ESPE Abstracts

Aim: to assess and follow-up neck circumference and its relationship with a metabolic score in patients with abdominal obesity after a lifestyle intervention.

Patients, Material and Methods: 122 children and adolescents with abdominal obesity, aged 7 to 16 years, were included in a control randomized intervention study (NCT031472). Abdominal obesity was diagnosed using the waist circumference. The intervention included an intensive phase during 2 months and follow-up at 12 and 24 months. Participants were divided in two groups: intervention and usual care. Intervention group was treated with hypocaloric Mediterranean diet and the usual care group with the standard recommendations from Community Nutrition Spanish Society, 2007. Both groups were advised to increase in 200 minutes per week their moderate-vigorous physical activity. Anthropometric parameters measured were: weight, height, body mass index (BMI), neck, waist, and hip circumferences, fat mass and fat-free mass, blood pressure was also determined. Biochemical parameters determined were: glucose, insulin, leptin, cholesterol and triglycerides. A metabolic syndrome score was calculated using the following formula: (2xwaist)/height + (glucose/5.6)+triglycerides/1.7 + (systolicBP/130)-HDL/1.02 (glucose, triglycerides and HDL in mmol/L).

Results: at onset, most of anthropometric and biochemical parameters were similar in both groups, except for glucose and leptin. Usual care group (n=30) had higher both glucose and leptin levels, than intervention group (n=84). Neck circumference significantly decreased (P<0.001) at 2 and 24 months in control group and at 2 months in the intervention group. The metabolic score improved significantly at 2 and 12 months in both groups. There were not significant differences between both groups. There was a highly significant association between the metabolic score and neck, waist and hip circumference (P<0.001). The decrease in both BMI-SDS and waist to hip ratio (WHR) was statistically significant at 2, 12 and 24 months in both groups. In the intervention group, fat mass percentage significantly decreased, at 2, 12 and 24 months; and at 2 and 12 months in the usual care group. Lean mass (Kg) significantly increased at 12 months.

Conclusions: in this intervention study, BMI-SDS, body composition improved significantly, likewise the metabolic score. All these favourable changes persisted at 12 and 24 months follow-up, in both groups, without finding relevant differences between them. The neck circumference was the parameter, which showed a higher statistically significant association with the metabolic score. Therefore, the neck circumference could be used as an indicator of metabolic risk in patients with obesity.