Effects of a Multidisciplinary Childhood Obesity Treatment Intervention on Adipocytokines, Inflammatory and Growth Mediators

Abstract

Background/Aims: To examine the effects of a 3-month multidisciplinary intervention on anthropometric measures, physical activity patterns and fitness, inflammatory cytokines, adipocytokines, and growth mediators in obese children. Methods: 21 obese subjects completed the 3-month intervention and were compared with 20 age-, gender- and maturity-matched controls. Subjects underwent anthropometric measurements (weight, height, BMI percentile and waist circumference), blood tests (IL-6, CRP, leptin, adiponectin, insulin, IGF-I and glucose), a progressive treadmill exercise test to evaluate fitness, and habitual activity assessment before and after the intervention. Results: The intervention led to a significant change of differences in body weight (-1.3 ± 4.1 vs. 2.5 ± 3.3 kg), BMI percentile (-0.96 ± 1.29 vs. 0.19 ± 0.8), waist circumference (-2.1 ± 2.7 vs. 2.9 ± 3.0 cm) and running time (149.9 ± 86.3 vs. -8.2 ± 88.0 s) in the intervention compared to control. There was a significant increase in leisure-time physical activity (Godin questionnaire, 29.04 ± 6.8 vs. -1.3 ± 9.2) and a decrease in sedentary activity (-1.4 ± 0.73 vs. 0.02 ± 0.62 h/day) in the intervention compared to control. Significant change differences in adiponectin (2,308 ± 1,640 vs. -801 ± 465 ng/ml), IGF-I (33.8 ± 37.8 vs. -1.0 ± 36.2 ng/ml), CRP (-0.06 ± 0.29 vs. 0.5 ± 0.86 mg/dl) and HOMA-IR (-0.15 ± 0.57 vs. 0.55 ± 0.84) were found in the intervention group compared to control. Conclusions: Our results highlight the short-term beneficial effects of a childhood obesity multidisciplinary intervention on anthropometrics, habitual activity, fitness, inflammatory and metabolic measures. The longer-term effects of these changes on obesity-associated metabolic risks are yet to be determined.

Fatness but Not Fitness Relative to the Fat-Free Mass Is Related to C-Reactive Protein in 18 Year-Old Adolescents

“…Similarly, exercise-induced reduction in CRP was not independent of changes in body composition [28]. This effect may depend on age, however, since among young women such an exercise-initiated decrease in CRP was independent of changes in body composition [25], and among children, the changes in CRP were not related to changes in body composition [26]. The interactive effects of fitness and fatness on CRP may also be more complicated as the effect appears to be larger among obese participants [25] and among more fit participants [28].…”

“…To further complicate this issue, the interactive effects may depend upon the age of the population studied as the independent relation of fitness to CRP appears less evident in children [12,14,16,17,23], which might be because CRP reflects chronic systematic low-grade inflammation that emerges over time [16]. Some intervention studies indicate that a decrease in CRP after an exercise intervention is dependent upon body mass or fat loss [21,24], others report that the effects of exercise are independent of changes in fatness and fitness [25], or even that changes in CRP are related to changes in physical activity and not body composition [26]. Not many intervention studies have investigated the fitness fatness interaction specifically and almost all of them have been conducted in middle-aged or older adults [20,27,28].…”

“…The results are conflicting, ranging from no relation between changes in CRP and changes in adiposity or fitness [20] to independent associations of changes in both fitness and fatness with changes in CRP [27]. In addition, many studies have used indirect measures or estimates of adiposity [12–14,16,22,26,27] and fitness [12–14,16,19,25–29], which may affect the nature of the relationship between fitness, fatness and CRP. Understanding the interrelationship of fitness and fatness may be the main way to develop preventive actions to attenuate systemic low grade inflammation [14] but precise measurements of the variables are needed [13].…”

Adiponectin, Inflammation and Cardiometabolic Risk Factors in Paediatric Obese Patients: Impact of Interventional Studies

“…Nevertheless, changes in adiponectin correlated negatively with changes in HOMA and body fat percentage, only in the CT, and baseline and postintervention adiponectin levels did not differ between them [99]. The independent role of PE, besides anthropometric improvements, in raising adiponectin levels has also been highlighted [100].…”

Effect of Weight Loss on Markers of Inflammation and Endothelial Function in Childhood Obesity

“…Among these studies, Gong et al [19], Roberts et al [20], Rynders et al [21], Izadpanah et al [22], Garanty-Bogacka et al [23], Martos Moreno et al [24], Balagopal et al [25] and Gallistl et al [26] showed similar change in IL-6 levels after decrease of BMI. On the other side, Nemet et al [27], Roth et al [28], and Amati et al [29] found no significant change. D' Adamo et al [30] recently demonstrated a significant increase of esRAGE in obese children after life style intervention combined with Vitamin E supplementation.…”