Fonvig Cilius Esmann, Chabanova Elizaveta, Ohrt Johanne Dam, Nielsen Louise Aas, Pedersen Oluf, Hansen Torben, Thomsen Henrik S, Holm Jens-Christian
The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, 4300, Holbæk, Denmark.
The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Medical and Health Sciences, University of Copenhagen, 2100, Copenhagen Ø, Denmark.
BMC Pediatr. 2015 Dec 30;15:196. doi: 10.1186/s12887-015-0513-6.
Ectopic fat deposition in liver and skeletal muscle tissue is related to cardiovascular disease risk and is a common metabolic complication in obese children. We evaluated the hypotheses of ectopic fat in these organs could be diminished following 1 year of multidisciplinary care specialized in childhood obesity, and whether this reduction would associate with changes in other markers of metabolic function.
This observational longitudinal study evaluated 40 overweight children and adolescents enrolled in a multidisciplinary treatment protocol at the Children's Obesity Clinic, Holbæk, Denmark. The participants were assessed by anthropometry, fasting blood samples (HbA1c, glucose, insulin, lipids, and biochemical variables of liver function), and liver and muscle fat content assessed by magnetic resonance spectroscopy at enrollment and following an average of 12.2 months of care. Univariate linear regression models adjusted for age, sex, treatment duration, baseline degree of obesity, and pubertal developmental stage were used for investigating possible associations.
The standard deviation score (SDS) of baseline median body mass index (BMI) was 2.80 (range: 1.49-3.85) and the median age was 14 years (10-17). At the end of the observational period, the 40 children and adolescents (21 girls) significantly decreased their BMI SDS, liver fat, muscle fat, and visceral adipose tissue volume. The prevalence of hepatic steatosis changed from 28 to 20 % (p = 0.26) and the prevalence of muscular steatosis decreased from 75 to 45 % (p = 0.007). Changes in liver and muscle fat were independent of changes in BMI SDS, baseline degree of obesity, duration of treatment, age, sex, and pubertal developmental stage.
A 1-year multidisciplinary intervention program in the setting of a childhood obesity outpatient clinic confers a biologically important reduction in liver and muscle fat; metabolic improvements that are independent of the magnitude of concurrent weight loss.
ClinicalTrials.gov registration number: NCT00928473 , the Danish Childhood Obesity Biobank. Registered June 25, 2009.
肝脏和骨骼肌组织中的异位脂肪沉积与心血管疾病风险相关，是肥胖儿童常见的代谢并发症。我们评估了以下假设：经过1年专门针对儿童肥胖的多学科护理后，这些器官中的异位脂肪可能会减少，以及这种减少是否与代谢功能的其他标志物变化相关。
这项观察性纵向研究评估了40名在丹麦霍尔拜克儿童肥胖诊所参加多学科治疗方案的超重儿童和青少年。在入组时以及平均接受12.2个月护理后，通过人体测量、空腹血样（糖化血红蛋白、血糖、胰岛素、血脂和肝功能生化指标）以及磁共振波谱评估肝脏和肌肉脂肪含量对参与者进行评估。使用针对年龄、性别、治疗持续时间、基线肥胖程度和青春期发育阶段进行调整的单变量线性回归模型来研究可能的关联。
基线中位体重指数（BMI）的标准差评分（SDS）为2.80（范围：1.49 - 3.85），中位年龄为14岁（10 - 17岁）。在观察期结束时，40名儿童和青少年（21名女孩）的BMI SDS、肝脏脂肪、肌肉脂肪和内脏脂肪组织体积显著降低。肝脂肪变性的患病率从28%变为20%（p = 0.26），肌肉脂肪变性的患病率从75%降至45%（p = 0.007）。肝脏和肌肉脂肪的变化独立于BMI SDS、基线肥胖程度、治疗持续时间、年龄、性别和青春期发育阶段的变化。
在儿童肥胖门诊环境中进行的为期1年的多学科干预计划可使肝脏和肌肉脂肪在生物学上显著减少；代谢改善与同时体重减轻的幅度无关。
ClinicalTrials.gov注册号：NCT00928473，丹麦儿童肥胖生物银行。2009年6月25日注册。
