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According to our results, clinically healthy obese children have a higher degree of albuminuria and beta-2-microglobulinuria than normal weight children, indicating early renal glomerular and tubular dysfunction as a consequence of childhood obesity. The urinary albumin/creatinine ratio in the obese children was associated with certain metabolic derangements linked to obesity, and also with the clustering of features of the metabolic syndrome.

Previously we reported significantly higher values of γ-linolenic acid (GLA, 18:3n-6), dihomo-γ-linolenic acid (DHGLA,, and arachidonic acid (20:4n-6) in plasma lipid classes in obese children than in nonobese controls. In the present study, fatty acid composition of plasma phospholipids (PL) and sterol esters (STE) was determined by high-resolution capillary gas-liquid chromatography in obese children with and without metabolic cardiovascular syndrome [MCS: defined as simultaneous presence of (i) dyslipidemia, (ii) hyperinsulinemia, (iii) hypertension, and (iv) impaired glucose tolerance] and in nonobese controls. Fatty acid composition of PL and STE lipids did not differ between obese children without MCS and controls. Obese children with MCS exhibited significantly lower linoleic acid (LA, values in PL (17.43 [2.36], % wt/wt, median [range from the first to the third quartile]) than obese children without MCS (19.14 [3.49]) and controls (20.28 [3.80]). In contrast, PL GLA values were significantly higher in obese children with (0.13 [0.08]) than in those without MCS (0.08 [0.04]), whereas STE GLA values were higher in obese children with MCS (1.04 [0.72]) than in controls (0.62 [0.48]). DHGLA values in PL were significantly higher in obese children with MCS (4.06 [0.74]) than in controls (2.69 [1.60]). The GLA/LA ratio was significantly higher, whereas the AA/DHGLA ratio was significantly lower in obese children with MCS than in obese children without MCS and in controls. In this study, LA metabolism was affected only in obese children with but not in those without MCS. In obese children with MCS, ∆6-desaturase activity appeared to be stimulated, whereas ∆5-desaturase activity appeared to be inhibited. Disturbances in LA metabolism may represent an additional health hazard within the multifaceted clinical picture of MCS.Prevalence of childhood obesity is high and still increasing in many affluent countries. In children and adolescents investigated from 1988 to 1991 in the United States, the prevalence of overweight based on body mass index was 11% according to the 95th and 22% according to the 85th percentile cutoff points (1). In Hungary, the prevalence of childhood obesity defined as body mass index exceeding the 90th percentile is around 13% (2). The long-term morbidity and mortality associated with childhood obesity are closely connected to the cardiovascular and metabolic status detectable in the pediatric age group (3). Therefore, identification of cardiovascular risk factors in obese children is of practical importance.Previously we found significantly higher percentage contributions of the n-6 long-chain polyunsaturated fatty acids (LCPUFA), γ-linolenic acid (GLA, 18:3n-6), dihomo-γ-linolenic acid (DHGLA, 20:3n-6), and arachidonic acid (AA, 20:4n-6) to the fatty acid composition of plasma lipid classes in obese children than in nonobese controls (4). Since LCPUFA are prone to lipid peroxidation, their enhanced availability in circulating lipids may represent a further risk factor of atherogenesis in ob...

These findings suggest that promoting MVPA may be have a beneficial effect on attention capacity, an important component of cognition, in adolescents.

OBJECTIVE: The present study was performed to investigate the ef®cacy and safety of a caffeineaephedrine (CE) mixture in obese adolescents. SUBJECTS: Thirty-two (maf 16a16) obese children were included into the study. They were treated by diet (calculated daily energy requirement minus 500 kcal) and either CE or placebo (PL) for 20 weeks in a randomized double-blind placebo-controlled trial. Those weighing less than 80 kg took one tablet three times (100 mga10 mg), whereas those weighing more than 80 kg took two tablets three times per day. There were three dropouts (girls) from the PL group. The age, weight body mass index (BMI) values (mean (range)) of the PL and CE groups were 16.0 (14.3 ± 17.6) and 16.0 (14.2 ± 17.7) y, 103.0 (77.2 ± 126.4) and 104.8 (69.8 ± 150.2) kg, 35.2 (28.3 ± 42.3) and 36.5 (31.3 ± 51.8) kgam 2 , respectively. RESULTS: The decrease in relative body weight, BMI and body fat (measured by bioelectric impedance) was signi®cantly (P`0.05) greater in the CE group (mean AE s.d.; 14.4 AE 10.5%, 2.9 AE 1.9 kgam 2 , 6.6 AE 6.0 kg) than in the PL group (2.2 AE 5.8%, 0.5 AE 1.6 kgam 2 , 0.5 AE 2.7 kg). Relative body weight decreased by more than 5% in 81% of the CE group, out only in 31% of the PL group. Adverse events were negligible and did not differ between the CE and PL groups. Withdrawal symptoms were mild, transient and their frequency and severity were not different between the placebo and active groups. CONCLUSION: According to the present pilot study, CE can be a safe and effective compound for the treatment of obesity in adolescents.

on behalf of the IDEFICS consortium OBJECTIVE: To establish age-and sex-specific reference values for serum leptin and adiponectin in normal-weight 3.0-8.9-year old European children. SUBJECTS AND METHODS: Blood samples for hormone analysis were taken from 1338 children of the IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS) study cohort. Only normal-weight children aged 3.0-8.9 years were included (n = 539) in our analysis. Using the General Additive Model for Location Scale and Shape, age-and sex-specific percentiles were derived. The influence of under/overweight and obesity on the proposed reference curves based on normal-weight children was investigated in several sensitivity analyses using the sample without obese children (n = 1015) and the whole study sample (n = 1338). RESULTS: There was a negative age trend of adiponectin blood levels and a positive trend of leptin levels in boys and girls. Percentiles derived for girls were generally higher than those obtained for boys. The corresponding age-specific differences of the 97th percentile ranged from − 2.2 to 4.6 μg ml − 1 and from 2.2 to 4.8 ng ml − 1 for adiponectin and leptin, respectively. CONCLUSIONS: According to our knowledge, these are the first reference values of leptin and adiponectin in prepubertal, normal-weight children. The presented adiponectin and leptin reference curves may allow for a more differentiated interpretation of children's hormone levels in epidemiological and clinical studies.

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