Intima-Media Thickness in Obese Children Before and After Weight Loss

Wünsch, R.; Sousa, Gideon de; Toschke, André Michael; Reinehr, Thomas

doi:10.1542/peds.2006-0302

Cited by 143 publications

(106 citation statements)

References 42 publications

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“…Additionally, this lifestyle intervention led to a reduction of carotid intima-media thickness (75) . Finally, the weight loss was also associated with an improvement of quality of life in the participants, suggesting a clinical relevance not only from the medical point of view but also from the participants' point of view (70) .…”

Section: Effectiveness Of the Lifestyle Intervention 'Obeldicks'mentioning

confidence: 99%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

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Section: Effectiveness Of the Lifestyle Intervention 'Obeldicks'mentioning

confidence: 99%

Effectiveness of lifestyle intervention in overweight children

Reinehr

2011

Proc. Nutr. Soc.

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“…12,13 However, few studies have investigated the effects of 1 year of interdisciplinary intervention in this parameter in obese adolescents. 14,15 The aim of this investigation was to verify whether 1 year of an interdisciplinary weight-loss program improved common carotid artery IMT and whether insulin resistance and/or inflammation (as measured by the levels of markers, plasminogen activator inhibitor type-1 and adiponectin) might underlie obesity in Brazilian adolescents.…”

Section: Introductionmentioning

confidence: 99%

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program

et al. 2010

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The aim of this study was to verify whether a 1-year interdisciplinary weight-loss program improved common carotid artery intima-media thickness (IMT) and whether insulin resistance and/or inflammation (as measured by the markers plasminogen activator inhibitor type-1 and adiponectin) might underlie obesity in adolescents. A group of 29 post-pubescent obese adolescents were submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery IMT was determined ultrasonographically. Body composition, blood pressure (BP), glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile and adipokine concentrations were analyzed before and after the intervention. The interdisciplinary weight-loss program promoted a significant improvement in body composition, insulin concentration, HOMA-IR, lipid profile, BP and inflammatory state, in addition to significantly decreasing the common carotid artery IMT. Furthermore, this study demonstrated that the difference between baseline and final values of HOMA-IR (DHOMA-IR) was negatively correlated with concomitant changes in the adiponectin concentration (Dadiponectin; r¼À0.42; P¼0.02) and positively correlated with changes in common carotid artery IMT (Dcarotid IMT; r¼0.41; P¼0.03). Multiple regression analysis adjusted by age, cardiovascular risk factors and inflammatory markers showed that DHOMA-IR was an independent predictor of significant changes in common carotid artery IMT. This investigation demonstrated that an interdisciplinary weight-loss program promoted a reduction of the common carotid artery IMT in obese Brazilian adolescents, and the improvement of HOMA-IR was an independent predictor of carotid IMT changes in this population.

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“…It is a mediator of endothelial dysfunction and neointimal hyperplasia and causes a paracrine effect of perivascular adipose tissue over the smooth muscle. 41 Among obese children, the intima-media layers are thicker; this is a noninvasive marker of early atherosclerotic changes. It has been demonstrated that this condition may be reversed through BMI normalization during childhood.…”

Section: Comorbidities In Obese Childrenmentioning

confidence: 99%

The obese child in the Intensive Care Unit. Update

Fuentes¹,

L²,

et al. 2016

Arch Argent Pediat

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Given that childhood obesity is an epidemic, the frequency of critically-ill patients who are overweight or obese seen at intensive care units has increased rapidly. Adipose tissue is an endocrine organ that secretes a number of protein hormones, including leptin, which stands out because it regulates adipose tissue mass. The presence of arterial hypertension, metabolic syndrome, diabetes mellitus, respiratory disease and chronic kidney disease may become apparent and complicate the course of obese pediatric patients in the Intensive Care Unit. Obesity management is complex and should involve patients, their families and the medical community. It should be coordinated with comprehensive government health policies and implemented in conjunction with a change in cultural context

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Intima-Media Thickness in Obese Children Before and After Weight Loss

Cited by 143 publications

References 42 publications

Effectiveness of lifestyle intervention in overweight children

Effectiveness of lifestyle intervention in overweight children

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program

The obese child in the Intensive Care Unit. Update

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