Cardiorespiratory fitness in adolescents with obesity: a 6-month follow-up study / Aptidão Cardiorrespiratória em Adolescentes com obesidade: um estudo de seguimento de 6 meses

The aim of this study was to investigate whether the effects of a multidisciplinary intervention on cardiorespiratory fitness are maintained after 6-month follow-up in adolescents with obesity. One-hundred and seven adolescents with obe-sity were intentionally allocated in two groups: experimental or control. Adolescents in experimental group underwent a multidisciplinary intervention (supervised aerobic exercise, psychological, nutritional, and clinical counseling). Cardiorespiratory fitness (direct gas analysis), body composition (dual-energy-DXA), anthropometry and blood lipids were measured before intervention (baseline), at the end of the 24-week intervention (post-intervention) and six months after the end of the intervention (follow-up). Cardiorespiratory fitness reduced in control group with no changes in experimental group, and these differences were maintained in the follow-up assessment (control group: 24.2±4.4 ml.kg-1.min-1to 22.6±4.9 ml.kg-1.min-1; follow-up: 22.6±4.9 ml.kg-1.min-1 vs. experimental group: 28.0±4.0 ml.kg-1.min-1 to 29.7±4.0 ml.kg-1.min-1; follow-up: 28.9±5.7 ml.kg-1.min-1). Reductions in z-score body mass index (BMI) and increases HDL-C af-ter multidisciplinary intervention were maintained after a 6-month follow-up. In conclusion, the benefits of a multidisciplinary intervention on cardiorespiratory fitness, BMI and blood lipids are maintained after a 6-month follow-up. These findings indicate that multidisciplinary interventions produce long-term health consequences on cardiorespiratory fitness. Reinforcing the importance of lifestyle changes as a therapeutic approach for the treatment of obesity in adolescents.

O objetivo do presente estudo foi investigar se os efeitos da intervenção multidisciplinar sobre a aptidão cardiorrespiratória são mantidos após um período de segmento de 6 meses em adolescentes com obesidade. Cento e sete adolescentes com obesidade foram intencionalmente alocados em dois grupos: experimental e controle. Os adolescentes do grupo experimental foram submetidos a intervenção multidisciplinar composta por acompanhamento psicológico, nutricional, clínico e treinamento aeróbio. Aptidão cardiorrespiratória (análise de gases), composição corporal (DEXA), antropometria e perfil lipídico foram avaliados no momento basal, após 24 semanas de intervenção e 6 meses após (follow up). A aptidão cardiorrespiratória reduziu no grupo controle sem alterações no grupo experimental, mesmo após o período de 6 meses (controle: 24,2±4,4 ml.kg-1.min-1 para 22,6±4,9 ml.kg-1.min-1; follow-up: 22,6±4,9 ml.kg-1.min-1 vs. grupo experimental: 28,0±4,0 ml.kg-1.min-1 para 29.7±4.0 ml.kg-1.min-1; follow-up: 28,9±5,7 ml.kg-1.min-1). Redução no escore-z do índice de massa corporal (Z-IMC) e elevação do HDL-c verificadas após 24 semanas, foram mantidas após o período de segmento. Os resultados indicam que os efeitos da intervenção multidisciplinar são mantidos após 6 meses de seguimento. Estes achados sugerem que intervenções multidisciplinares podem produzir alterações benéficas de longo prazo na capacidade cardiorrespiratória.

Exactitud de los parámetros antropométricos como indicadores de adiposidad visceral previstos para ecuación bidimensional / Accuracy parameters as indicators of anthropometric adiposity visceral scheduled for two-dimensional equation

Introducción: los indicadores antropométricos son fáciles de aplicar y pueden ayudar en la identificación de la acumulación de grasa visceral, lo que favorece la aparición de eventos cardiovasculares, así como, el aumento de la morbilidad y mortalidad por enfermedades crónicas. Objetivo: evaluar la exactitud de los indicadores antropométricos de distribución de la grasa abdominal para determinar la adiposidad visceral. Sujetos/Métodos: estudio transversal realizado con pacientes ambulatorios, de ambos sexos, mayores de 20 años. Fueron evaluados: circunferencia de la cintura (CC); relación cintura-cadera (WHR); cintura-altura (CER); índice Taper (CI); diámetro abdominal sagital (DAS); (DC) de diámetro coronal; índice de masa corporal (IMC); porcentaje de grasa corporal (% GC); adiposidad visceral (AV/AS) predicha por la fórmula; glucosa en sangre en ayunas; colesterol total (TC); lipoproteína de baja densidad (LDL); lipoproteína de alta densidad (HDL); lipoproteínas de muy baja densidad (VLDL) y triglicéridos (TG). Resultados: se evaluaron 129 pacientes, edad media 51, 06 + 14,02 años y una mayor prevalencia de adultos (72,9%) y mujeres (75,2%). CC 102,9 (+ 10,82), HF 2,08 (± 0,13) y AV/AS 1,03 (+ 0,16), mostraron valores altos con significación estadística entre los hombres, p < 0,001. Lo mismo ocurrió con la CT (+ 46,4 212,41), HDL (50,15 + 13,24) y LDL (135,62 + 40,16) entre las mujeres, p < 0,05. DC, RCE, DAS y DC mostraron una correlación inversa y significativa con la AV/AS: r = -0,364; -0.457; -0.403; -0.296; -0.475, respectivamente, p < 0,001. Sin embargo, que mejor explicó la varianza de la obesidad visceral fueron el DC (R² = 0,77), CQ (R² = 0,64) y RCE (R² = 0,59). Discusión/Conclusión: la DC y el CER fueron los mejores predictores para las mediciones antropométricas de la obesidad visceral (AU)

Introduction: anthropometric indicators are easy to apply and can help identify the accumulation of visceral fat, which favors the occurrence of cardiovascular events, increasing morbidity and mortality from chronic degenerative diseases. Objective: to evaluate the accuracy of anthropometric indicators for the location of abdominal fat in determining visceral adiposity. Subjects/Methods: cross-sectional study conducted among patients attending outpatient, of both sexes, aged over 20 years. Evaluated: Waist Circumference (WC), Waist-Hip Ratio (WHR), waist-to- stature ratio (CER), conicity index (CI); Sagittal Abdominal Diameter (DAS); Coronal Diameter (DC); Mass Index (BMI), percentage of body fat (% BF); Visceral Adiposity (AV/AS) predicted by the formula , fasting glucose , total cholesterol (TC), Low Density Lipoprotein (LDL), high density lipoprotein (HDL), Very Low Density lipoprotein (VLDL) and Triglycerides (TG). Results: 129 patients were included, mean age 51, 06 + 14.02 years and a higher prevalence of adults (72,9%) and female (75,2%). CC 102,9 (+ 10,82 ), CI 2,08 (+ 0,13), and the AV/AS 1,03 (+ 0,16), showed high values with statistical significance among men, p<0.001 . The same occurred with the CT (212,41 + 46,4), HDL (50,15 + 13,24) and LDL (135,62 + 40,16) among women, p<0.05. The CC, RCE, DAS and DC showed an inverse and significant correlation with the AV/AS: r = -0,364; -0,457; -0,403; -0,296; -0,475; respectively, p<0.001. However, best explained the variance in visceral obesity were the DC (R² = 0.77), CQ (R² = 0.64) and CERs (R² = 0.59). Discusión/Conclusion: the DC and CERs were the best predictors anthropometric measures of visceral obesity (AU)

Relation between leukocyte count, adiposity, and cardiorespiratory fitness in pubertal adolescents / Relação entre contagem de leucócitos, adiposidade e aptidão cardiorrespiratória em adolescentes púberes

Objective To compare the total and differential leukocyte count in obese and normal-weight adolescents, and to verify their possible relations with cardiorespiratory fitness and adiposity indicators. Methods A cross-sectional study conducted with 139 adolescents (107 obese and 32 normal weight) aged between 13 and 18 years. Cardiorespiratory fitness was determined by direct gas analysis during an incremental treadmill test. Total leukocytes and subsets were estimated by flow cytometry. Body composition was assessed by dual-energy X-ray absorptiometry. The t-test for independent samples was used for comparison between groups. The relation between leukocytes, cardiorespiratory fitness and adiposity indicators was verified by Pearson’s correlation and multiple linear regression (adjusted for age and body mass index) tests. Results Obese adolescents had higher leukocyte (8.12±2.36u/L x 103; p=0.001), neutrophil (4.33±1.86u/L x 103; p=0.002), and monocyte (0.70±0.22u/L x 103; p=0.002) counts compared to the levels of normal weight subjects. After the necessary adjustments, cardiorespiratory fitness had a negative association with leukocytes, neutrophils, and monocytes in boys. Conclusion Obese adolescents had higher total and differential leucocyte count when compared to normal weight individuals. We also observed a weak positive association between adiposity and total leukocyte, monocyte, and neutrophil counts, and in boys, a negative association between cardiorespiratory fitness and total count of leukocytes, monocytes, and neutrophils. .

Objetivo Comparar a contagem total e diferencial de leucócitos de adolescentes obesos e eutróficos, e verificar suas possíveis relações com a aptidão cardiorrespiratória e indicadores de adiposidade. Métodos Estudo transversal realizado com 139 adolescentes (107 obesos e 32 eutróficos), com idades entre 13 e 18 anos. A aptidão cardiorrespiratória foi determinada por análise direta de gases durante um teste incremental em esteira rolante. As contagens de leucócitos totais e subconjuntos foram estimadas por citometria de fluxo. A composição corporal foi avaliada pelo método de dupla energia de raios X. O teste t para amostras independentes foi utilizado para comparação entre os grupos. A relação entre leucócitos, aptidão cardiorrespiratória e indicadores de adiposidade foi verificada por meio dos testes de correlação de Pearson e regressão linear múltipla (ajustado para idade e índice de massa corporal). Resultados Os adolescentes obesos apresentaram leucócitos (8,12±2,36u/L x 103; p=0,001), neutrófilos (4,33±1,86u/L x 103; p=0,002) e monócitos (0,70±0,22u/L x 103; p=0,002) mais elevados em comparação com os níveis dos eutróficos. Após os ajustes necessários, a aptidão cardiorrespiratória foi negativamente associada com leucócitos, neutrófilos e monócitos em meninos. Conclusão Adolescentes obesos apresentaram maior contagem de leucócitos totais e subpopulações, quando comparados aos eutróficos. Observou-se também uma fraca relação positiva entre adiposidade e leucócitos totais, monócitos ...

Relation between leukocyte count, adiposity, and cardiorespiratory fitness in pubertal adolescents.

OBJECTIVE: To compare the total and differential leukocyte count in obese and normal-weight adolescents, and to verify their possible relations with cardiorespiratory fitness and adiposity indicators. METHODS: A cross-sectional study conducted with 139 adolescents (107 obese and 32 normal weight) aged between 13 and 18 years. Cardiorespiratory fitness was determined by direct gas analysis during an incremental treadmill test. Total leukocytes and subsets were estimated by flow cytometry. Body composition was assessed by dual-energy X-ray absorptiometry. The t-test for independent samples was used for comparison between groups. The relation between leukocytes, cardiorespiratory fitness and adiposity indicators was verified by Pearson's correlation and multiple linear regression (adjusted for age and body mass index) tests. RESULTS: Obese adolescents had higher leukocyte (8.12±2.36u/L x 103; p=0.001), neutrophil (4.33±1.86u/L x 103; p=0.002), and monocyte (0.70±0.22u/L x 103; p=0.002) counts compared to the levels of normal weight subjects. After the necessary adjustments, cardiorespiratory fitness had a negative association with leukocytes, neutrophils, and monocytes in boys. CONCLUSION: Obese adolescents had higher total and differential leucocyte count when compared to normal weight individuals. We also observed a weak positive association between adiposity and total leukocyte, monocyte, and neutrophil counts, and in boys, a negative association between cardiorespiratory fitness and total count of leukocytes, monocytes, and neutrophils.