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Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme

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Abstract

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7–9 years (≥85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7–9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.

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Abbreviations

BMI:

Body mass index

BP:

Blood pressure

CDC:

Centers of Disease Control

CRP:

C-reactive protein

CVD:

Cardiovascular diseases

GT:

Group-based treatment

HDL:

High-density lipoprotein

HOMA-IR:

Homeostasis model assessment of insulin resistance

IT:

Individual treatment

MS:

Metabolic syndrome

SD:

Standard deviation

TG:

Triglycerides

WC:

Waist circumference

zBMI:

Standard deviation score of body mass index

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Acknowledgements

We thank the children and the parents who participated in the study. We also like to thank to the nurse Fernanda Gomes for assistance and to the endocrinologist Joana Guimarães for review and comments. This work was supported by a Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo/ABBOTT grant.

Conflict of interest

None.

Ethical standards

The research protocol was approved by the Ethics Committee of the Hospital Infante D. Pedro and informed consent was obtained from the children’s parents.

Author information

Authors and Affiliations

  1. Faculty of Nutrition and Food Sciences of University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal

    Carla Pedrosa, Bruno M. P. M. Oliveira, Maria Daniel Vaz-de-Almeida & Flora Correia

  2. Department of Endocrinology, Diabetes and Nutrition, Hospital Infante D. Pedro, EPE, Av Artur Ravara, 3814-501, Aveiro, Portugal

    Carla Pedrosa, Isabel Albuquerque & Carlos Simões-Pereira

  3. Department of Endocrinology, Hospital de S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Flora Correia

Authors
  1. Carla Pedrosa
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  2. Bruno M. P. M. Oliveira
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  3. Isabel Albuquerque
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  4. Carlos Simões-Pereira
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  5. Maria Daniel Vaz-de-Almeida
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  6. Flora Correia
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Correspondence to Carla Pedrosa.

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Pedrosa, C., Oliveira, B.M.P.M., Albuquerque, I. et al. Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme. Eur J Pediatr 170, 483–492 (2011). https://doi.org/10.1007/s00431-010-1316-2

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  • DOI: https://doi.org/10.1007/s00431-010-1316-2

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