Gajewska Joanna, Weker Halina, Ambroszkiewicz Jadwiga, Chełchowska Magdalena, Więch Małgorzata, Laskowska-Klita Teresa
Screening Department, Institute of Mother and Child, Warsaw.
Med Wieku Rozwoj. 2011 Jul-Sep;15(3):298-305.
It is widely recognized that lifestyle intervention with modification of dietary habits and physical activity is effective in weight reduction and may improve the biochemical parameters in obese children and adolescents. However, the levels of adiponectin multimeric complexes during lifestyle intervention have not been extensively studied in obese children.
The aim of this study was to investigate the effect of the 3-months weight-reduction programme on serum adiponectin multimeric complexes in obese prepubertal children.
Changes in clinical, anthropometric and metabolic parameters including total adiponectin and its multimeric forms were assessed in 30 obese children aged 4-10 years, after a 3-months lifestyle intervention programme. This programme consisted of dietary and physical activity modifications and behaviour therapy including individual psychological care for the child and its family. The recommended daily intake from low-energy diet was 1200-1400 kcal/day. The reference group consisted of 35 healthy normal-weight children. Concentration of serum total adiponectin (Total-A) and its multimeric complexes: low molecular weight (LMW) adiponectin, medium molecular weight (MMW) adiponectin and high molecular weight (HMW) adiponectin were measured by ELISA kit.
We observed that the concentrations of total adiponectin and HMW adiponectin were 25% (p<0.01) and 45% (p<0.0001) lower respectively, in obese children compared to controls. HMW/ Total-A ratio was lower in the obese children than in the controls (p<0.001), whereas LMW/Total-A ratio was higher in the obese as compared to the normal-weight children (p<0.001). After 3-months therapy the increases of total adiponectin concentration (by 20%, p<0.001), HMW (by 25%, p<0.001) and MMW adiponectin (by 30%, p<0.05) were recorded in these patients in comparison to baseline values. The increase of HMW/Total-A ratio (p<0.05) and the decrease of LMW/Total-A ratio (p<0.05) were also found in obese patients after weight-reduction programme as compared to the level before therapy. After modification of the diet and physical activity, the BMI of the obese children declined by 10% (p<0.01).
Our results indicate that the weight loss in children after 3-months therapy is associated with the increase of total and HMW, MMW adiponectin concentration. This suggests that the intervention programme is sufficient to detect significant changes in adiponectin multimeric profile, which confirms the efficacy of this therapy in prepubertal obese children.
人们普遍认识到，通过改变饮食习惯和进行体育活动来进行生活方式干预，对减轻体重有效，并且可能改善肥胖儿童和青少年的生化指标。然而，在肥胖儿童的生活方式干预过程中，脂联素多聚体复合物的水平尚未得到广泛研究。
本研究的目的是调查为期3个月的减重计划对肥胖青春期前儿童血清脂联素多聚体复合物的影响。
在一项为期3个月的生活方式干预计划后，对30名4至10岁的肥胖儿童的临床、人体测量和代谢参数变化进行了评估，包括总脂联素及其多聚体形式。该计划包括饮食和体育活动调整以及行为疗法，包括对儿童及其家庭的个体心理护理。低能量饮食的推荐每日摄入量为1200 - 1400千卡/天。对照组由35名健康的正常体重儿童组成。通过酶联免疫吸附测定试剂盒测量血清总脂联素（Total - A）及其多聚体复合物的浓度：低分子量（LMW）脂联素、中分子量（MMW）脂联素和高分子量（HMW）脂联素。
我们观察到，与对照组相比，肥胖儿童的总脂联素和HMW脂联素浓度分别低25%（p<0.01）和45%（p<0.0001）。肥胖儿童的HMW/Total - A比值低于对照组（p<0.001），而与正常体重儿童相比，肥胖儿童的LMW/Total - A比值更高（p<0.001））。经过3个月治疗后，与基线值相比，这些患者的总脂联素浓度增加了20%（p<0.001），HMW脂联素增加了25%（p<0.001），MMW脂联素增加了30%（p<0.05）。与治疗前水平相比，肥胖患者在减重计划后还发现HMW/Total - A比值增加（p<0.05），LMW/Total - A比值降低（p<0.05）。在调整饮食和体育活动后，肥胖儿童的体重指数下降了10%（p<0.01）。
我们的结果表明，3个月治疗后儿童体重减轻与总脂联素、HMW脂联素和MMW脂联素浓度增加有关。这表明该干预计划足以检测脂联素多聚体谱的显著变化，证实了该疗法对青春期前肥胖儿童的疗效。
