Objective: The human serum metabolite profile is reflective of metabolic processes, including pathophysiological changes characteristic of diseases. Therefore, investigation of serum metabolite concentrations in obese children might give new insights into biological mechanisms associated with childhood obesity. Methods: Serum samples of 80 obese and 40 normal-weight children between 6 and 15 years of age were analyzed using a mass spectrometry-based metabolomics approach targeting 163 metabolites. Metabolite concentrations and metabolite ratios were compared between obese and normal-weight children as well as between children of different pubertal stages. Results: Metabolite concentration profiles of obese children could be distinguished from those of normal-weight children. After correction for multiple testing, we observed 14 metabolites (glutamine, methionine, proline, nine phospholipids, and two acylcarnitines, p < 3.8 × 10^–4) and 69 metabolite ratios (p < 6.0 × 10^–6) to be significantly altered in obese children. The identified metabolite markers are indicative of oxidative stress and of changes in sphingomyelin metabolism, in β-oxidation, and in pathways associated with energy expenditure. In contrast, pubertal stage was not associated with metabolite concentration differences. Conclusion: Our study shows that childhood obesity influences the composition of the serum metabolome. If replicated in larger studies, the altered metabolites might be considered as potential biomarkers in the generation of new hypotheses on the biological mechanisms behind obesity.

Younger age was associated with the best long-term outcome after participation in the lifestyle intervention, which supports the need for early intervention in childhood obesity. Children aged 8-10 y may need modified intervention, because BMI-SDS increased more in the older children in the long term. However, mean BMI-SDS was significantly lower 4 y after the end of the intervention than at baseline in all age groups. This study was registered at clinicaltrials.gov as NCT00435734.

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Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS.

Objective: Small for gestational age (SGA) children are at risk of both later obesity and metabolic syndrome (MetS). However, it is unknown whether obesity or SGA status leads to MetS in these subjects. We hypothesized that overweight children with former SGA status had more present components of the MetS than overweight children with former appropriate for gestational age (AGA) status. Methods: We analyzed 803 overweight children (4% SGA, mean age 11G0.1 years, body mass index (BMI) 27.3G0.2, SDS-BMI 2.32G0.02) concerning blood pressure, lipids, glucose, and insulin. Oral glucose tolerance tests (oGTT) were performed in all 35 former SGA children and 147 randomly chosen former non-SGA children. Results: After adjustment for age, sex, pubertal stage, and BMI-SDS, former SGA status was significantly related to blood pressure, triglyceride, insulin, and 2 h glucose levels in oGTT. The MetS prevalence was more than doubled in overweight former SGA subjects (40% MetS) compared with overweight former AGA subjects (17% MetS). The corresponding adjusted odds ratio was 4.08 (95% confidence interval 1.48 to 11.22) for SGA compared with AGA children. Conclusions: Overweight former SGA children had an increased risk for the components of the MetS compared with overweight former AGA children. Therefore, SGA status seems to be a risk factor for the MetS independently of weight status. Particularly overweight children with former SGA status should be screened for the MetS.