Weight was obtained to the nearest 0&#46;1<span class="elsevierStyleHsp" style=""></span>kg using calibrated digital scales&#46; Standing height was considered as the average of three measures&#44; in the nearest millimeter&#44; using a fixed stadiometer&#46; AC was obtained with tape measure at just above the uppermost lateral border of the right ileum&#44; at the end of a normal expiration&#44; and was recorded to the nearest millimeter&#44; as recommended by the NCHS&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Pubertal stage was determined according to Tanner criteria&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> and the patients were classified&#58; &#40;i&#41; pre-pubertal&#58; boys at genital stage I&#44; girls at breast stage I&#59; &#40;ii&#41; early-puberty boys at genital stage II&#8211;III&#44; girls at breast stage II&#8211;III&#59; &#40;iii&#41; late&#47;post pubertal&#58; boys at genital stage &#8805;IV&#44; girls at breast stage &#8805;IV&#46; Systolic and diastolic blood pressures were measured on three different occasions&#44; in the right arm&#44; after a 10-min rest in the supine position using a calibrated sphygmomanometer&#44; and the two values were averaged&#46; Blood pressure measurements were also evaluated following the recommendations of the Fourth Task Force Report&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Blood sampling</span><p id="par0040" class="elsevierStylePara elsevierViewall">After informed consent&#44; all subjects were submitted to blood collection for the measurement of fasting glucose&#44; insulin&#44; total cholesterol&#44; high-density lipoprotein &#40;HDL&#41; cholesterol&#44; low-density lipoprotein &#40;LDL&#41; cholesterol&#44; very low-density lipoprotein &#40;VLDL&#41; cholesterol&#44; triglycerides&#44; adiponectin&#44; leptin&#44; resistin&#44; and sTNFR1&#46; Blood sampling occurred at one occasion after an overnight fast of 12<span class="elsevierStyleHsp" style=""></span>h through peripheral venous puncture&#46; One sample was taken for fasting glucose&#44; insulin&#44; total cholesterol&#44; HDL-cholesterol&#44; LDL-cholesterol&#44; and triglycerides measurements&#44; according to standard recommendations&#46; The second sample was for adiponectin&#44; leptin&#44; resistin&#44; and sTNFR1 measurements&#46; For these measurements&#44; samples were immediately immersed in ice&#44; and processed within 30<span class="elsevierStyleHsp" style=""></span>min after collection&#46; Cells were centrifuged at 700<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 10<span class="elsevierStyleHsp" style=""></span>min at 4<span class="elsevierStyleHsp" style=""></span>&#176;C&#59; then supernatant plasma was collected and re-spun for another 20<span class="elsevierStyleHsp" style=""></span>min at 1300<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> to sediment the platelets&#46; Cell-free plasma was aliquoted into 0&#46;5<span class="elsevierStyleHsp" style=""></span>mL samples and stored at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C until measurements&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Measurements</span><p id="par0045" class="elsevierStylePara elsevierViewall">Fasting glucose&#44; cholesterol&#44; and triglycerides levels were determined by enzymatic colorimetric assay &#40;Advia Chemistry<span class="elsevierStyleSup">&#174;</span>&#59; Siemens<span class="elsevierStyleSup">&#174;</span>&#59; LA&#44; USA&#41;&#44; while insulin was measured by chemiluminescence &#40;reference value&#58; &#60;29<span class="elsevierStyleHsp" style=""></span>&#956;IU&#47;mL&#59; &#40;Immulite<span class="elsevierStyleSup">&#174;</span> 2000&#44; LA&#44; USA&#41;&#46; The insulin resistance was estimated by the homeostasis model assessment for insulin resistance &#40;HOMA-IR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> Plasma levels of adiponectin&#44; leptin&#44; resistin&#44; and sTNFR1 were measured by specific ELISA kits &#40;R&#38;D Systems<span class="elsevierStyleSup">&#174;</span>&#44; Minneapolis&#44; USA&#41;&#44; following the manufacturer&#39;s instructions&#46; All samples were assayed in duplicate during a single assay to avoid inter-assay variation&#46; The intra-assay variation was below 3&#37;&#46; The detection limits were 5<span class="elsevierStyleHsp" style=""></span>pg&#47;mL for adiponectin&#44; resistin&#44; and leptin&#59; 10<span class="elsevierStyleHsp" style=""></span>pg&#47;mL for sTNFR1&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Statistical analyses were performed using SPSS software version 19&#46;0 &#40;SPSS Inc&#44; Chicago&#44; USA&#41;&#46; Sample size was estimated as at least a total of 96 individuals&#44; considering a power of 0&#46;80 &#40;1<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#946;</span>&#41;&#44; a difference of 20&#37; between groups&#44; a significance &#40;<span class="elsevierStyleItalic">&#945;</span>&#41; level of 0&#46;05&#44; and a standard deviation no greater than 25&#37;&#46; All variables were tested for normality of distribution by the Shapiro&#8211;Wilk test&#46; Association between dichotomous variables was assessed by chi-squared or Fisher&#39;s exact test&#46; Differences among groups were compared using the Kruskal&#8211;Wallis test with Dunn&#39;s multiple comparison post-test&#46; Spearmann&#39;s correlation analyses were performed to examine the relationship between adipokines&#44; sTNFR1 levels&#44; and age&#44; BMI&#44; glucose&#44; insulin&#44; HOMA-IR&#44; HDL-cholesterol&#44; LDL-cholesterol&#44; and triglycerides&#46; The significance level was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Ethical issues</span><p id="par0055" class="elsevierStylePara elsevierViewall">The Ethics Committee of the institution approved the study according to the protocol ETIC 0415&#47;06&#46; Informed consent was obtained from subjects and their parents&#46; The research protocol did not interfere with any medical prescriptions and follow-up was guaranteed even in cases of refusal to participate in the study&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Anthropometrical&#44; clinical&#44; and laboratorial characteristics in obese&#44; overweight&#44; and lean groups</span><p id="par0060" class="elsevierStylePara elsevierViewall">Subjects were allocated into three groups&#58; lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#44; 54&#46;2&#37; female&#41;&#44; overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#44; 80&#37; female&#41;&#44; and obese subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#44; 44&#37; female&#41;&#46; Anthropometrical&#44; clinical&#44; and laboratorial characteristics are displayed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Lean and obese subjects were comparable regarding age and gender distribution&#46; There was an increased frequency of females in the overweight group in comparison with obese subjects &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46; In the univariate analysis&#44; the groups differed according to Tanner stage&#44; BMI&#44; AC&#47;height&#44; blood pressure classification&#44; and HDL cholesterol levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The obese group had significantly higher BMI&#44; AC&#47;height ratio&#44; and prevalence of hypertension than lean and overweight subjects&#46; HDL cholesterol levels were significantly lower in both the obese and overweight groups than in lean individuals&#46; However&#44; fasting glucose&#44; insulin&#44; HOMA-IR&#44; LDL cholesterol&#44; and triglycerides were comparable in lean&#44; overweight&#44; and obese subjects &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">As also shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; plasma levels of sTNFR1 were similar in lean and overweight subjects &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; but were significantly increased in obese subjects &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01 overweight <span class="elsevierStyleItalic">vs&#46;</span> obese and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 lean <span class="elsevierStyleItalic">vs&#46;</span> obese&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows plasma levels of adiponectin&#44; resistin&#44; and leptin in obese&#44; overweight&#44; and lean subjects&#46; Adipokines did not differ when overweight were compared to obese subjects &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Adiponectin levels &#40;pg&#47;mL&#41; were decreased in overweight and obese subjects in comparison with lean subjects &#40;5199&#46;18 in lean subjects&#59; 4537&#46;57 in the overweight group&#59; 3467&#46;57 in the obese group &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 overweight <span class="elsevierStyleItalic">vs&#46;</span> lean and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 obese <span class="elsevierStyleItalic">vs&#46;</span> lean&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#41;&#46; Plasma levels of resistin &#40;pg&#47;mL&#41; were increased in the overweight and obese groups in comparison with lean subjects &#40;1140&#46;38 in the lean group&#59; 1788&#46;51 in the overweight group&#59; 2256&#46;39 in the obese group &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 overweight <span class="elsevierStyleItalic">vs&#46;</span> lean and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 obese <span class="elsevierStyleItalic">vs&#46;</span> lean&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#41;&#46; The same profile was detected for leptin levels &#40;702&#46;54<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in the lean group&#59; 1933&#46;04<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in the overweight group&#59; 1965&#46;91<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in the obese group &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 overweight <span class="elsevierStyleItalic">vs&#46;</span> lean and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 obese <span class="elsevierStyleItalic">vs&#46;</span> lean&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">In order to evaluate gender influence&#44; this study also compared plasma levels of adipokines in males <span class="elsevierStyleItalic">vs&#46;</span> females for each group &#40;lean&#44; overweight&#44; and obese subjects&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; In the lean group&#44; males presented higher levels of adiponectin &#40;5642&#46;81 <span class="elsevierStyleItalic">vs&#46;</span> 4983&#46;64<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in females&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; and lower concentrations of leptin than females &#40;371&#46;79<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in males <span class="elsevierStyleItalic">vs&#46;</span> 1391&#46;26<span class="elsevierStyleHsp" style=""></span>pg&#47;mL in females&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; No other marker differed when comparing males and females&#46; No differences were detected in leptin&#44; resistin&#44; and adiponectin levels for the comparisons between male and females in overweight and obese groups &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">To investigate a potential interference of Tanner&#39;s stage&#44; the levels of adipokines in pre-pubertal <span class="elsevierStyleItalic">vs&#46;</span> early puberty <span class="elsevierStyleItalic">vs&#46;</span> late puberty were compared for each group &#40;lean&#44; overweight&#44; and obese individuals&#41;&#46; No differences were detected in resistin and adiponectin levels for the comparisons between Tanner&#39;s stages classification in all groups&#46; Leptin levels exhibited a mild increase according to the progression of Tanner&#39;s stage only in the obese group &#40;data not shown&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Correlation analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Considering all subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>104&#41;&#44; plasma levels of adiponectin were negatively correlated with BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;402&#41;&#44; insulin &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;247&#41;&#44; HOMA-IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;263&#41;&#44; and triglycerides &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;261&#41;&#46; Leptin levels were positively correlated with age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;425&#41;&#44; BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;577&#41;&#44; insulin &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;500&#41;&#44; HOMA-IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;497&#41;&#44; triglycerides &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;325&#41;&#44; and negatively correlated with HDL-cholesterol &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;240&#41;&#46; Resistin concentrations were positively correlated with BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;469&#41;&#44; and negatively correlated with HDL-cholesterol &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;247&#41;&#46; Plasma levels of sTNFR1 were positively correlated with BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;338&#41; and negatively correlated with adiponectin levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;212&#41;&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study showed that circulating levels of adipokines discriminated lean from overweight&#47;obese subjects&#46; Overweight and obese individuals presented similar levels of all the evaluated adipokines&#46; Remarkably&#44; adiponectin levels were decreased while leptin and resistin levels were increased in overweight and obese groups in comparison with lean controls&#46; Traditional metabolic parameters were similar in all groups&#44; while sTNFR1 levels were increased in the obese in comparison with the overweight and lean groups&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Fasting plasma glucose&#44; insulin&#44; HOMA-IR&#44; LDL cholesterol&#44; and triglycerides are traditionally used to assess metabolic and cardiovascular risks in obesity&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> and their mean values were comparable among lean&#44; overweight&#44; and obese groups in the present study&#46; On the other hand&#44; sTNFR1 levels were higher in obese individuals than in the lean or overweight groups&#46; Increased levels of sTNFR1 support the general idea of a low-grade inflammatory state in obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;8&#44;9</span></a> Furthermore&#44; adipokines were significantly altered in subjects with overweight and obesity in comparison with lean individuals&#44; suggesting that adipokines might be early markers of changing from lean to overweight&#47;obesity status&#44; even before the occurrence of metabolic alterations&#46; Similarly&#44; other studies have shown that serum levels of leptin and resistin were significantly higher in obese children than in lean children&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#8211;18</span></a> In addition&#44; BMI positively correlated with leptin and resistin&#44; and negatively with adiponectin levels&#44; as previously described&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#8211;20</span></a> In contrast&#44; another study reported similar levels of resistin in obese and lean subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> Nevertheless&#44; when obese children were stratified by insulin resistance values&#44; obese children with insulin resistance had higher resistin levels than children with normal weight or obese children without insulin resistance&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> Corroborating the present data&#44; Adamska et al&#46; reported increased levels of sTNFR1 and reduced levels of adiponectin in overweight and obese adults compared with lean subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> On the other hand&#44; the relation between sTNFR and BMI is controversial&#46; Whereas there was also positive correlation between BMI and sTNFR1 in the present sample&#44; Huang et al&#46; did not detect any association&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> No significant correlation was previously observed among sTNFRs and lipid profile&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">18&#44;22</span></a> while&#44; in the present study&#44; sTNFR1 was negatively correlated with HDL-cholesterol&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">There is a paucity of data on the role of adipokines in the transition from lean to overweight and from overweight to obesity&#44; especially in pediatric patients without metabolic syndrome or comorbidities&#46; In comparison with the control group&#44; it was found that circulating levels of adipokines are already changed in overweight subjects&#44; who present a similar profile to the obese group&#46; Similarly&#44; Ko et al&#46; have shown that leptin levels were associated with increased risk of children being overweight&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Leptin is critical for metabolic regulation by signaling nutritional status to the hypothalamus&#44; which&#44; in turn&#44; produces neuropeptides and neurotransmitters to modulate food intake and energy expenditure&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;23</span></a> Leptin levels positively correlated with insulin&#44; HOMA-IR&#44; and triglycerides&#59; they negatively correlated with HDL cholesterol&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Johnson et al&#46; found a significant association between leptin levels and increasing fat mass in children&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> Two possible explanations are that resistance to leptin actions at the receptor level might contribute to overweight and that homeostatic alterations precede the occurrence of obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In the present study&#44; plasma levels of adiponectin negatively correlated with insulin&#44; HOMA-IR&#44; and triglycerides&#44; while leptin concentrations were positively correlated with the same metabolic parameters&#46; Adamska and co-workers showed that insulin sensitivity positively correlated to adiponectin and negatively correlated to sTNFR1 and sTNFR2 levels in obese adults&#46; Soluble TNF receptors and adiponectin also negatively correlated with insulin sensitivity&#44; and these markers have multiple effects on glucose and lipid metabolism in obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Plasma levels of adiponectin negatively correlated with insulin&#44; HOMA-IR&#44; and triglycerides<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;27</span></a> and positively correlated with insulin sensitivity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> The present results also showed a negative correlation between sTNFR1 and adiponectin levels&#44; supporting the general idea that increased concentrations of adiponectin may compensate low-grade inflammation&#46; Indeed&#44; adiponectin has anti-inflammatory effects that contribute to its protective role against metabolic stress in obesity&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;28</span></a> In this context&#44; increased concentrations of adiponectin may be related to better metabolic profile despite the greater fat mass&#46; However&#44; the majority of studies included obese adults already exhibiting significant changes in metabolic parameters&#44; while the present sample only had pediatric individuals without co-morbidities or metabolic syndrome&#46; Therefore&#44; reduction of adiponectin levels seems to occur later than changes in leptin concentrations&#44; but may come before metabolic alterations in pediatric obesity&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Circulating levels of resistin have also been positively associated with body fat mass&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">29&#44;30</span></a> Accordingly&#44; a study with Mexican children and adolescents found negative correlation between resistin and HDL-cholesterol levels&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Studies have also associated high resistin levels with increased risk for metabolic and cardiovascular diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> Similarly to adiponectin&#44; the elevation of resistin levels probably precedes co-morbidities related to obesity in pediatric patients&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The authors are aware of the limitations of this study&#46; First&#44; the cross sectional design precludes the evaluation of interactions among variables&#46; Second&#44; the sample was relatively small&#44; mostly considering overweight and lean subjects&#46; Third&#44; the use of a convenience sample makes homogeneity among the selected groups very difficult to obtain&#44; since differences in gender and Tanner&#39;s stage may change adipokine levels&#46; However&#44; no differences were detected in resistin and adiponectin levels for the comparisons between male and females and between Tanner&#39;s stage in the overweight and obese groups&#46; Leptin levels only exhibited a mild elevation according to Tanner&#39;s stage in obese group&#46; Nevertheless&#44; other aspects increase the strength of the findings&#44; such as strict inclusion and exclusion criteria&#44; well-established protocol for measurements&#44; and a representative number of obese individuals&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In conclusion&#44; the findings suggest that changes in plasma levels of adipokines &#40;leptin&#44; resistin&#44; and adiponectin&#41; may come before alterations in traditional metabolic markers of obesity in pediatric patients&#46; Longitudinal studies with larger samples are necessary to elucidate how adipokines interact with clinical&#44; metabolic&#44; and inflammatory markers in pediatric obesity&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">This work was supported by grants from the <span class="elsevierStyleGrantSponsor" id="gs1">Research Foundation of the State of Minas Gerais &#40;FAPEMIG&#41;</span> and from the <span class="elsevierStyleGrantSponsor" id="gs2">National Council of Scientific and Technological Development &#40;CNPq&#41;</span>&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicts of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres758952"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec760920"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres758951"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec760921"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:6 [
            0 => array:3 [
              "identificador" => "sec0015"
              "titulo" => "Subjects"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0020"
                  "titulo" => "Inclusion criteria"
                ]
                1 => array:2 [
                  "identificador" => "sec0025"
                  "titulo" => "Exclusion criteria"
                ]
              ]
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Study protocol"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Blood sampling"
            ]
            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Measurements"
            ]
            4 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Statistical analysis"
            ]
            5 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Ethical issues"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0055"
          "titulo" => "Results"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Anthropometrical&#44; clinical&#44; and laboratorial characteristics in obese&#44; overweight&#44; and lean groups"
            ]
            1 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Correlation analysis"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Funding"
        ]
        9 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-09-11"
    "fechaAceptado" => "2016-02-22"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec760920"
          "palabras" => array:5 [
            0 => "Leptin"
            1 => "Adiponectin"
            2 => "Resistin"
            3 => "Metabolic markers"
            4 => "Soluble tumor necrosis factor receptor"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec760921"
          "palabras" => array:5 [
            0 => "Leptina"
            1 => "Adiponectina"
            2 => "Resistina"
            3 => "Marcadores metab&#243;licos"
            4 => "Receptor sol&#250;vel de fator de necrose tumoral"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Childhood obesity has been associated with metabolic syndrome and cardiovascular diseases&#46; This study aimed to compare plasma levels of traditional metabolic markers&#44; adipokines and soluble tumor necrosis factor receptor type 1 &#40;sTNFR1&#41; in overweight&#44; obese and lean children&#46; We also assessed the relationships of these molecules with classical metabolic risk factors&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study included 104 children and adolescents&#44; which were grouped as&#58; lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; and obese subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; They were subjected to anthropometrical&#44; clinical and laboratorial measurements&#46; All measurements were compared between groups&#46; Correlation analyses were also performed to evaluate the association between clinical data&#44; traditional metabolic markers&#44; adipokines and sTNFR1&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fasting glucose&#44; insulin&#44; homeostatic model assessment of insulin resistance &#40;HOMA-IR&#41;&#44; LDL-cholesterol and triglycerides were comparable in lean&#44; overweight and obese subjects&#46; Plasma levels of sTNFR1 were similar in lean and overweight subjects&#44; but significantly increased in obese group&#46; Leptin&#44; adiponectin and resistin levels did not differ when overweight were compared to obese subjects&#46; However&#44; all adipokines differed significantly when lean subjects were compared to overweight and obese individuals&#46; Plasma levels of adiponectin were negatively correlated with body mass index &#40;BMI&#41;&#44; whereas leptin&#44; resistin and sTNFR1 concentrations positively correlated with BMI&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our results showed significant differences in circulating levels of the evaluated markers when lean&#44; overweight and obese individuals were compared&#44; suggesting that these biomarkers may change from lean to overweight and from overweight to obesity&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A obesidade na inf&#226;ncia tem sido associada &#224; s&#237;ndrome metab&#243;lica e a doen&#231;as cardiovasculares&#46; O objetivo deste estudo foi comparar n&#237;veis plasm&#225;ticos de marcadores metab&#243;licos tradicionais&#44; adipocinas e do receptor sol&#250;vel de fator de necrose tumoral tipo 1 &#40;sTNFR1&#41; em crian&#231;as com sobrepeso&#44; obesas e magras&#46; Tamb&#233;m avaliamos as rela&#231;&#245;es dessas mol&#233;culas com fatores de risco metab&#243;lico cl&#225;ssicos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudo incluiu 104 crian&#231;as e adolescentes&#44; agrupados da seguinte forma&#58; indiv&#237;duos magros &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; com sobrepeso &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41; e obesos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; Eles foram submetidos a medi&#231;&#245;es antropom&#233;tricas&#44; cl&#237;nicas e laboratoriais&#46; Todas as medi&#231;&#245;es foram comparadas entre os grupos&#46; Tamb&#233;m foram realizadas an&#225;lises de correla&#231;&#227;o para avaliar a associa&#231;&#227;o entre dados cl&#237;nicos&#44; marcadores metab&#243;licos tradicionais&#44; adipocinas e sTNFR1&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Glicemia de jejum&#44; insulina&#44; modelo de avalia&#231;&#227;o da homeostase da resist&#234;ncia &#224; insulina &#40;HOMA-IR&#41;&#44; colesterol LDL e triglicer&#237;deos foram compar&#225;veis em indiv&#237;duos magros&#44; com sobrepeso e obesos&#46; Os n&#237;veis plasm&#225;ticos de sTNFR1 foram similares em indiv&#237;duos magros e com sobrepeso&#44; por&#233;m significativamente maiores no grupo obeso&#46; Os n&#237;veis de leptina&#44; adiponectina e resistina n&#227;o diferiram quando indiv&#237;duos com sobrepeso foram comparados aos obesos&#46; Contudo&#44; todas as adipocinas diferiram significativamente quando indiv&#237;duos magros foram comparados a indiv&#237;duos com sobrepeso e obesos&#46; Os n&#237;veis plasm&#225;ticos de adiponectina estavam negativamente correlacionados ao &#237;ndice de massa corporal &#40;IMC&#41;&#44; ao passo que as concentra&#231;&#245;es de leptina&#44; resistina e sTNFR1 estavam positivamente correlacionadas ao IMC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nossos resultados mostraram diferen&#231;as significativas nos n&#237;veis circulantes dos marcadores avaliados ao comparar indiv&#237;duos magros&#44; com sobrepeso e obesos&#44; sugerindo que esses biomarcadores poder&#227;o mudar de indiv&#237;duos magros para indiv&#237;duos com sobrepeso e de indiv&#237;duos com sobrepeso para obesos&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Mantovani RM&#44; Rocha NP&#44; Magalh&#227;es DM&#44; Barbosa IG&#44; Teixeira AL&#44; Sim&#245;es e Silva AC&#46; Early changes in adipokines from overweight to obesity in children and adolescents&#46; J Pediatr &#40;Rio J&#41;&#46; 2016&#59;92&#58;624&#8211;30&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 756
            "Ancho" => 1595
            "Tamanyo" => 79182
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Plasma levels of adiponectin&#44; resistin&#44; and leptin &#40;pg&#47;mL&#41; in lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; and obese subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; &#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01 &#40;Kruskal&#8211;Walis&#44; Dunn&#39;s <span class="elsevierStyleItalic">post hoc</span> test&#41;&#46; &#42;&#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 &#40;Kruskal&#8211;Walis&#44; Dunn&#39;s <span class="elsevierStyleItalic">post hoc</span> test&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2480
            "Ancho" => 1490
            "Tamanyo" => 208235
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Gender influence on plasma levels of adipokines &#40;pg&#47;mL&#41; in lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#44; and obese subjects &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41;&#46; A&#44; adiponectin&#59; B&#44; leptin&#59; C&#44; resistin&#46; &#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#46; &#42;&#42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 Mann&#8211;Whitney test&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BMI&#44; body mass index&#59; HDL&#44; high-density lipoprotein&#59; HOMA-IR&#44; homeostasis model assessment for insulin resistance&#59; LDL&#44; low-density lipoprotein&#59; SD&#44; standard deviation&#59; sTNFR&#44; soluble tumor necrosis factor&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lean &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41; A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Overweight &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41; B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Obese &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#41; C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age in years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;93 &#40;&#177;2&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;28 &#40;&#177;2&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;65 &#40;&#177;2&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;23<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Female gender &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;007<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tanner&#39;s stage &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pre-pubertal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Early-puberty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Late&#47;postpubertal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;39 &#40;&#177;3&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;76 &#40;&#177;2&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;60 &#40;&#177;7&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br>A<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>B<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AC&#47;height ratio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;46 &#40;&#177;0&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56 &#40;&#177;0&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63 &#40;&#177;0&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br>A<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>B<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Blood pressure classification &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;003<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Normotensive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pre-hypertensive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertensive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Glucose &#40;mmol&#47;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&#46;15 &#40;&#177;8&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#46;82 &#40;&#177;6&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#46;08 &#40;&#177;7&#46;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;22<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Insulin &#40;&#956;U&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;31 &#40;&#177;30&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;85 &#40;&#177;12&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;77 &#40;&#177;27&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;14<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HOMA-IR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;18 &#40;&#177;7&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;49 &#40;&#177;2&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;50 &#40;&#177;6&#46;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;16<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HDL-cholesterol &#40;mg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;15 &#40;&#177;12&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#46;38 &#40;&#177;9&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;83 &#40;&#177;10&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;03<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br>A<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>B<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&#59; B<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&#59; A<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LDL-cholesterol &#40;mg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#46;25 &#40;&#177;13&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&#46;32 &#40;&#177;23&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94&#46;22 &#40;&#177;30&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;39<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Triglycerides &#40;mg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;83 &#40;&#177;34&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;92 &#40;&#177;31&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#46;50 &#40;&#177;41&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;16<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">sTNFR1 plasma levels &#40;pg&#47;mL&#41; &#40;</span>&#177;<span class="elsevierStyleItalic">SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">623&#46;75 &#40;&#177;347&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">624&#46;73 &#40;&#177;191&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">855&#46;14 &#40;&#177;269&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br>A<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>B<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&#59; A<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&#59; B<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>C<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1254060.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Kruskal&#8211;Wallis test&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Pearson&#39;s chi-squared test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Dunn post-test&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Clinical and laboratory characteristics &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41; for lean&#44; overweight&#44; and obese subjects&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of severe childhood obesity in England&#58; 2006&#8211;2013"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;J&#46; Ells"
                            1 => "C&#46; Hancock"
                            2 => "V&#46; Copley"
                            3 => "E&#46; Mead"
                            4 => "H&#46; Dinsdale"
                            5 => "S&#46; Kinra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/archdischild-2014-307036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2015"
                        "volumen" => "100"
                        "paginaInicial" => "631"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25628459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity&#58; preventing and managing the global epidemic&#58; report of a WHO consultation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "WHO"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "World Health Organ Tech Rep Ser"
                        "fecha" => "2000"
                        "volumen" => "894"
                        "paginaInicial" => "1"
                        "paginaFinal" => "253"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relation of childhood BMI to adult adiposity&#58; the Bogalusa heart study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;S&#46; Freedman"
                            1 => "L&#46;K&#46; Khan"
                            2 => "M&#46;K&#46; Serdula"
                            3 => "W&#46;H&#46; Dietz"
                            4 => "S&#46;R&#46; Srinivasan"
                            5 => "G&#46;S&#46; Berenson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2004-0220"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2005"
                        "volumen" => "115"
                        "paginaInicial" => "22"
                        "paginaFinal" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15629977"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High cardiovascular risk in severely obese young children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Van Emmerik"
                            1 => "C&#46;M&#46; Redners"
                            2 => "M&#46; van de Veer"
                            3 => "S&#46; van Buuren"
                            4 => "O&#46;H&#46; van der Baan-Slootweg"
                            5 => "J&#46;E&#46; Kist-van Holthe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/archdischild-2012-301877"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2012"
                        "volumen" => "97"
                        "paginaInicial" => "818"
                        "paginaFinal" => "821"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22826539"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adipocytokines in obesity and metabolic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Cao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/JOE-13-0339"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Endocrinol"
                        "fecha" => "2014"
                        "volumen" => "220"
                        "paginaInicial" => "T47"
                        "paginaFinal" => "T59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24403378"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood obesity&#58; evidence of an association between plasminogen activator inhibitor-1 levels and visceral adiposity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Mantovani"
                            1 => "D&#46;R&#46; Rios"
                            2 => "L&#46;C&#46; Moura"
                            3 => "J&#46;M&#46; Oliveira"
                            4 => "F&#46;F&#46; Carvalho"
                            5 => "S&#46;B&#46; Cunha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Endocrinol Metab"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "paginaInicial" => "361"
                        "paginaFinal" => "367"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21823537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and cluster of cardiometabolic biomarkers in overweight and obese school children&#58; results from a large survey in southwest Germany"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Nagel"
                            1 => "K&#46; Rapp"
                            2 => "M&#46; Wabitsch"
                            3 => "G&#46; B&#252;chele"
                            4 => "A&#46; Kroke"
                            5 => "I&#46; Z&#246;llner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1373/clinchem.2007.094821"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chem"
                        "fecha" => "2008"
                        "volumen" => "54"
                        "paginaInicial" => "317"
                        "paginaFinal" => "325"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18089656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The potential biological and clinical significance of the soluble tumor necrosis factor receptors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Aderka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cytokine Growth Factor Rev"
                        "fecha" => "1996"
                        "volumen" => "7"
                        "paginaInicial" => "231"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8971478"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationships between serum adiponectin and soluble TNF-&#945; receptors and glucose and lipid oxidation in lean and obese subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Adamska"
                            1 => "A&#46; Niko&#322;ajuk"
                            2 => "M&#46; Karczewska-Kupczewska"
                            3 => "I&#46; Kowalska"
                            4 => "E&#46; Otziomek"
                            5 => "M&#46; G&#243;rska"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00592-010-0252-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Diabetol"
                        "fecha" => "2012"
                        "volumen" => "49"
                        "paginaInicial" => "17"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21234613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Establishing a standard definition for child overweight and obesity worldwide&#58; international survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;J&#46; Cole"
                            1 => "M&#46;C&#46; Bellizzi"
                            2 => "K&#46;M&#46; Flegal"
                            3 => "W&#46;H&#46; Dietz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "2000"
                        "volumen" => "320"
                        "paginaInicial" => "1240"
                        "paginaFinal" => "1243"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available at&#58; <a class="elsevierStyleInterRef" id="intr0010" href="http://www.cdc.gov/nchs/data/nhanes/bm.pdf">http&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;nchs&#47;data&#47;nhanes&#47;bm&#46;pdf</a> &#91;cited 16&#46;05&#46;15&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anthropometry procedures manual"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "National Health and Nutrition Examination Survey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2000"
                        "editorial" => "Centers for Disease Control and Prevention"
                        "editorialLocalizacion" => "Atlanta&#44; GA"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Growth and maturation during adolescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46; Tanner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr Rev"
                        "fecha" => "1981"
                        "volumen" => "39"
                        "paginaInicial" => "43"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7010232"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The fourth report on the diagnosis&#44; evaluation&#44; and treatment of high blood pressure in children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents 2004"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2004"
                        "volumen" => "114"
                        "paginaInicial" => "555"
                        "paginaFinal" => "576"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15286277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Homeostasis model assessment&#58; insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;R&#46; Matthews"
                            1 => "J&#46;P&#46; Hosker"
                            2 => "A&#46;S&#46; Rudenski"
                            3 => "B&#46;A&#46; Naylor"
                            4 => "D&#46;F&#46; Treacher"
                            5 => "R&#46;C&#46; Turner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetologia"
                        "fecha" => "1985"
                        "volumen" => "28"
                        "paginaInicial" => "412"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3899825"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood obesity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;W&#46; Speiser"
                            1 => "M&#46;C&#46; Rudolf"
                            2 => "H&#46; Anhalt"
                            3 => "C&#46; Camacho-Hubner"
                            4 => "F&#46; Chiarelli"
                            5 => "A&#46; Eliakim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2004-1389"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2005"
                        "volumen" => "90"
                        "paginaInicial" => "1871"
                        "paginaFinal" => "1887"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15598688"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lack of association between&#44; insulin resistance&#44; cardiovascular risk factors&#44; and obesity in children&#58; a longitudinal analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Reinehr"
                            1 => "J&#46; Woelfle"
                            2 => "C&#46;L&#46; Roth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.metabol.2011.02.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Metabolism"
                        "fecha" => "2011"
                        "volumen" => "60"
                        "paginaInicial" => "1349"
                        "paginaFinal" => "1354"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21489579"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elevated vaspin and leptin levels are associated with obesity in prepubertal Korean children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Ko"
                            1 => "M&#46; Lee"
                            2 => "H&#46;S&#46; Park"
                            3 => "K&#46; Han"
                            4 => "G&#46;J&#46; Cho"
                            5 => "T&#46;G&#46; Hwang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr J"
                        "fecha" => "2013"
                        "volumen" => "60"
                        "paginaInicial" => "609"
                        "paginaFinal" => "616"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23318644"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of six-month lifestyle intervention on adiponectin&#44; resistin and soluble tumor necrosis factor-&#945; receptors in obese adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Huang"
                            1 => "B&#46;E&#46; Del-R&#237;o-Navarro"
                            2 => "J&#46;A&#46; P&#233;rez-Ontiveros"
                            3 => "E&#46; Ruiz-Bedolla"
                            4 => "O&#46;J&#46; Saucedo-Ram&#237;rez"
                            5 => "S&#46; Villafa&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr J"
                        "fecha" => "2014"
                        "volumen" => "61"
                        "paginaInicial" => "921"
                        "paginaFinal" => "931"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25029953"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adiponectin and leptin trajectories in Mexican-American children from birth to 9 years of age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Volberg"
                            1 => "B&#46; Heggeseth"
                            2 => "K&#46; Harley"
                            3 => "E&#46; Ruiz-Bedolla"
                            4 => "O&#46;J&#46; Saucedo-Ram&#237;rez"
                            5 => "S&#46; Villafa&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0077964"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2013"
                        "volumen" => "8"
                        "paginaInicial" => "e77964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24205046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adiponectin in eutrophic and obese children as a biomarker to predict metabolic syndrome and each of its components"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Kl&#252;nder-Kl&#252;nder"
                            1 => "S&#46; Flores-Huerta"
                            2 => "R&#46; Garc&#237;a-Macedo"
                            3 => "J&#46; Peralta-Romero"
                            4 => "M&#46; Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-13-88"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2013"
                        "volumen" => "13"
                        "paginaInicial" => "88"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23363707"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma resistin levels are associated with homocysteine&#44; endothelial activation&#44; and nitrosative stress in obese youths"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Codo&#241;er-Franch"
                            1 => "S&#46; Tav&#225;rez-Alonso"
                            2 => "M&#46; Porcar-Almela"
                            3 => "M&#46; Navarro-Solera"
                            4 => "&#193;&#46; Arilla-Codo&#241;er"
                            5 => "E&#46; Alonso-Iglesias"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clinbiochem.2014.07.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Biochem"
                        "fecha" => "2014"
                        "volumen" => "47"
                        "paginaInicial" => "44"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25020262"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adipocytokines&#44; body composition&#44; and fitness in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Nemet"
                            1 => "P&#46; Wang"
                            2 => "T&#46; Funahashi"
                            3 => "Y&#46; Matsuzawa"
                            4 => "S&#46; Tanaka"
                            5 => "L&#46; Engelman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/00006450-200301000-00025"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2003"
                        "volumen" => "53"
                        "paginaInicial" => "148"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12508095"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular dysfunction in obesity and new diagnostic imaging techniques&#58; the role of noninvasive image methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;A&#46; Barbosa"
                            1 => "A&#46;B&#46; Rodrigues"
                            2 => "C&#46;C&#46; Mota"
                            3 => "M&#46;M&#46; Barbosa"
                            4 => "A&#46;C&#46; Sim&#245;es e Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/VHRM.S17801"
                      "Revista" => array:6 [
                        "tituloSerie" => "Vasc Health Risk Manag"
                        "fecha" => "2011"
                        "volumen" => "7"
                        "paginaInicial" => "287"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21633726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of leptin on changes in body fat during growth in African American and white children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;S&#46; Johnson"
                            1 => "T&#46;T&#46; Huang"
                            2 => "R&#46; Figueroa-Colon"
                            3 => "J&#46;H&#46; Dwyer"
                            4 => "M&#46;I&#46; Goran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/oby.2001.78"
                      "Revista" => array:6 [
                        "tituloSerie" => "Obes Res"
                        "fecha" => "2001"
                        "volumen" => "9"
                        "paginaInicial" => "593"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11595775"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of markers of inflammation&#44; insulin resistance and endothelial dysfunction in children at risk for overweight"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Akinci"
                            1 => "B&#46; Akinci"
                            2 => "S&#46; Coskun"
                            3 => "P&#46; Bayindir"
                            4 => "Z&#46; Hekimsoy"
                            5 => "B&#46; Ozmen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Hormones &#40;Athens&#41;"
                        "fecha" => "2008"
                        "volumen" => "7"
                        "paginaInicial" => "156"
                        "paginaFinal" => "162"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic syndrome risk factors in overweight&#44; obese&#44; and extremely obese Brazilian adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Rizzo"
                            1 => "T&#46;B&#46; Goldberg"
                            2 => "C&#46;C&#46; Silva"
                            3 => "C&#46;S&#46; Kurokawa"
                            4 => "H&#46;R&#46; Nunes"
                            5 => "J&#46;E&#46; Corrente"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1475-2891-12-19"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutr J"
                        "fecha" => "2013"
                        "volumen" => "12"
                        "paginaInicial" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23363783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low adiponectin state is associated with metabolic abnormalities in obese children&#44; particularly depending on apolipoprotein E phenotype"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Wardaningsih"
                            1 => "T&#46; Miida"
                            2 => "U&#46; Seino"
                            3 => "Y&#46; Fueki"
                            4 => "M&#46; Ito"
                            5 => "K&#46; Nagasaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/acb.2008.007237"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Clin Biochem"
                        "fecha" => "2008"
                        "volumen" => "45"
                        "paginaInicial" => "496"
                        "paginaFinal" => "503"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18753423"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating pro-inflammatory cytokines and adiponectin in young men with type 2 diabetes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;C&#46; Su"
                            1 => "D&#46; Pei"
                            2 => "C&#46;H&#46; Hsieh"
                            3 => "F&#46;C&#46; Hsiao"
                            4 => "C&#46;Z&#46; Wu"
                            5 => "Y&#46;J&#46; Hung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00592-009-0171-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Diabetol"
                        "fecha" => "2011"
                        "volumen" => "48"
                        "paginaInicial" => "113"
                        "paginaFinal" => "119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20058158"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistin levels are related to fat mass&#44; but not to body mass index in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Ortega"
                            1 => "P&#46; Riestra"
                            2 => "P&#46; Navarro"
                            3 => "T&#46; Gavela-P&#233;rez"
                            4 => "L&#46; Soriano-Guill&#233;n"
                            5 => "C&#46; Garc&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.peptides.2013.08.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Peptides"
                        "fecha" => "2013"
                        "volumen" => "49"
                        "paginaInicial" => "49"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24012666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High serum resistin is associated with an increase in adiposity but not a worsening of insulin resistance in Pima Indians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Vozarova de Courten"
                            1 => "M&#46; Degawa-Yamauchi"
                            2 => "R&#46;V&#46; Considine"
                            3 => "P&#46;A&#46; Tataranni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes"
                        "fecha" => "2004"
                        "volumen" => "53"
                        "paginaInicial" => "1279"
                        "paginaFinal" => "1284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15111497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00217557/0000009200000006/v1_201611170050/S0021755716300997/v1_201611170050/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "10179"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009200000006/v1_201611170050/S0021755716300997/v1_201611170050/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755716300997?idApp=UINPBA000049"
]

Article information

ISSN: 00217557
Original language: English

DOI:10.1016/j.jped.2016.02.015

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	8	4	12
2024 October	22	28	50
2024 September	30	28	58
2024 August	41	30	71
2024 July	39	43	82
2024 June	27	11	38
2024 May	23	13	36
2024 April	27	24	51
2024 March	19	19	38
2024 February	23	29	52
2024 January	27	36	63
2023 December	23	28	51
2023 November	27	30	57
2023 October	33	31	64
2023 September	32	45	77
2023 August	13	12	25
2023 July	20	18	38
2023 June	16	17	33
2023 May	31	17	48
2023 April	16	16	32
2023 March	37	17	54
2023 February	31	15	46
2023 January	23	9	32
2022 December	57	22	79
2022 November	23	22	45
2022 October	40	20	60
2022 September	20	31	51
2022 August	30	27	57
2022 July	32	29	61
2022 June	18	29	47
2022 May	46	23	69
2022 April	38	35	73
2022 March	32	41	73
2022 February	14	17	31
2022 January	14	19	33
2021 December	17	19	36
2021 November	17	32	49
2021 October	15	20	35
2021 September	9	13	22
2021 August	27	16	43
2021 July	12	5	17
2021 June	10	4	14
2021 May	19	9	28
2021 April	15	21	36
2021 March	9	4	13
2021 February	8	10	18
2021 January	12	10	22
2020 December	9	10	19
2020 November	14	11	25
2020 October	12	6	18
2020 September	12	10	22
2020 August	13	2	15
2020 July	17	7	24
2020 June	6	2	8
2020 May	18	4	22
2020 April	8	8	16
2020 March	9	6	15
2020 February	26	12	38
2020 January	26	12	38
2019 December	21	16	37
2019 November	23	7	30
2019 October	16	12	28
2019 September	10	6	16
2019 August	13	14	27
2019 July	22	14	36
2019 June	16	24	40
2019 May	14	15	29
2019 April	26	11	37
2019 March	16	9	25
2019 February	16	11	27
2019 January	20	5	25
2018 December	9	9	18
2018 November	31	7	38
2018 October	98	17	115
2018 September	8	11	19
2018 August	19	11	30
2018 July	12	7	19
2018 June	7	3	10
2018 May	14	7	21
2018 April	14	2	16
2018 March	5	2	7
2018 February	5	3	8
2018 January	3	1	4
2017 December	0	2	2
2017 November	4	5	9
2017 October	17	3	20
2017 September	4	2	6
2017 August	9	4	13
2017 July	8	3	11
2017 June	5	6	11
2017 May	8	2	10
2017 April	12	4	16
2017 March	5	7	12
2017 February	10	2	12
2017 January	17	9	26
2016 December	22	22	44
2016 November	14	17	31
2016 October	1	10	11
2016 September	3	7	10
2016 August	18	12	30

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter