Effects of life style intervention on obesity-related vascular dysfunction in children / 中华流行病学杂志

ABSTRACT

Objective To evaluate the reversibility of obesity-related arterial dysfunction and thickening carotid intima-media through dietary and/or exercise intervention programs.Methods Seventyeight 9 to 12 year-old overweight children,were randomly assigned to group Aonly dietary modification,group Bdiet plus a supervised structured exercise program for 6 weeks(SE)and subsequently for 1 year (CE).The prospectively defined primary end points were assessed through ultrasound-derived arterial endothelial function(endothelium-dependent dilation)of the brachial artery and intima-media thickness of common carotid artery.Results At 6 weeks,both interventions were associated with improved arterial endothelial function[group A(6.36±0.81)% vs.(5.32±0.84)%,P＜0.01;group B(7.46±0.91)% vs.(5.20±0.87)%,P＜0.01 ].A conbination of diet and exercise were associated with a significantly greater improvement in endothelial function than on diet alone(P＜0.01).At 1 year,there appeared significantly Less thickening of the carotid wall in group CE[(0.57±0.05)mm vs.(0.59±0.07)mm,P＜0.001].Compared with children in group SE[(6.38±1.04)% vs.(5.22±0.96)%,P＜0.05],vascular function appeared significantly better in group CE[(8.29±0.78)% vs.(5.38±0.65)%,P＜0.001].Conclusion Obesity-related vascular dysfunction in young children was partially reversible with diet alone but more obvious when combined with exercise training for 6 weeks.Sustained improvements at 1 year was seen in those who persisted in diet program plus regular exercise.