Orlistat improves endothelial function in obese adolescents: a randomised trial.

AIM: To investigate the effect of orlistat on endothelial function in obese adolescents. METHODS: Single-blind 10-week controlled trial of 67 normolipidaemic obese adolescents randomised into three groups. Group 1 (diet alone), Group 2 (diet and orlistat), Group 3 (diet, orlistat and exercise). Endothelial function measured by flow-mediated dilatation (FMD) of the brachial artery, anthropometric parameters, blood pressure, fasting blood lipids, insulin and glucose levels were recorded at baseline and at 10 weeks. RESULTS: Sixty four subjects completed the study. Groups were comparable at baseline. FMD increased significantly with orlistat (Groups 2 and 3) but not in Group 1. Orlistat treatment resulted in significantly reduced bodyweight, body mass index (BMI), waist circumference, total and low-density lipoprotein (LDL) cholesterol levels. High-density lipoprotein cholesterol levels were unchanged. Triglyceride and insulin levels were significantly reduced in all three groups. The reduction in cholesterols did not correlate with reductions in weight and BMI. A slight reduction of body fat, both with and without orlistat treatment, correlated with reduction in BMI after adjustment for baseline values. Blood pressure was unaltered by orlistat. Calorie intake was reduced with orlistat, and the decrease noted in % fat and increase in % carbohydrate was significant only in those taking orlistat. The addition of exercise (Group 3 compared with Group 2) altered no parameter. CONCLUSIONS: Orlistat improves endothelial function and reduces bodyweight, BMI, fasting total and LDL-cholesterol in obese adolescents when combined with dietary control. Improvement in endothelial function if maintained could reflect long-term cardiovascular benefit.

[Waist circumference distribution of Chinese school-age children and adolescents].

OBJECTIVE: To study the distribution of waist circumference (WC) in a representative group of Chinese children for establishing the Chinese WC cut-off points. METHODS: Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 178 865 children and adolescents, aged 7 - 18 years-old in total. All subjects were divided into five regional groups-costal city, non-coastal city, northern rural, southern rural, and Hong Kong, for analyzing the distribution of WC. RESULTS: Large variations in WC distribution were found among Netherlands demonstrated the necessity of setting up China's own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using the LMS method. CONCLUSION: Data obtained from this study could be used to develop the national WC cutoff points for Chinese children and adolescents.

[Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents aged 7 - 18 years].

OBJECTIVE: To explore the optimal threshold values of waist circumference (WC) in detecting the risk on cardiovascular (CV) among the Chinese children and adolescents. METHODS: Association of WC and CV risk factors were studied among 65 898 children and adolescents aged 7 - 18 years whose data were pooled from nine studies carried out in China. Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting the CV risk factors. RESULTS: A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, and at the 90th percentiles it could detect at least two of the above three CV risk factors. In comparison with children whose waist circumference was below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between 75th and 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing remained significant with waist circumference after having been stratified by BMI category. CONCLUSION: The 75th and the 90th percentile of WC appeared to be the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents.