ESPE Abstracts (2016) 86 P-P1-489

Impact of a Group-based Treatment Program on Adipocytokines, Oxidative status, Inflammatory Cytokines, and Pulse Wave Velocity in Obese Children and Adolescents

Jeerunda Santiprabhoba, Kawewan Limprayoonb, Prapun Aanpreungc, Ratiya Charoensakdid, Ruchaneekorn W. Kalpravidhd, Benjaluck Phonrate & Rungsunn Tungtrongchitrf


aDivision of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; bDivision of Respiratory and Critical Care, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; cDivision of Gastroenterology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; dDepartment of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; eDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; fDepartment of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand


Background: The link between obesity and dysregulation of adipocytokines, inflammatory cytokines, and oxidative status has been found to underline the pathogenesis of obesity-related complications, such as cardiovascular disease and type 2 diabetes.

Objective and hypotheses: The objectives were i) to evaluate the effect of a group-based lifestyle modification program on adipocytokines, inflammatory cytokines, oxidative status, and brachial-ankle pulse wave velocity (ba-PWV) in obese youths and ii) to determine the relationship between changes in obesity, insulin resistance, cytokines, oxidative status, and ba-PWV. The hypothesis was weight reduction would result in improvement of adipocytokines, inflammatory cytokines, oxidative stress, and arterial stiffness.

Method: The 1-year weight reduction program included 126 obese youths. The intervention involved initial hospitalization and five out-patient group-based sessions for instruction on healthy lifestyle living. Measurements included anthropometric data, blood tests, body composition, and ba-PWV pre-and post-intervention.

Results: The study was completed by 115 participants. Percentage weight for height and percentage total fat decreased significantly (both P<0.001). High molecular weight (HMW) adiponectin increased (P<0.001), while leptin, interleukin 6 (IL-6), and high sensitivity C-reactive protein decreased significantly (all P<0.001). No significant change in oxidative status was detected. The ba-PWV decreased from baseline (P<0.001). Even participants without weight reduction had decreased levels of leptin (P=0.021), IL-6 (P=0.019), and ba-PWV (P=0.031). Change (Δ, before-after) in percentage weight for height was positively correlated with Δleptin (r=0.624, P<0.001) and Δhomeostasis model assessment of insulin resistance (HOMA-IR) (r=0.230, P=0.021). Change in HMW adiponectin was negatively correlated with Δpercentage total fat (r=−0.289, P=0.003). Changes in ba-PWV were positively correlated with Δplasma malondialdehyde (r=0.233, P=0.036) and ΔHOMA-IR (r=0.253, P=0.025).

Conclusion: A group-based healthy lifestyle program for obese youths had beneficial effects on adipocytokines, inflammatory process, and arterial stiffness. Participants without change in weight status also benefited. These improvements may reduce the risk of obese youths developing obesity-related complications.