A multidisciplinary intervention in childhood obesity acutely improves insulin resistance and inflammatory markers independent from body composition

Abstract: Childhood obesity is an increasing health care problem associated with insulin resistance and low-level systemic inflammation, which can ultimately lead to diabetes. Evidence for efficacy of therapeutic intervention programs on the early development of obesity associated sequelae is moderate. This paper investigates the effect of a multidisciplinary short-term intervention program on insulin resistance and metaflammation in childhood obesity. Two hundred and 36 overweight or obese children and adolescents between the ages of 10 and 14 were included in a prospective 5 months intervention study, which included sports, psychotherapy, and nutritional counseling. Primary endpoints were the effects on body mass index standard deviation score (BMI-SDS) and homeostatic model assessment of insulin resistance (HOMA-IR), key secondary endpoints were the levels of C-reactive protein (CRP), leptin, and adiponectin. At baseline, a substantial proportion of participants showed signs of insulin resistance (mean HOMA-IR 5.5 ± 3.4) despite not meeting the diagnostic criteria for diabetes, and low-level inflammation (mean CRP 3.9 mg/l ± 3.8 mg/l). One hundred and 95 participants (83%) completed the program resulting in a significant reduction in BMI-SDS, HOMA-IR, CRP, and leptin and a significant increase in adiponectin (mean change compared to baseline −0.14, −0.85, −1.0 mg/l, −2.8 ng/ml, and 0.5 μg/ml, respectively; p < 0.001 each). Effects on BMI-SDS, HOMA-IR, CRP, and adiponectin were largely independent whereas leptin was positively correlated with BMI-SDS and total fat mass before and after intervention (r = 0.56 and 0.61, p < 0.001 each). Short-term multidisciplinary intervention successfully improved body composition, insulin sensitivity, low-level systemic inflammation, and the adipokine profile in childhood obesity. Our findings highlight the immediate connection between obesity and the pathophysiology of its sequelae, and emphasize the importance of early intervention. Continued lifestyle modification is likely necessary to consolidate and augment the long-term effects

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch
Notes
Frontiers in pediatrics. - 8 (2020) , ISSN: 2296-2360

Keyword
Fettsucht
Insulinresistenz
Entzündung
Body-Mass-Index
Adipokine

Event
Veröffentlichung
(where)
Freiburg
(who)
Universität
(when)
2020
Creator
Mayerhofer, Ernst
Ratzinger, Franz
Kienreich, Nina
Stiel, Annika
Witzeneder, Nadine
Schrefl, Eva
Greiner, Georg
Wegscheider, Christoph
Graf, Irene
Schmetterer, Klaus
Marculescu, Rodrig
Szekeres, Thomas
Perkmann, Thomas
Fondi, Martina
Wagner, Oswald
Esterbauer, Harald
Mayerhofer, Matthias
Holocher-Benetka, Stefana
Wojnarowski, Claudia
Hoermann, Gregor

DOI
10.3389/fped.2020.00052
URN
urn:nbn:de:bsz:25-freidok-1661244
Rights
Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
14.08.2025, 10:59 AM CEST

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Associated

  • Mayerhofer, Ernst
  • Ratzinger, Franz
  • Kienreich, Nina
  • Stiel, Annika
  • Witzeneder, Nadine
  • Schrefl, Eva
  • Greiner, Georg
  • Wegscheider, Christoph
  • Graf, Irene
  • Schmetterer, Klaus
  • Marculescu, Rodrig
  • Szekeres, Thomas
  • Perkmann, Thomas
  • Fondi, Martina
  • Wagner, Oswald
  • Esterbauer, Harald
  • Mayerhofer, Matthias
  • Holocher-Benetka, Stefana
  • Wojnarowski, Claudia
  • Hoermann, Gregor
  • Universität

Time of origin

  • 2020

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