Effects of an interdisciplinary intervention on insulin resistance indicators in overweight and obese adolescents
Keywords:Obesity, Insulin Resistance, Uric acid, Adolescent, Intervention Studies
Introduction: Overweight children and adolescents are more susceptible to metabolic disorders. However, changes in lifestyle can prevent or delay the appearance of risk factors, highlighting the importance of intervening early in this population.
Objective: To analyze the effects of a six months interdisciplinary intervention program on the indicators of insulin resistance and uric acid levels in overweight and obese students.
Methods: This is an interventional study in overweight adolescents, composed of a control group (n=19) and an intervention group (n=20). The group participated in a six-month program with nutritional, psychological and physical exercise intervention, three times a week. The values of waist circumference, glucose, insulin, uric acid assessment and HOMA-IR index, were evaluated before and after the program.
Results: After 6 months, the intervention group had a significant reduction in waist circumference (p=0.007), HOMA-IR index (p=0.048) and uric acid (p=0.036); the control group did not present differences in the pre and post evaluation.
Conclusion: The intervention program was effective in reducing waist circumference, HOMA-IR and uric acid levels in overweight adolescents.
2. Lindström J, Neumann A, Sheppard KE, Gilis-Januszewska A, Greaves CJ, Handke U, et al. Take action to prevent diabetes: the image toolkit for the prevention of type 2 Diabetes in Europe. Horm Metab Res. 2010;42(Suppl 1):S37-55. DOI: https://doi.org/10.1055/s-0029-1240975
3. Reyes M, Gahagan S, Díaz E, Blanco E, Leiva L, Lera L, et al. Relationship of adiposity and insulin resistance mediated by inflammation in a group of overweight and obese Chilean adolescents. Nutr J. 2011;10: 4. DOI: https://doi.org/10.1186/1475-2891-10-4
4. The Healthy Study Group. A school-based intervention for diabetes risk reduction. N Engl J Med. 2010;363:443-53. DOI: https://doi.org/10.1056/NEJMoa1001933
5. Qiu Q, Gong Y, Liu X, Dou L, Wang Y, Wang B, et al. Serum Uric Acid and Impaired Glucose Tolerance: The Cardiometabolic Risk in Chinese (CRC) Study. Cell Biochem Biophys. 2015;73(1):155-162. DOI: https://doi.org/10.1007/s12013-015-0597-5
6. Blüher S, Petroff D, Wagner A, Warich K, Gausche R, Klemm T, et al. The one year exercise and lifestyle intervention program KLAKS: Effects on anthropometric parameters, cardiometabolic risk factors and glycemic control in childhood obesity. Metabolism. 2014; 63(3):422-30. DOI: https://doi.org/10.1016/j.metabol.2013.11.016
7. Calcaterra V, Larizza D, Codrons E, Silvestri A, Brambilla P, Abela S, et al. Improved metabolic and cardiorespiratory fitness during a recreational training program in obese children. J Pediatr Endocrinol Metab 2013;26(3-4):271-6. DOI: https://doi.org/10.1515/jpem-2012-0157
8. Park TG, Hong HR, Lee J, Kang HS. Lifestyle plus exercise intervention improves metabolic syndrome markers without change in adiponectin in obese girls. Ann Nutr Metab. 2007; 51(3):197-203. DOI: https://doi.org/10.1159/000104137
9. Zorba E, Cengiz T, Karacabey K. Exercise training improves body composition, blood lipid profile and serum insulin levels in obese children. J Sports Med Phys Fitness 2011;51(4):664-9.
10. K?l?nç FN, Ça?da? DN. Diet and physical activity interventions do have effects on body composition and metabolic syndrome parameters in overweight and obese adolescents and their mothers. Turk J Pediatr. 2013;55(3):292-9.
11. Uysal Y, Wolters B, Knop C, Reinehr T. Components of the metabolic syndrome are negative predictors of weight loss in obese children with lifestyle intervention. Clin Nutr. 2014; 33(4):620-5. DOI: https://doi.org/10.1016/j.clnu.2013.09.007
12. Chang C, Liu W, Zhao X, Li S, Yu C. Effect of supervised exercise intervention on metabolic risk factors and physical fitness in Chinese obese children in early puberty. Obes Rev. 2008;9(Suppl 1):135-41. DOI: https://doi.org/10.1111/j.1467-789X.2007.00455.x
13. Huang SH, Weng KP, Hsieh KS, Ou SF, Lin CC, Chien KJ, et al. Effects of a classroom-based weight-control intervention on cardiovascular disease in elementary-school obese children. Acta Paediatr Taiwan 2007;48(4):201-6.
14. Lira FS, Rosa JC, Pimentel GD, Santos RV, Carnier J, Sanches PL, et al. Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescentes. Nutr J. 2012;11:74. DOI: https://doi.org/10.1186/1475-2891-11-74
15. Savoye M, Shaw M, Dziura J, Tamborlane WV, Rose P, Guandalini C, et al. Effects of a weight management program on body composition and metabolic parameters in overweight children. JAMA. 2007;297(24):2697-2704. DOI: http://dx.doi.org/10.1016/j.clnu.2013.06.002
16. Hofsteenge GH, Chinapaw MJ, Delemarre-van Waal HA, Weijs PJ. Long-term effect of the Go4it group treatment for obese adolescents: a randomised controlled trial. Clin Nutr 2014; 33(3):385-91. DOI: http://dx.doi.org/10.1016/j.clnu.2013.06.002
17. Togashi K, Masuda H, Iguchi K. Effect of diet and exercise treatment for obese Japanese children on abdominal fat distribution. Res Sports Med 2010;18(1):62-70. DOI: http://dx.doi.org/10.1080/15438620903423924
18. Krzystek-Korpacka M, Patryn E, Kustrzeba-Wojcicka I, Chrzanowska J, Gamian A, Noczynska A. The effect of a one-year weight reduction program on serum uric acid in overweight/obese children and adolescents. Clin Chem Lab Med 2011;49(5):915-21. DOI: http://dx.doi.org/10.1515/CCLM.2011.130
19. World Health Organization (WHO). Growth reference data for 5-19 years. [internet] 2007. [cited 2020 May 12] Available from: http://www.who.int/growthref/en/.
20. Brambilla P, Pozzobon G, Pietrobelli A. Physical activity as the main therapeutic tool for metabolic syndrome in childhood. Int J Obes (Lond). 2011;35(1):16-28. DOI: http://dx.doi.org/10.1038/ijo.2010.255
21. Dietz P, Hoffmann S, Lachtermann E, Simon P. Influence of exclusive resistance training on body composition and cardiovascular risk factors in overweight or obese children: a systematic review. Obes Facts. 2012;5(4):546-60. DOI: http://dx.doi.org/10.1159/000341560
22. Mello MT, Piano A, Carnier J, Sanches Pde L, Corrêa FA, Tock L, et al. Long-term effects of aerobic plus resistance training on the metabolic syndrome and adiponectinemia in obese adolescents. J Clin Hypertens (Greenwich). 2011;13(5):343-50. DOI: http://dx.doi.org/10.1111/j.1751-7176.2010.00388.x
23. Blüher S, Molz E, Wiegand S, Otto KP, Sergeyev E, Tuschy S, et al. Body Mass Index, waist circumference, and waist-to-height ratio as predictors of cardiometabolic risk in childhood obesity depending on pubertal development. J Clin Endocrinol Metab. 2013;98(8): 3384–93. DOI: https://doi.org/10.1210/jc.2013-1389
24. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059-61. DOI: https://doi.org/10.1016/S0140-6736(07)60958-1
25. Maz?c?oglu MM, Hatipoglu N, Ozturk A, Cicek B, Ustunbas HB, Kurtoglu S. Waist circumference and mid-upper arm circumference in evaluation of obesity in children aged between 6 and 17 years. J Clin Res Pediatr Endocrinol. 2010;2(4):144-50. DOI: https://doi.org/10.4274/jcrpe.v2i4.144
26. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;(1): CD001872. DOI: http://dx.doi.org/10.1002/14651858.CD001872.pub2
27. Bordenave S, Brandou F, Manetta J, Fedou C, Mercier, J, Brun JF. Effects of acute exercise on insulin sensitivity, glucose effectiveness and disposition index in type 2 diabetic patients. Diabetes Metab. 2008;34(3):250-7. DOI: http://dx.doi.org/10.1016/j.diabet.2007.12.008
28. Li XH, Lin S, Guo H, Huang Y, Wu L, Zhang Z, et al. Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC Public Health 2014;14:1282. DOI: http://dx.doi.org/10.1186/1471-2458-14-1282