[机构收容或居家肥胖青少年身体成分和基础代谢率的纵向变化]

[Longitudinal changes in body composition and basal metabolic rate in institutionalized or domiciled obese adolescents].

作者信息

Lazzer S, Meyer M, Derumeaux H, Boirie Y, Vermorel M

机构信息

Unité d'étude du métabolisme protéinoénergétique, centre de recherche en nutrition humaine, Inra, université d'Auvergne, CRNH, 63001 Clermont-Ferrand, France.

出版信息

Arch Pediatr. 2005 Sep;12(9):1349-57. doi: 10.1016/j.arcped.2005.04.077.

DOI:10.1016/j.arcped.2005.04.077

PMID:15946831

Abstract

UNLABELLED

The prevalence of obesity in children has increased dramatically during the past decades, and requires efficient care.

OBJECTIVES

To determine changes in anthropometric parameters and basal metabolic rate (BMR) in obese adolescents during and after 2 types of weight-reduction programs.

SUBJECTS AND METHODS

Twenty-six adolescents (group I, Z-score of BMI = 4.72) followed a 9-month-weight reduction program including a moderate energy restriction and regular physical activities in a specialized institution. In addition, 39 adolescents (group E, Z-score of BMI = 2.83) followed at home a 9-month-weight reduction program including medical and dietetic advices. Body composition (by impedancemetry) and BMR (by indirect calorimetry) were assessed before the beginning (M0), 4 months after (M4) and at the end (M9) of the programs, then 4 months (M13) and 16 month (M25) after the end of the weight-reduction programs.

RESULTS

Twenty-two adolescents in group I and 20 adolescents in group E completed the study. At M0, age, body weight (BW), fat-free mass (FFM) and BMR of subjects of group I were higher (1.0 year, 36 %, 30 % and 23 %, respectively, P < 0.001), than those of group E. Pubertal stage and percentage of fat mass (FM) were not significantly different between the 2 groups. At M9, adolescents of group I showed significant reductions in BW and FM (-19 and -37 %, respectively, P < 0.001), but not significant differences in FFM. In addition, BMR decreased significantly between M0 and M4, both in absolute value (-6.7%, P < 0.001) and after adjustment for FFM (-5.8%, P < 0.001), and the difference was maintained until M9. Between M9 and M13, BW and Z-score of BMI were maintained in 12 adolescents, but increased (+9.7% and 14.8%, respectively, P < 0.001) in 10 adolescents. However, BMR did not change significantly in all adolescents. Between M13 and M25, BW, FM, FFM and BMR increased significantly (+13%, +34%, +6% et +5%, respectively, P < 0.001). During the 25 month period, adolescents of group E showed significant increases in BW, FFM and BMR (+8%, +14% and +10%, respectively, P < 0.001), and maintained their Z-score and FM.

CONCLUSION

The reduction in BMR during the weight-reduction program at the institution could contribute to body weight regain in the post-obese adolescents if they do not maintain the lifestyle habits taught during the weight-reduction period. In other respects, Z-score was stabilized in 51% of domiciled obese adolescents.

摘要

未标注

在过去几十年中，儿童肥胖的患病率急剧上升，需要有效的治疗。

目的

确定两种减肥方案期间及之后肥胖青少年人体测量参数和基础代谢率（BMR）的变化。

对象与方法

26名青少年（I组，BMI的Z评分=4.72）在一家专业机构参加了为期9个月的减肥计划，包括适度的能量限制和规律的体育活动。此外，39名青少年（E组，BMI的Z评分=2.83）在家中参加了为期9个月的减肥计划，包括医学和饮食建议。在计划开始前（M0）、4个月后（M4）和结束时（M9），然后在减肥计划结束后4个月（M13）和16个月（M25）评估身体成分（通过阻抗测量法）和BMR（通过间接量热法）。

结果

I组的22名青少年和E组的20名青少年完成了研究。在M0时，I组受试者的年龄、体重（BW）、去脂体重（FFM）和BMR高于E组（分别高1.0岁、36%、30%和23%，P<0.001）。两组的青春期阶段和脂肪量（FM）百分比无显著差异。在M9时，I组青少年的BW和FM显著降低（分别降低19%和37%，P<0.001），但FFM无显著差异。此外，在M0和M4之间，BMR绝对值显著下降（-6.7%，P<0.001），在调整FFM后也下降（-5.8%，P<0.001），且差异一直维持到M9。在M9和M13之间，12名青少年的BW和BMI的Z评分保持稳定，但10名青少年增加（分别增加9.7%和14.8%，P<0.001）。然而，所有青少年的BMR没有显著变化。在M13和M25之间，BW、FM、FFM和BMR显著增加（分别增加13%、34%、6%和5%，P<0.001）。在25个月期间，E组青少年的BW、FFM和BMR显著增加（分别增加8%、14%和10%，P<0.001），并维持其Z评分和FM。