Objective: This study’s purpose was to investigate the effects of different intensities of physical activity on cardiovascular metabolism in obese children and adolescents based on an isochronous replacement model.Methods: A total of 196 obese children and adolescents (mean age, 13.44 ± 1.71 years) who met the inclusion criteria and attended a summer camp from July 2019 to August 2021 were recruited for this study, and all subjects wore a GT3X + triaxial motion accelerometer uniformly around the waist to record physical activity levels. We collected the subjects’ height, weight, and cardiovascular risk factors such as waist circumference, hip circumference, fasting lipids, blood pressure, fasting insulin, and fasting glucose before and after 4 weeks of camp and constructed cardiometabolic risk score (CMR-z). We analyzed the effects of different intensities of physical activity on cardiovascular metabolism in obese children using isotemporal substitution model (ISM).Results: After 4 weeks, cardiovascular risk factors such as body weight, waist circumference, triglyceride, and total cholesterol were reduced in adolescents with obesity (p <0.01), and CMR-z was also reduced (p <0.01). ISM analysis revealed that all sedentary behavior (SB) replacement with 10 min of light physical activity (LPA) reduced CMR-z [β = −0.10, 95% CI (−0.20, −0.01)]; 10-min of moderate physical activity (MPA) replacement of SB reduced CMR-z [β = −0.32, 95% CI (−0.63, −0.01)]; 10-min of vigorous physical activity (VPA) replacement of SB reduced CMR-z [β = −0.39, 95% CI (−0.66, −0.12)].Conclusion: Replacement of SB with 10 min of LPA, MPA, and VPA were all effective in improving cardiovascular risk health, respectively, but MPA or VPA was more effective.
Objective This study aims to screen for measures and lipid-derived indicators associated with insulin resistance (IR) in obese children and adolescents and develop a nomogram model for predicting the risk of insulin resistance. Methods A total of 404 eligible obese children and adolescents aged 10–17 years were recruited for this study from a summer camp between 2019 and 2021. The risk factors were screened using the least absolute shrinkage and selection operator (LASSO)-logistic regression model, and a nomogram model was developed. The diagnostic value of the model was evaluated by plotting the receiver operator characteristic curve and calculating the area under the curve. Internal validation was performed using the Bootstrap method, with 1000 self-samples to evaluate the model stability. The clinical applicability of the model was assessed by plotting the clinical decision curve. Results On the basis of the LASSO regression analysis results, three lipid-related derivatives, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were finally included in the IR risk prediction model. The nomogram model AUC was 0.804 (95% CI: 0.760 to 0.849). Internal validation results show a C-Index of 0.799, and the mean absolute error between the predicted and actual risks of IR was 0.015. The results of the Hosmer–Lemeshow goodness-of-fit test show a good model prediction (χ2 = 9.523, P = 0.300). Conclusion Three early warning factors, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were screened, which can effectively predict the risk of developing IR in obese children and adolescents, and the nomogram model has an eligible diagnostic value.
Purpose: This study aimed to explore the characteristics of resting energy expenditure (REE) and lipid metabolism during incremental load exercise in obese children and adolescents with insulin resistance (IR) to provide evidence for exercise intervention in obese children and adolescents with IR.Method: From July 2019 to August 2021, 195 obese children and adolescents aged 13–17 were recruited through a summer camp. The participants were divided into IR (n = 67) and no-IR (without insulin resistance, n = 128) groups and underwent morphology, blood indicators, body composition, and resting energy consumption gas metabolism tests. Thirty participants each were randomly selected from the IR and no-IR groups to carry out the incremental treadmill test.Results: Significant metabolic differences in resting and exercise duration were found between the IR and no-IR groups. In the resting state, the resting metabolic equivalents (4.33 ± 0.94 ml/min/kg vs. 3.91 ± 0.73 ml/min/kg, p = 0.001) and REE (2464.03 ± 462.29 kcal/d vs. 2143.88 ± 380.07 kcal/d, p < 0.001) in the IR group were significantly higher than in the no-IR group. During exercise, the absolute maximal fat oxidation (0.33 ± 0.07 g/min vs. 0.36 ± 0.09 g/min, p = 0.002) in the IR group was significantly lower than in the no-IR group; maximal fat oxidation intensity (130.9 ± 8.9 bpm vs. 139.9 ± 7.4 bpm, p = 0.040) was significantly lower in the IR group.Conclusion: Significant resting and exercise metabolic differences were found between obese IR and no-IR children and adolescents. Obese IR children and adolescents have higher REE and lower maximal fat oxidation intensity than obese no-IR children and adolescents.
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