ABSTRACT
OBJECTIVES: This study aimed to investigate the effect of vitamin D on cardiovascular risk in obese adolescents. METHODS: Thirty (16 females/14 males) post-puberty obese adolescents (15-19 years) were involved and measurements of inflammatory biomarkers, body composition, visceral fat, and vitamin D (serum and intake) were performed. The adolescents were submitted to a long-term interdisciplinary therapy with physical exercise, nutritional, psychological, and clinical interventions. RESULTS: Negative correlations between vitamin D intake with plasminogen activator inhibitor-1 (PAI-1) (r=-0.69; p=0.01) and vascular cell adhesion molecule (VCAM-1) (r=-0.82; p=0.001) were found in the population analyzed. Improvement in PAI-1, VCAM-1, body composition, and visceral fat, were observed. CONCLUSIONS: We showed that low vitamin D intake is associated with an increase in the cardiovascular risk factors in obese adolescents.
Subject(s)
Cardiovascular Diseases/epidemiology , Pediatric Obesity/epidemiology , Vitamin D Deficiency/epidemiology , Vitamin D/administration & dosage , Adolescent , Adult , Cardiovascular Diseases/prevention & control , Combined Modality Therapy , Eating/physiology , Female , Humans , Male , Pediatric Obesity/blood , Risk Factors , Vitamin D/blood , Vitamin D Deficiency/blood , Weight Reduction Programs , Young AdultABSTRACT
BACKGROUND/OBJECTIVES: Obesity is related to inflammation and cardiovascular disease. The increase in saturated fatty acid intake (SFA) can potentiate cardiovascular risks. The aim of this study was to assess the influence of change in SFA on carotid intima-media thickness (cIMT), metabolic profile and anti/pro-inflammatory adipokines in obese adolescents. METHODS: Sixty obese adolescents were subjected to 1 year of interdisciplinary intervention (nutrition, psychology, physical exercise and clinical therapy). Blood glucose, insulin, lipid profile, leptin and adiponectin were analysed. Insulin resistance was estimated by HOMA-IR and HOMA-AD. cIMT was measured by ultrasonography. Dietetic intake was calculated by 3-day dietary record. Volunteers were analysed according to tertiles of change (Δ) in SFA intake: Low-SFA reduction<3.68 g; Moderate-SFA reduction 3.68-13.67 g; and High-SFA reduction>13.67 g. RESULTS: Moderate and High-SFA tertiles presented reduction in insulin, leptin/adiponectin ratio, cIMT and increase in adiponectin and adiponectin/leptin ratio. Adiponectin/leptin ratio was predictor of cIMT. HOMA-IR, total cholesterol and LDL-cholesterol reduced only in High-SFA tertile, and was associated with SFA independent of visceral fat. Negative correlations between Δ of SFA and adiponectin and adiponectin/leptin ratio were observed. CONCLUSION: Obese adolescents with moderate and high reduction in SFA presented improvements on pro/anti-inflammatory biomarkers and cIMT, leading to reduction in cardiovascular risks.
Subject(s)
Cardiovascular Diseases/prevention & control , Pediatric Obesity/diet therapy , Adolescent , Blood Glucose , Cardiovascular Diseases/complications , Carotid Intima-Media Thickness , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Combined Modality Therapy , Diet, Fat-Restricted , Female , Humans , Insulin/blood , Male , Pediatric Obesity/blood , Pediatric Obesity/complications , Pediatric Obesity/pathology , Pediatric Obesity/therapy , Severity of Illness IndexABSTRACT
AIM: The aim of this study was to evaluate the role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders. METHODS: Thirty-seven post-pubertal, obese adolescents (14 to 19 years old) with symptoms of eating disorders were submitted to long-term interdisciplinary therapy (1 year). Bulimic and binge eating symptoms were measured using the Bulimic Investigatory Test, Edinburgh, and the Binge Eating Scale respectively. Neuropeptide Y, melanin-concentrating hormone, total ghrelin, alpha-melanocyte stimulating hormone and leptin were measured using radioimmunoassay. RESULTS: After long-term interdisciplinary therapy, the adolescents showed significantly improved body composition, visceral and subcutaneous fat and reduced symptoms of bulimia and binge eating. Intriguingly, orexigenic peptides were up-regulated after short-term therapy and down-regulated at the end of therapy, whereas the anorexigenic pathway was improved with therapy. Furthermore, after long-term therapy, a negative correlation was observed between leptin concentration and melanin-concentrating hormone. DISCUSSION: We suggest that long-term therapy promotes an intrinsic association between weight loss, improvement of eating disorder symptoms and a decrease in orexigenic factors. Together, these results represent a more effective course by which patients can normalise behaviours related to eating disorders as well the actions of hormones involved in energy balance, and thus advance obesity control. CONCLUSION: Long-term interdisciplinary therapy was effective to improve anorexigenic and orexigenic factors that influence energy balance and avoid the development of eating disorders in obese adolescents. However, the associations between eating disorders and neuroendocrine factors need to be confirmed in future studies.
Subject(s)
Binge-Eating Disorder/diet therapy , Bulimia Nervosa/diet therapy , Obesity/diet therapy , Weight Loss/physiology , Adolescent , Body Mass Index , Energy Intake , Female , Ghrelin/metabolism , Humans , Hypothalamic Hormones/metabolism , Male , Melanins/metabolism , Neuropeptide Y/metabolism , Patient Care Team , Physical Therapy Modalities , Pituitary Hormones/metabolismABSTRACT
BACKGROUND: Visceral adiposity is the major risk factor for paediatric nonalcoholic fatty liver disease. AIMS: Determine the prevalence of nonalcoholic fatty liver disease according to the visceral fat quartile. SUBJECTS: 181 obese adolescents including 113 girls (16.58+/-1.56 years) and 68 boys (16.87+/-1.62 years) were evaluated. METHODS: The inclusion criteria were obesity and post-pubertal stage of Tanner. Visceral fat of obese adolescents was distributed in quartiles after ultrasound nonalcoholic fatty liver disease diagnosis. RESULTS: Nonalcoholic fatty liver disease prevalence was 45.30%. It was observed that 62.07% and 76.47% of girls and boys with nonalcoholic fatty liver disease were found in the 4th quartile. In a multivariate logistic analysis it was observed that only visceral fat remained statistically significant, every 1cm increase in visceral fat was associated with a 1.97 fold (95% CI 1.06-3.66) in boys and 2.08 fold (95% CI 1.38-3.13) in girls increased risk to develop nonalcoholic fatty liver disease. Indeed it was verified a positive correlation between visceral fat, body mass index, insulin levels, homeostasis model assessment insulin resistance index and steatosis degree. CONCLUSIONS: Our findings suggested that the expansion of visceral fat was a determinant factor to increase nonalcoholic fatty liver disease prevalence and the visceral fat measured by ultrasound might be a good predictor to identify risk for nonalcoholic fatty liver disease in obese adolescents. It was confirmed by a stronger correlation between visceral fat and body mass index.
