Post-Graduate Program of Nutrition, Universidade Federal de São Paulo, SP, Brazil.
Clin Endocrinol (Oxf). 2013 Jul;79(1):55-64. doi: 10.1111/j.1365-2265.2012.04504.x. Epub 2013 Mar 25.
Obesity is a chronic disease defined by an excess amount of adipose tissue and presents a low-grade inflammatory state, increasing cardiovascular risk.
To assess the effect of weight loss magnitude on the inflammatory profile and carotid intima-media thickness (cIMT) in obese adolescents engaged in interdisciplinary therapy.
Seventy-seven postpubertal obese adolescents with a BMI greater than the 95th percentile (37·18 ± 5·14), of both genders and between the ages of 14 and 19 years (16·74 ± 1·59) were subjected to a 1-year period of interdisciplinary intervention (nutrition, psychology, physical exercise and clinical support).
Blood samples were collected to analyse glucose, lipid and adipokine concentrations. Body composition, anthropometric profiles and cIMT were measured. The results are presented according to quartiles of weight loss: 1st (≤5·80 kg) = low; 2nd (5·80-10·90 kg) = low to moderate; 3rd (10·90-15·90 kg) = moderate; and 4th (>15·90 kg) = massive.
Leptin, the leptin/adiponectin ratio and plasminogen activator inhibitor 1 (PAI-1) were decreased significantly in the low-to-moderate weight loss. The cIMT was reduced in the moderate weight loss. Moreover, adiponectin was increased only in the massive weight loss. Additionally, weight loss was an independent predictor of changes in leptin level, the adiponectin/leptin ratio (A/L ratio) and PAI-1 when the data were adjusted for age and gender. BMI changes were predictors of changes in leptin and PAI-1 levels. A/L ratio was associated with lean body mass (%), independent of gender and age. In addition, changes in A/L ratio were independent predictors of cIMT alterations.
Interdisciplinary therapy may reduce cardiovascular risk factors among adolescents depending on their degree of weight loss (moderate to massive) and when correlated with their inflammatory profile, metabolic state and cIMT.
肥胖是一种由脂肪组织过多引起的慢性疾病，表现为低度炎症状态，增加心血管风险。
评估在接受跨学科治疗的肥胖青少年中，体重减轻的幅度对炎症谱和颈动脉内膜中层厚度（cIMT）的影响。
77 名青春期后肥胖青少年，BMI 大于第 95 百分位数（37.18±5.14），男女不限，年龄 14-19 岁（16.74±1.59），接受为期 1 年的跨学科干预（营养、心理学、体育锻炼和临床支持）。
采集血样分析血糖、血脂和脂肪因子浓度。测量身体成分、人体测量学特征和 cIMT。结果按体重减轻的四分位数呈现：1 分位（≤5.80kg）=低；2 分位（5.80-10.90kg）=低到中度；3 分位（10.90-15.90kg）=中度；4 分位（>15.90kg）=大量。
低到中度体重减轻时，瘦素、瘦素/脂联素比值和纤溶酶原激活物抑制剂 1（PAI-1）显著降低。中度体重减轻时 cIMT 降低。此外，仅在大量体重减轻时，脂联素增加。此外，在调整年龄和性别后，体重减轻是瘦素水平、脂联素/瘦素比值（A/L 比值）和 PAI-1 变化的独立预测因子。BMI 变化是瘦素和 PAI-1 水平变化的预测因子。A/L 比值与瘦体重（%）相关，与性别和年龄无关。此外，A/L 比值的变化是 cIMT 改变的独立预测因子。
跨学科治疗可能会根据青少年的体重减轻程度（中度到大量）降低心血管风险因素，并且与炎症谱、代谢状态和 cIMT 相关。
