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Objective: This study was to investigate the developmental characteristics of executive function (EF) in obese adolescents and the time-course effects of a 14-week exercise intervention combining aerobic exercise and resistance training on EF in this population. Methods: The experimental group of 28 obese junior high school students participated in the exercise intervention combining aerobic exercise and resistance training, while the control group of 24 healthy weight junior high school students engaged in the regular recess exercise. EF, including inhibition, working memory, and cognitive flexibility, was assessed 1 week prior to the exercise intervention and at 12 and 14 weeks post-intervention. Changes in EF sub-functions in both groups at different time points during the exercise intervention were analyzed. Results: The findings revealed that obese junior high school students exhibited lower levels of inhibition (p = 0.003, Cohen's d = 0.848) and cognitive flexibility (p = 0.013, Cohen's d = 0.706) compared to their healthy weight peers. The exercise intervention combining aerobic exercise and resistance training led to significant improvements in EF among obese junior high school students, with inhibition (p < 0.01, Cohen's d = 0.713; p = 0.003, Cohen's d = 0.683) and cognitive flexibility (p = 0.001, Cohen's d = 0.797; p < 0.01, Cohen's d = 0.890) showing significant improvement at 12 and 14 weeks post-intervention, and working memory demonstrating significant improvement at 14 weeks (p = 0.004, Cohen's d = 0.710). No significant differences were observed in EF over time in healthy weight junior high school students. Conclusion: Obese adolescents had impaired EF, as evidenced by low levels of the inhibition and cognitive flexibility compared to healthy weight adolescents. The exercise intervention combining aerobic exercise and resistance training had a positive effect on EF of obese adolescents. The time-course effects of the intervention on improvements in inhibition, working memory, and cognitive flexibility varied with intervention duration in obese adolescents, with significant changes in inhibition and cognitive flexibility observed at 12 weeks and significant changes in working memory at 14 weeks. [ABSTRACT FROM AUTHOR]

Abstract It is known that telomere length (TL) (evaluated with T/S ratio) is shortened in the presence of obesity. In this study, we aimed to investigate how obesity in adolescents and non-alcoholic liver disease (NAFLD) within the obese group affect TL and the clinical significance of the human telomerase reverse transcriptase (hTERT) gene MNS16A VNTR variant in terms of NAFLD. Adolescents with exogenous obesity and healthy controls (aged 10–19 years) who applied to our adolescent outpatient clinic between May-October 2023 were included in this study. We performed upper abdominal ultrasonography to investigate the presence of NAFLD in adolescents with obesity and divided into two groups: those without hepatosteatosis (obese NAFLD (-)) and those with hepatosteatosis (obese NAFLD (+)). We recorded body weight, height, waist circumference, and blood pressure measurements and measured the T/S ratio (telomere sequence copy number/gene single copy number) by the Quantitative Polymerase Chain Reaction method. The groups were compared using frequentist and Bayesian methods. Eighty-three obese adolescents [63 NAFLD(+) 20 NAFLD(-)] and 69 lean controls were included in the study. Pairwise comparisons revealed that T/S ratio was significantly lower in the obese NAFLD (-) group than the obese NAFLD (+) and the control group (p = 0.025, p = 0.007, respectively). T/S ratio was lower in the LL allele group than in the other alleles (p = 0.022) and slightly higher in the obese group with metabolic syndrome compared to the obese group without metabolic syndrome (p = 0.072). hTERT-MNS16A-VNTR gene variant LL allele had a negative correlation with T/S ratio among the obese adolescent group. Patients with LL alleles had higher ALT, GGT, HOMA-IR, and ALT/AST. Diastolic blood pressure had a significant correlation with the T/S ratio. The T/S ratio was shorter in the obese adolescent group compared to healthy ones but was higher in the NAFLD (+) obese compared to the NAFLD (-) obese. ALT level and ALT/AST ratio were higher, T/S ratio was lower in the hTERT MNS16A VNTR variant LL allele group among obese adolescents. In addition, there was a significant correlation between the T/S ratio and diastolic blood pressure in obese adolescents.

Objective: This study was to investigate the developmental characteristics of executive function (EF) in obese adolescents and the time-course effects of a 14-week exercise intervention combining aerobic exercise and resistance training on EF in this population. Methods: The experimental group of 28 obese junior high school students participated in the exercise intervention combining aerobic exercise and resistance training, while the control group of 24 healthy weight junior high school students engaged in the regular recess exercise. EF, including inhibition, working memory, and cognitive flexibility, was assessed 1 week prior to the exercise intervention and at 12 and 14 weeks post-intervention. Changes in EF sub-functions in both groups at different time points during the exercise intervention were analyzed. Results: The findings revealed that obese junior high school students exhibited lower levels of inhibition (p = 0.003, Cohen's d = 0.848) and cognitive flexibility (p = 0.013, Cohen's d = 0.706) compared to their healthy weight peers. The exercise intervention combining aerobic exercise and resistance training led to significant improvements in EF among obese junior high school students, with inhibition (p < 0.01, Cohen's d = 0.713; p = 0.003, Cohen's d = 0.683) and cognitive flexibility (p = 0.001, Cohen's d = 0.797; p < 0.01, Cohen's d = 0.890) showing significant improvement at 12 and 14 weeks post-intervention, and working memory demonstrating significant improvement at 14 weeks (p = 0.004, Cohen's d = 0.710). No significant differences were observed in EF over time in healthy weight junior high school students. Conclusion: Obese adolescents had impaired EF, as evidenced by low levels of the inhibition and cognitive flexibility compared to healthy weight adolescents. The exercise intervention combining aerobic exercise and resistance training had a positive effect on EF of obese adolescents. The time-course effects of the intervention on improvements in inhibition, working memory, and cognitive flexibility varied with intervention duration in obese adolescents, with significant changes in inhibition and cognitive flexibility observed at 12 weeks and significant changes in working memory at 14 weeks. [ABSTRACT FROM AUTHOR]

Objective: Irisin is a myokine that has a beneficial effect on obesity by increasing energy expenditure. The aim of this study was to compare the effect of exercise intensity on serum irisin levels and lipid profile in obese adolescents. Materials and Methods: Forty-six male students with an average age of 13.43 ± 0.77 years; height 163.18 ± 23 cm, weight 85.84 ± 8.46 kg, body fat percentage 37.001 ± 4.508 were randomly assigned to three groups: low-intensity activity (experimental 1), high-intensity activity (experimental 2), and control. The training program in experimental group 1 included running at 45-60% heart rate reserve intensity, and in experimental group 2, it was similar to group 1 along with combined exercises at 60-75% heart rate reserve intensity, performed 4 sessions per week for 10 weeks. A paired t-test was used to examine within-group differences, and Mixed ANOVA was used to examine between-group differences. All tests were conducted at a significance level of 0.05 using SPSS22 software. Results: The findings indicated a significant decrease in serum irisin levels in both experimental groups 1 and 2 (p < 0.001). Additionally, weight, body fat percentage, and low-density lipoprotein significantly decreased in both experimental groups. Cholesterol and LDL/HDL ratio only significantly decreased in the high-intensity group. Conclusion: Considering the impact of exercise at both intensities on weight, body fat percentage, and irisin levels, regular physical activity is recommended for adolescents. [ABSTRACT FROM AUTHOR]

Introduction: This study explores the relationship between perceived school climate and exercise behavior among obese adolescents, as well as the multiple mediating effects of perseverance qualities and exercise benefits. Methods: A survey was conducted on 586 obese adolescents in Beijing, with an age range of 13-18 years old and an average age of 15.40 ± 1.824, among who 337 were male, 249 were female, 303 were high school students and 238 were middle school students. A standard scale was used to evaluate perceived school climate, exercise benefits, perseverance qualities, and exercise behaviors. The data was analyzed by independent samples t-test, bivariate correlation analysis, descriptive statistical analysis, and structural equation model (SEM). Results: (1) Perceived school climate among obese adolescents positively predicted exercise behavior (Z = 2.870, p < 0.01), perseverance qualities (Z = 3.107, p < 0.01) and exercise benefits (Z = 4.290, p < 0.001); perseverance qualities positively predicted exercise behavior in obese adolescents (Z = 4.431, p < 0.001); exercise benefits positively predicted the obese adolescents' exercise behavior (Z = 4.267, p < 0.001). (2) Perseverance qualities (Z = 2.282, 95% CI [0.032, 0.191], [0.028, 0.179]) and exercise benefits (Z = 2.518, 95% CI [0.060, 0.287], [0.053, 0.271]) play a mediating role in the obese adolescents' perceived school climate and exercise behavior, respectively. These two factors have parallel multiple mediating effects between obese adolescents' perceived school climate and exercise behavior, with mediating effects accounting for 16 and 25%, respectively. The mediating effect of exercise benefits is greater than that of perseverance qualities. (3) There is no difference in the specific indirect effects of perseverance qualities and exercise benefits (Z = -0.800, 95% CI [- 0.198, 0.064], [-0.190, 0.068]). Conclusion: Obese adolescents' perception of school climate can effectively enhance their motivation to participate in exercise behavior and indirectly influence exercise behavior through exercise benefits and perseverance qualities, cultivate good physical exercise behavior among obese adolescents, and effectively prevent and intervene in the occurrence of obesity. [ABSTRACT FROM AUTHOR]

Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P <.05), waist-to-hip ratio (WHR) (OR = 1.258; P <.05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P <.01), diastolic blood pressure (DBP) (OR = 1.304; P <.01), and HRR values (OR = 0.892; P <.05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism. [ABSTRACT FROM AUTHOR]

Background: Adolescent obesity is associated with impaired inhibitory control. Acute exercise can improve executive function. However, due to the influence of exercise intensity, cognitive test timing, and cardiorespiratory fitness (CF) level, the most effective exercise program remains controversial. Methods: The current study investigated the time-course effects of moderateintensity continuous exercise (MICE) and high-intensity interval exercise (HIIE) on inhibitory control (Stroop) and task-related heart rate variability (HRV) in adolescents with different CF. A mixed experimental design of 2 CF levels (high CF, HCF; low CF, LCF) × 3 exercise methods (MICE, HIIE, CON) × 3 test timing (pre, post-0, post-20) was adopted. Heart rate variability (HRV) and Stroop task tests were conducted before exercise (pre), immediately after exercise (post-0), and 20 min after exercise (post-20). Results: Individuals with HCF exhibited a positive decrease in Stroop response time immediately and 20 min after MICE and HIIE, compared to pretest response times (RT). Conversely, individuals with LCF showed a slight increase in Stroop task (RT) only immediately after HIIE. All individuals had a slight increase in ACC after MICE and HIIE compared to before exercise. In addition, compared with the control group, the time-domain index (the square root of the mean squared differences of successive NN intervals, RMSSD) of HRV was significantly decreased, the frequency-domain index (the absolute power of the Low-Frequency band/the absolute power of the High-Frequency band ratio, LF/HF) was significantly increased after MICE and HIIE, and the effect of HIIE on RMSSD and LF/HF was significantly greater than that of MICE. Conclusion: The current study found that the acute effects of MICE and HIIE on inhibitory control in obese adolescents were influenced by the interaction of cognitive test timing and cardiorespiratory fitness. Individuals with high cardiorespiratory fitness performed better on the Stroop task than individuals with low cardiorespiratory fitness. The inhibitory control of HIIE in highcardiorespiratory obese adolescents produced positive effects similar to those in MICE but more lasting, suggesting that HIIE is more beneficial for highcardiorespiratory obese adolescents. MICE promoted inhibitory control in obese adolescents with low cardiorespiratory fitness, but HIIE impaired inhibitory control in obese adolescents with low cardiorespiratory fitness immediately after exercise, suggesting that low cardiopulmonary fitness obese adolescents may be suitable for MICE rather than HIIE exercise intervention. The shift from balanced HRV to sympathetic dominance after acute exercise reflects increased arousal levels and may be one of the underlying mechanisms by which acute exercise brings benefits to executive function. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aims to screen for measures and lipid-derived indicators associated with insulin resistance (IR) in obese children and adolescents and develop a nomogram model for predicting the risk of insulin resistance. Methods A total of 404 eligible obese children and adolescents aged 10–17 years were recruited for this study from a summer camp between 2019 and 2021. The risk factors were screened using the least absolute shrinkage and selection operator (LASSO)-logistic regression model, and a nomogram model was developed. The diagnostic value of the model was evaluated by plotting the receiver operator characteristic curve and calculating the area under the curve. Internal validation was performed using the Bootstrap method, with 1000 self-samples to evaluate the model stability. The clinical applicability of the model was assessed by plotting the clinical decision curve. Results On the basis of the LASSO regression analysis results, three lipid-related derivatives, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were finally included in the IR risk prediction model. The nomogram model AUC was 0.804 (95% CI: 0.760 to 0.849). Internal validation results show a C-Index of 0.799, and the mean absolute error between the predicted and actual risks of IR was 0.015. The results of the Hosmer–Lemeshow goodness-of-fit test show a good model prediction (χ2 = 9.523, P = 0.300). Conclusion Three early warning factors, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were screened, which can effectively predict the risk of developing IR in obese children and adolescents, and the nomogram model has an eligible diagnostic value.

One hour plasma glucose (1-hr PG) concentration during an oral glucose tolerance test (OGTT) is steadily emerging as an independent predictor of type 2 diabetes (T2D). Methods: We applied the current cut off thresholds reported in the pediatric literature for the 1-hr PG, 132.5 (7.4 mmol/l) and 155 mg/dL (8.6 mmol/l) during an OGTT, to report abnormal glucose tolerance (AGT) using ROC curve analyses. We determined the empirical optimal cut point for 1-hr PG for our multi ethnic cohort using the Youden Index. Results: About 1-hour and 2-hours plasma glucose showed the highest predictive potential based on Areas under the curve (AUC) values of 0.91 [CI: 0.85, 0.97] and 1 [CI: 1, 1], respectively. Further comparison of the ROC curves of the 1-hour and 2-hour PG measurements as predictors of an abnormal OGTT showed that their associated AUCs differed significantly (X 2(1) = 9.25, P <.05). Using 132.5 mg/dL as the cutoff point for plasma glucose at 1-hour yielded a ROC curve with an AUC of 0.796, a sensitivity of 88%, and a specificity of 71.2%. Alternatively, the cutoff point of 155 mg/dL resulted in a ROC AUC of 0.852, a sensitivity of 80%, and a specificity of 90.4%. Conclusion: Our cross-sectional study affirms that the 1-hr PG can identify obese children and adolescents at increased risk for prediabetes and/or T2D with almost the same accuracy as a 2-hr PG. In our multi-ethnic cohort, a 1-hr PG ⩾ 155 mg/dL (8.6 mmol/l) serves as an optimal cut-point, using the estimation of the Youden index with AUC of 0.86 and sensitivity of 80%.We support the petition to consider the 1-hr PG as integral during an OGTT, as this adds value to the interpretation of the OGTT beyond the fasting and 2-hr PG. [ABSTRACT FROM AUTHOR]

Purpose The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE. Methods This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE. Results Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (P

Objective: This study aims to screen for measures and lipid-derived indicators associated with insulin resistance (IR) in obese children and adolescents and develop a nomogram model for predicting the risk of insulin resistance. Methods: A total of 404 eligible obese children and adolescents aged 10–17 years were recruited for this study from a summer camp between 2019 and 2021. The risk factors were screened using the least absolute shrinkage and selection operator (LASSO)-logistic regression model, and a nomogram model was developed. The diagnostic value of the model was evaluated by plotting the receiver operator characteristic curve and calculating the area under the curve. Internal validation was performed using the Bootstrap method, with 1000 self-samples to evaluate the model stability. The clinical applicability of the model was assessed by plotting the clinical decision curve. Results: On the basis of the LASSO regression analysis results, three lipid-related derivatives, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were finally included in the IR risk prediction model. The nomogram model AUC was 0.804 (95% CI: 0.760 to 0.849). Internal validation results show a C-Index of 0.799, and the mean absolute error between the predicted and actual risks of IR was 0.015. The results of the Hosmer–Lemeshow goodness-of-fit test show a good model prediction (χ2 = 9.523, P = 0.300). Conclusion: Three early warning factors, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were screened, which can effectively predict the risk of developing IR in obese children and adolescents, and the nomogram model has an eligible diagnostic value. [ABSTRACT FROM AUTHOR]

Emotional eating is when the food is eaten to satisfy one's feelings instead of satisfying hunger. This study aims to assess emotional eating on obese and non-obese adolescents. Non-experimental, Comparative research approach was used to achieve the objectives of the study. Researcher selected 120 adolescents studying in university by using Non probability purposive sampling technique. Result represents that Emotional eating is significantly found higher among obese individuals. Comparison of emotional eating among obese and non-obese adolescents was tested by using unpaired t test with t=5.869 at df=238 and p=0.001 indicates statistically significant at p<0.05. In this study significant difference in emotional eating among obese and non-obese adolescents with clear indication of high mean score of emotional eating in obese 43.84 in compared to 33.40 mean emotional eating score of non-obese with a mean difference of 10.44. Further findings revealed that Gender of obese adolescents was significantly associated with emotional eating at p<0.05 level of significance. Analyzing and evaluating the data collected and by comparing this to obese and non-obese adolescents, researcher found that in obese adolescents emotional eating is higher which suggests link between emotional eating and obesity. [ABSTRACT FROM AUTHOR]

Objective: In order to examine the effect of 4-week combinatorial intervention with exercise training and dietary restriction on serum fatty acids, and to explore the correlation of intervention-induced improvement of serum fatty acid profile with the reduction of body fat and arterial stiffness. Methods: Thirty-three obese adolescents were randomized into the intervention (n = 19) and control (n = 14) groups. The participants from the intervention group were subjected to 4-week combinatorial intervention with exercise training and dietary restriction while the participants from the control group maintained regular activities and diet habits. Anthropometry, serum fatty acids and arterial stiffness were measured before and after 4-week intervention. Results: The participants upon combinatorial intervention revealed the improved body compositions and serum fatty acid profile, and reduced arterial stiffness when compared with their basal levels and the control participants (p < 0.05). Moreover, the decrease in myristic acid, stearic acid, arachidic acid, behenic acid, palmitoleic acid, and dihomo-γ-linolenic acid, was associated with the reduction in body fat. A positive correlation between arachidonic acid and left brachial ankle pulse velocity was observed, and the increase in docosahexaenoic acid was associated with the reduction of left brachial ankle pulse wave velocity and the enhancement of right ankle brachial index. Conclusion: The 4-week combinatorial intervention is a useful strategy to improve serum fatty acid profile along with the reduction of body fat and arterial stiffness in obese adolescents.

Objective:Characteristics of the glucose response during oral glucose tolerance test (OGTT) may reflect differences in insulin secretion and action. The aim was to examine whether timing of the glucose peak, shape of the glucose curve and their combination could be indicators of beta-cell dysfunction in obese/severely obese adolescents with normal glucose tolerance (NGT).Methods:Data from 246 obese/severely obese adolescents who completed OGTT were reviewed. Out of 184 adolescents with NGT, 174 could be further classified into groups based on timing of the glucose peak (early/30 minutes vs late/≥60 minutes) and shape of the glucose curve (monophasic vs biphasic). Groups were compared with respect to insulin sensitivity (whole body insulin sensitivity index - WBISI), early-phase insulin secretion (insulinogenic index - IGI) and beta-cell function relative to insulin sensitivity (oral disposition index - oDI).Results:Late glucose peak (p=0.004) and monophasic glucose curve (p=0.001) were both associated with lower oDI after adjustment for age, sex, puberty stage and body mass index z-score. Among obese/severely obese adolescents with NGT, those with coexistent late glucose peak and monophasic glucose curve had lower oDI than those with early glucose peak and biphasic glucose curve (p=0.002). Moreover, a combination of late glucose peak and monophasic glucose curve was the most powerful predictor of the lowest oDI quartile [odds ratio (OR): 11.68, 95% confidence interval: 3.048-44.755, p

Background Adolescent obesity has been a striking global health issue in recent decades. Although nonsurgical weight loss strategies like lifestyle modifications, physical exercise, and dietary control have been crucial in obesity management in that age group, they have shown disappointing results. Consequently, growing interest has emerged on the surface in bariatric surgery for adolescents. Laparoscopic sleeve gastrectomy (LSG) can be an effective treatment option for adolescent obesity and controlling or even eliminating its obesity-related comorbidities. Patients and methods Data were collected from the prospectively maintained database between 2014 and 2019 in the Gastrointestinal Surgical Center of Mansoura University. Obese adolescents aged 12–19 years who underwent LSG with a BMI of more than 40kg/ m² or a BMI of greater than 35kg/m² associated with obesity-related comorbidities were included. Results A total of 40 patients were included in the study, comprising 18 males and 22 females. The median age was 17 years. The mean preoperative body weight and BMI were 147.15±36.31kg and 52.55±11.61kg/m2 , respectively. All patients had at least one comorbidity. Osteoarthritis and depression were the commonest in the study cohort (14 patients each, 35%). After 2 years of follow-up, the Excess Body Weight Loss (EBWL) was 40.84kg. All patients had achieved %EBWL more than 50% at 12 months. No nutritional deficiency was encountered in the study period. All obesity-related comorbidities (diabetes mellitus, hypertension, Obstructive sleep apnea syndrome (OSAS), and dyslipidemia) had been resolved. Conclusion Obese adolescents will grow into obese adults, with increasing burden on health care systems. LSG is feasible, effective, and safe for management of adolescent obesity in the terms of weight loss and resolution of obesity-related comorbidities. Long-term follow-up is needed in future studies. [ABSTRACT FROM AUTHOR]

Background: Obesity is defined as the accumulation of excess body fat tissue which harms health, such as cardiovascular disease, metabolic syndrome, diabetes mellitus type 2 and dyslipidemia. Lower adiponectin levels are strongly associated with overweight, obesity, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular risk factors in adulthood. ADIPOQ +45 T>G gene polymorphism is one of a genetic variations that affect plasma adiponectin levels. Methods: A cross-sectional study of 180 obese adolescents aged 13-18 years in Surabaya and Sidoarjo. Obesity is defined as body mass index (BMI)>p95 on the BMI for age curve according to Centers for Disease Control and Prevention (CDC) 2000. Blood samples were taken for ICAM-1 examination using the ELISA method, HOMA-IR with fasting insulin and glucose calculations, and ADIPOQ + 5 T>G gene polymorphisms by PCR-RFLP. Data were analyzed using the Chi-square, Mann-Whitney, and T-test using SPSS version 21, p-value<0.05 was considered significant. Results: There was a significant difference in the mean BMI by age group (p <0.001). There was no statistically significant difference between the median BMI in the three groups (wild, mutant homozygote, and mutant heterozygote) of genotype distributions. ADIPOQ +45 T>G gene polymorphisms occur with the same frequency in both males and females. There was no association between the genotype distribution of the ADIPOQ +45 T>G gene polymorphism with insulin resistance and ICAM-1 value, but the ICAM-1 value was found to be higher in the = 15 years age group. There was no association between insulin resistance and ICAM-1 values. Conclusion: There was no association between ADIPOQ + 45 T>G gene polymorphisms with insulin resistance and ICAM-1 values in obese adolescents. There was no association between insulin resistance and ICAM-1 values. [ABSTRACT FROM AUTHOR]

The present study assessed the obese adolescents' health-related quality of life (HRQoL) based on both adolescent-reported and maternal-reported questionnaires to clarify adolescent-related psychiatric factors, maternal psychiatric factors, and body mass index (BMI) percentile variables that independently affect the quality of life (QoL). A total of 190 adolescents (120 females and 70 males) were included in the study. The impact of clinical and psychiatric factors on the Pediatric Quality of Life Inventory-Child Version (PedsQL-C) scores was analyzed using hierarchical linear regression methods. The final models showed that only the Revised Child Anxiety and Depression Scale-Child Version major depressive disorder scores negatively predicted the physical, psychosocial, and total health scores of the PedsQL-C. The psychosocial scores of the PedsQL-P were negatively predicted by the Strengths and Difficulties Questionnaire emotional, and Conners' Parent Rating Scale-Revised-Short Form (CPRS-R-S) attention-deficit/hyperactivity disorder (ADHD) index scores. The PedsQL-P total scores were negatively predicted by the CPRS-R-S ADHD index scores. The findings of this study indicate that the adolescents' psychiatric symptoms and BMI percentile played a significant role in the PedsQL subscale functioning of obese adolescents compared to maternal psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Obesity has become increasingly prevalent in adolescents due to unhealthy diet habits, sedentary behavior and a lack of physical activities. This study aims to assess the effects of different exercise modalities in the treatment of cardiometabolic risk factors (CRF) in obese adolescents with sedentary behavior. Methods: A systematic search was conducted using databases (PubMed, Embase, Cochrane library, Web of Science, CNKI and VIP database) from the earliest available date to August 2021. Nineteen randomized controlled trials (RCTs) with 704 participants were included. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool, and a statistical analysis was performed by the Review Manage 5.3 and Stata 15.1 software. Results: The results of the meta-analysis showed that exercise could significantly improve obese adolescents’ body mass index (BMI) (MD = -1.99, 95% CI: -2.81 to -1.17, p < 0.00001), low density liptein cholesterol (LDL-C) (SMD = -0.98, 95% CI: -1.58 to -0.37, p = 0.002), triglyceride (TG) (SMD = -0.93, 95% CI: -1.72 to -0.14, p = 0.02), total cholesterol (TC) (SMD = -1.00, 95% CI: -1.73 to -0.26, p = 0.008), peak oxygen uptake (VO2peak) (MD = 3.27, 95% CI: 1.52 to 5.02, p = 0.0003) and homeostatic model assessment insulin resistance (HOMA-IR) (SMD = -2.07, 95% CI: -3.3 to -0.84, p = 0.001). However, there was no statistically significant difference in high-density liptein cholesterol (HDL-C) (SMD = 0.40, 95% CI: -0.28 to 1.08, p = 0.25). Conclusion: Exercise can effectively improve cardiometabolic risk factors in obese adolescents with sedentary behavior. For obese adolescents who want to lose weight and improve cardiorespiratory fitness, combined aerobic and resistance training and high-intensity interval training are optimal choices. For obese adolescents with high blood lipids, aerobic training can be regarded as a primary exercise modality to reduce the high risk of cardiovascular diseases; For obese adolescents with insulin resistance, combined aerobic and resistance training can be considered to reduce the high risk of diabetes. It is hoped that more high-quality studies will further expand the meta-analysis results and demonstrate the optimal exercise frequency and treatment intensity of cardiometabolic risk factors in obese adolescents with sedentary behavior in the future. [ABSTRACT FROM AUTHOR]

In order to examine the effect of 4-week combinatorial intervention with exercise training and dietary restriction on serum fatty acids, and to explore the correlation of intervention-induced improvement of serum fatty acid profile with the reduction of body fat and arterial stiffness. Thirty-three obese adolescents were randomized into the intervention (n = 19) and control (n = 14) groups. The participants from the intervention group were subjected to 4-week combinatorial intervention with exercise training and dietary restriction while the participants from the control group maintained regular activities and diet habits. Anthropometry, serum fatty acids and arterial stiffness were measured before and after 4-week intervention. The participants upon combinatorial intervention revealed the improved body compositions and serum fatty acid profile, and reduced arterial stiffness when compared with their basal levels and the control participants (p < 0.05). Moreover, the decrease in myristic acid, stearic acid, arachidic acid, behenic acid, palmitoleic acid, and dihomo-γ-linolenic acid, was associated with the reduction in body fat. A positive correlation between arachidonic acid and left brachial ankle pulse velocity was observed, and the increase in docosahexaenoic acid was associated with the reduction of left brachial ankle pulse wave velocity and the enhancement of right ankle brachial index. The 4-week combinatorial intervention is a useful strategy to improve serum fatty acid profile along with the reduction of body fat and arterial stiffness in obese adolescents. [ABSTRACT FROM AUTHOR]

Introduction: The adiponectin level should decrease in obese people, however, many previous studies' results about its role in obesity still remain controversies. The present study aimed to evaluate the profile of adiponectin serum level among obese adolescents in Javanese population and its correlation with body mass index (BMI). Methods: A cross-sectional study involving obese adolescents aged 13-18 years old from some schools was conducted from May to September 2020. The subject were determined by using a total population sampling method that met inclusion and exclusion criteria. Anthropometries were measured to count BMI and determine obesity according to CDC 2000. The adiponectin serum level was examined by ELISA from blood samples. Data were analyzed using Mann-Whitney Test and Spearmann correlation, with a significance value at p < 0.05. Results: There were 240 obese adolescents involved (52.1% boys) in the present study. There were significant differences in the mean of body-weight and body-height according to gender (p<0.05), however, there was no significant difference in BMI based on genders. The median of adiponectin serum level was 13.9 (1.5-46.6) μg/ml, which had no correlation with BMI (p=0.98; r=0.002). Conclusion: The adiponectin serum level had no significant correlation to body mass index. More studies are suggested to find out several factors that might influence the adiponectin serum level in Javanese population. [ABSTRACT FROM AUTHOR]

Background and Aim: Childhood obesity is associated with vitamin D (VD) deficiency and vascular dysfunction. Considering evidence indicates that VD may improve vascular function, this study, for the first time, assessed the effect of VD supplementation on microvascular reactivity in obese adolescents (OA).Methods and Results: This randomized controlled trial included 26 OA, receiving fruit juice with (n = 13) or without VD (4000 IU/d; n = 13) over a 3-month lifestyle program, as well as 23 normal-weight adolescents (controls). The primary outcome was the pre-to-post-program change in microvascular reactivity determined by laser speckle contrast imaging with acetylcholine and sodium nitroprusside iontophoresis. Changes in 25 hydroxyvitamin D (25(OH)D), flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), insulin resistance (HOMA-IR) and inflammatory markers (C-reactive protein [CRP]) were monitored. At inclusion, in comparison to controls, OA exhibited lower total and free 25(OH)D, impaired microvascular responses, and impaired FMD, but similar NMD. After the lifestyle program, total and free 25(OH)D increased in all OA, with a greater increase in those receiving VD supplements. HOMA-IR and CRP decreased in all OA. Neither FMD nor NMD were altered in either group. Endothelium-dependent microvascular reactivity only increased in the VD-supplemented group, reaching values comparable to that of controls. Similar results were found when analyzing only OA with a VD deficiency at baseline.Conclusion: VD supplementation during a lifestyle program attenuated microvascular dysfunction in OA without altering macrovascular function.Registration Number For Clinical Trial: NCT02400151. [ABSTRACT FROM AUTHOR]

Objective: Characteristics of the glucose response during oral glucose tolerance test (OGTT) may reflect differences in insulin secretion and action. The aim was to examine whether timing of the glucose peak, shape of the glucose curve and their combination could be indicators of beta-cell dysfunction in obese/severely obese adolescents with normal glucose tolerance (NGT). Methods: Data from 246 obese/severely obese adolescents who completed OGTT were reviewed. Out of 184 adolescents with NGT, 174 could be further classified into groups based on timing of the glucose peak (early/30 minutes vs late/=60 minutes) and shape of the glucose curve (monophasic vs biphasic). Groups were compared with respect to insulin sensitivity (whole body insulin sensitivity index - WBISI), early-phase insulin secretion (insulinogenic index - IGI) and beta-cell function relative to insulin sensitivity (oral disposition index - oDI). Results: Late glucose peak (p=0.004) and monophasic glucose curve (p=0.001) were both associated with lower oDI after adjustment for age, sex, puberty stage and body mass index z-score. Among obese/severely obese adolescents with NGT, those with coexistent late glucose peak and monophasic glucose curve had lower oDI than those with early glucose peak and biphasic glucose curve (p=0.002). Moreover, a combination of late glucose peak and monophasic glucose curve was the most powerful predictor of the lowest oDI quartile [odds ratio (OR): 11.68, 95% confidence interval: 3.048-44.755, p<0.001]. Conclusion: Late timing of the glucose peak, monophasic shape of the glucose curve and, in particular, a combination of those characteristics during OGTT may indicate early beta-cell dysfunction in obese/severely obese adolescents with NGT. [ABSTRACT FROM AUTHOR]

Objective: To identify risk factors affecting the development of insulin resistance in obese adolescents, and to build a nomograph model for predicting the risk of insulin resistance and achieve early screening of insulin resistance., Methods: A total of 404 obese adolescents aged 10 to 17 years were randomly recruited through a weight loss camp for the detection and diagnosis of lipids and insulin resistance between 2019 and 2021, and key lipid indicators affecting the development of insulin resistance were screened by Lasso regression, nomogram model was constructed, and internal validation of the models was performed by Bootstrap method, and the area under the working characteristic curve(ROC-AUC) and clinical decision curve were used to assess the calibration degree and stability of the column line graph., Results: The AUC was 0.825(95% CI 0.782-0.868), the internal validation result C-Index was 0.804, the mean absolute error of the column line graph model to predict the risk of insulin resistance was 0.015 and the Brier score was 0.163. The Hosmer-Lemeshow goodness-of-fit test showed that model is ideal and acceptable(χ~2=5.59, P=0.70)., Conclusion: The nomogram model of triglyceride, low-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol based on Lasso-logistic regression can effectively predict the risk of insulin resistance in obese children and adolescents.

PurposeObesity in children and in adolescents can lead to adult cardiovascular diseases, and the gut microbiota plays a crucial role in obesity pathophysiology. Exercise and diet interventions are typical approaches to improve physical condition and to alter the gut microbiota in individuals with obesity. However, whether central hemodynamic parameters including subendocardial viability ratio, the augmentation index standardized to a heart rate of 75/min (AIx75), resting heart rate, and blood pressure, correlate with gut microbiota changes associated with exercise and diet is unclear.MethodsAdolescents (n = 24, 12.88 ± 0.41 years) with obesity completed our 6-week program of endurance and strength exercises along with dietary restriction. Blood and fecal samples were collected, and physical parameters were measured before and 24 h after the last session of the intervention program. Pulse wave analysis using applanation tonometry provided the subendocardial viability ratio, a surrogate measure of microvascular myocardial perfusion, and AIx75, a measure of arterial stiffness and peripheral arteriolar resistance. Correlation analysis detected any associations of anthropometric or central hemodynamic parameters with gut microbiome composition.ResultsExercise and diet interventions significantly reduced body weight, body mass index, body fat, and waist-to-hip ratio, and lowered levels of fasting blood glucose, serum triglycerides, and high-density lipoprotein cholesterol. AIx75 and resting heart rate were also significantly reduced after the intervention without changes to systolic or diastolic blood pressure. The ratio of intestinal microbiota Firmicutes to Bacteroidetes displayed a marked increase after intervention. Interventional changes in gut microbiota members were significantly associated with anthropometric and metabolic parameters. Microbial changes were also significantly correlated with central hemodynamic parameters, including subendocardial viability ratio, AIx75, and resting heart rate.ConclusionExercise and diet interventions significantly improved measures of central hemodynamics, including subendocardial viability ratio, AIx75, and resting heart rate, which were correlated with altered gut microbiota in adolescents with obesity. Our findings shed light on the effects and mechanisms underlying exercise and diet interventions on obesity and suggest this approach for treating patients with both cardiovascular disease and obesity.

Opportunistic microorganisms in the gut biocenosis were studied in adolescents with normal body weight and obesity (patients consulted at the Clinical Department of Research Center of Family Health and Human Reproduction Problems). The biological material was studied by standard bacteriological methods, representatives of Enterobacteriaceae family were also characterized using metagenomic sequencing of V3-V4 variable regions of 16S gene rRNA. Gut microbiota of obese adolescents was unbalanced and was characterized by low levels of bifido- and lactoflora representatives, a spectrum of E. coli associations, and high prevalence of opportunistic microorganisms and their associations. Representatives of Enterobacteriaceae family were most often found in the gut microbiota of obese adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Obesity in children and in adolescents can lead to adult cardiovascular diseases, and the gut microbiota plays a crucial role in obesity pathophysiology. Exercise and diet interventions are typical approaches to improve physical condition and to alter the gut microbiota in individuals with obesity. However, whether central hemodynamic parameters including subendocardial viability ratio, the augmentation index standardized to a heart rate of 75/min (AIx75), resting heart rate, and blood pressure, correlate with gut microbiota changes associated with exercise and diet is unclear. Methods: Adolescents (n = 24, 12.88 ± 0.41 years) with obesity completed our 6-week program of endurance and strength exercises along with dietary restriction. Blood and fecal samples were collected, and physical parameters were measured before and 24 h after the last session of the intervention program. Pulse wave analysis using applanation tonometry provided the subendocardial viability ratio, a surrogate measure of microvascular myocardial perfusion, and AIx75, a measure of arterial stiffness and peripheral arteriolar resistance. Correlation analysis detected any associations of anthropometric or central hemodynamic parameters with gut microbiome composition. Results: Exercise and diet interventions significantly reduced body weight, body mass index, body fat, and waist-to-hip ratio, and lowered levels of fasting blood glucose, serum triglycerides, and high-density lipoprotein cholesterol. AIx75 and resting heart rate were also significantly reduced after the intervention without changes to systolic or diastolic blood pressure. The ratio of intestinal microbiota Firmicutes to Bacteroidetes displayed a marked increase after intervention. Interventional changes in gut microbiota members were significantly associated with anthropometric and metabolic parameters. Microbial changes were also significantly correlated with central hemodynamic parameters, including subendocardial viability ratio, AIx75, and resting heart rate. Conclusion: Exercise and diet interventions significantly improved measures of central hemodynamics, including subendocardial viability ratio, AIx75, and resting heart rate, which were correlated with altered gut microbiota in adolescents with obesity. Our findings shed light on the effects and mechanisms underlying exercise and diet interventions on obesity and suggest this approach for treating patients with both cardiovascular disease and obesity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of multidisciplinary treatment with and without psychological counseling on obese adolescents’ self‐reported quality of life. Methods: Seventy‐six obese adolescents (15.87 ± 1.53 y) were allocated into psychological counseling group (PCG; n = 36) or control group (CG; n = 40) for 12 weeks. All participants received the same supervised exercise training, nutritional and clinical counseling. Participants in PCG also received psychological counseling. QOL was measured before and after 12 weeks of intervention by Generic Questionnaire for the Evaluation of Quality of Life (SF‐36). Results: The dropout rate was higher in GC (22.5%) when compared with PCG (0.0%) (p

ObjectiveThe aim of this study was to determine whether a combined exercise and dietary intervention improved cognitive and physical self-control and whether pre-to-post interventional changes in self-control were mediated by changes in body mass index (BMI) and maximal grip strength (MGS), in a sample of obese adolescents.MethodsForty-four obese adolescents were randomly assigned to a combined exercise and dietary program or to a waitlist control group; the data from 36 participants (n = 18 for each group) were analyzed. The combined exercise and dietary program was performed over 6 weeks and was supervised by qualified trainers in a closed boot camp. The exercise consisted primarily of typical aerobic training, sports, outdoor training, yoga, and resistance training. Participants were placed on moderate dietary restriction according to individual target body weight (30 kcal/kg × target weight). The primary outcomes of this study were metrics based on cognitive and physical self-control, assessed by the Stroop task and a handgrip task, respectively. Secondary outcomes included BMI and MGS.ResultsThe combined exercise and dietary intervention significantly improved both cognitive and physical self-control. Similar positive effects were also found for reduced BMI and enhanced MGS. Correlation analyses showed that the reduced BMI and enhanced MGS were significantly closely associated with improved cognitive and physical self-control. The mediation analyses revealed that the pre-to-post intervention changes in BMI and MGS significantly mediated physical self-control, but did not mediate cognitive self-control.ConclusionOur combined exercise and dietary intervention is an effective approach to improve multiple aspects of self-control, reduce BMI, and strengthen MGS among obese adolescents. These findings also suggest that reduced BMI and enhanced MGS mediate specific aspects of self-control.

FIFA 11+ training program has been recognized as an effective means of prevention and treatment for obesity. The FIFA 11+ is a low-to-moderate exercise intensity and with a higher fat oxidation rate than other aerobic exercise intensities. This study aimed to investigate the effect of 12 weeks of the FIFA 11+ training program on body mass index (BMI) and physical fitness among obese adolescents. The study included 20 obese adolescents showed that physical fitness improved (p = 0.004) and BMI decreased (p = 0.02) significantly before and after intervention. Food intake as a confounding factor was found as a predictor which decreased the BMI (0.74 kcal/day; p = 0.00) better than exercise (0.38 kcal/week; p = 0.176). Obese adolescents and the whole family need to be given an understanding that diet and exercise are not completed when weight loss can be achieved, but calorie restriction must be carried out and become a daily habit. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether a combined exercise and dietary intervention improved cognitive and physical self-control and whether pre-to-post interventional changes in self-control were mediated by changes in body mass index (BMI) and maximal grip strength (MGS), in a sample of obese adolescents. Methods: Forty-four obese adolescents were randomly assigned to a combined exercise and dietary program or to a waitlist control group; the data from 36 participants (n = 18 for each group) were analyzed. The combined exercise and dietary program was performed over 6 weeks and was supervised by qualified trainers in a closed boot camp. The exercise consisted primarily of typical aerobic training, sports, outdoor training, yoga, and resistance training. Participants were placed on moderate dietary restriction according to individual target body weight (30 kcal/kg × target weight). The primary outcomes of this study were metrics based on cognitive and physical self-control, assessed by the Stroop task and a handgrip task, respectively. Secondary outcomes included BMI and MGS. Results: The combined exercise and dietary intervention significantly improved both cognitive and physical self-control. Similar positive effects were also found for reduced BMI and enhanced MGS. Correlation analyses showed that the reduced BMI and enhanced MGS were significantly closely associated with improved cognitive and physical self-control. The mediation analyses revealed that the pre-to-post intervention changes in BMI and MGS significantly mediated physical self-control, but did not mediate cognitive self-control. Conclusion: Our combined exercise and dietary intervention is an effective approach to improve multiple aspects of self-control, reduce BMI, and strengthen MGS among obese adolescents. These findings also suggest that reduced BMI and enhanced MGS mediate specific aspects of self-control. [ABSTRACT FROM AUTHOR]

Obesity in adolescents is considered a major public health problem; combined interventional approaches such as omega-3 supplementation with lifestyle intervention (LI) might exert synergistic effects and exceed the impact of each individual strategy. The purpose of the present study was to evaluate if the supplementation of omega-3 with LI could improve metabolic and endothelial abnormality in obese adolescents with hypertriglyceridemia. The study involved sixty-nine adolescents with normal weight and seventy obese adolescents with hypertriglyceridemia. All obese adolescents were applied to LI and randomly assigned to omega-3 supplementation or placebo group for 12 weeks. The obese adolescents with hypertriglyceridemia presented increased levels of leptin, retinol binding protein 4 (RBP4), selectin E (sE) and asymmetric dimethylarginine (ADMA) and decreased levels of adiponectin compared with control subjects. After 12-week intervention, omega-3 supplementation with LI decreased significantly in triglycerides, HOMA, leptin, RBP4, ADMA and sE. Moreover, omega-3 with LI displayed a significant reduction in triglycerides, ADMA and sE in comparison with LI alone. In subjects with omega-3 combined with LI assessed by multivariate regression model, the reduction in triglycerides was the only independent determinant of the decrease in ADMA. The reductions in triglycerides and HOMA were significantly contributed to the changes in sE. Our data indicated that omega-3 combined with LI in short duration significantly improved dyslipidemia, insulin resistance, abnormality of adipokines, endothelial dysfunction in comparison of LI alone, indicating the combined approach is an effective clinical and applicable strategy to control metabolic abnormality and decrease the risks of cardiovascular diseases in obese adolescents. [ABSTRACT FROM AUTHOR]

Background Adipose tissue is not merely a site for energy storage, but is also the largest endocrine organ, secreting various adipocytokines. Plasma visfatin, an adipocytokine predominantly secreted from visceral adipose tissue, has insulin-mimetic effects, and has been closely linked to insulin resistance. Objective To compare plasma visfatin levels between obese and non-obese adolescents, as well as between obese adolecents with and without insulin resistance. Methods This cross-sectional study was conducted in students who attended three senior high schools in Padang. Subjects comprised 28 obese and 28 non-obese adolescents. The age of the subjects ranged from 14-18 years. Obesity criteria were based on body mass index (BMI) measurements. Fasting serum glucose level was measured by glucose hexokinase photometry and serum insulin was measured by chemiluminesence immunoassay. Plasma visfatin was measured by enzyme-linked immunosorbent assay (ELISA). The insulin resistance index was estimated from fasting serum insulin and glucose levels using the homeostatic model assessment for insulin resistance (HOMA-IR). Differences in the variables were tested using independent T-test and Mann-Whitney test, depending on the distribution of the variables. Results The mean plasma visfatin level was significantly higher in the obese than in the control group [2.55 (SD 1.54) vs. 1.61 (SD 0.64) ng/mL, respectively; (P=0.005)]. The insulin resistant group had significantly higher mean plasma visfatin level than the non-resistant group [3.61 (SD 1.59) vs. 1.96 (SD 1.18) ng/mL, respectively; (P=0.004)]. Conclusion Obese adolescents with insulin resistance have signifcantly higher plasma visfatin levels compared to those without insulin resistance.

Background Obesity in adolescents is a major health problem and has been associated with low academic achievement. Brainderived neurotrophic factor (BDNF), a neurotrophin, plays a role in appetite suppression and memory, and its secretion is enhanced by physical activity. This neurotrophin may be associated with academic achievement in obese. Objective To compare physical fitness and serum BDNF levels to short term memory levels in obese adolescents aged 10–14 years. Methods This comparative, cross-sectional, analytic study was carried out on 40 elementary and high school students in Bandung, West Java, who were recruited by stratified random sampling. Short term memory was assessed by a psychologist using the Wechsler Intelligence Scale for Children-III Digit Span test (WISC-III Digit Span). Physical fitness was assessed by a clinical exercise physiologist using the Asian Committee on the Standardization of Physical Fitness Test (ACSPFT). Serum BDNF levels were measured by ELISA test in a certified laboratory. ANOVA test was used to assess for a correlation between serum BDNF concentration and short term memory, as well as between physical fitness level and short term memory. Pearson’s correlation test was used to analyze for a correlation between serum BDNF and physical fitness levels. Results The majority of subjects were in the physical fitness categories of moderate or poor. Subjects had a mean BDNF level of 44,227.8 (SD 10,359) pg/mL. There was no statistically significant difference in physical fitness with either serum BDNF or with short term memory levels (P=0.139 and P=0.383, respectively). Also, no correlation was determined between serum BDNF and physical fitness levels (r=0.222; P=0.169). Conclusion In obese adolescents, short term memory levels are not significantly different between physical fitness levels nor between serum BDNF levels.

Background: The increasing prevalence of adolescents obesity in the last decade have an impact on the increased prevalence of adolescents metabolic syndrome (MetS). Diet quality is one of the determining factors in the incidence of adolescents obesity, so it can also be a factor for MetS. Objective: To analyze the relationship between diet quality and MetS risk factors in obese adolescents. Method: A cross-sectional study was conducted on the 57 obese students in 7th and 8th grades of Nasima and Kesatrian Junior High School in Semarang. Blood pressure (BP) and waist circumference (WC) measurements, as well as blood samples for measurement of fasting blood glucose (FBG), triglyceride (TG) and HDL cholesterol (HDL-C), were conducted to determine the number of risk factors experienced by the subject. Diet quality was measured through assessment of food consumption using a food frequency questionnaire (FFQ). Pearson and Spearman's test was used to determine the correlation between diet quality and MetS risk factors. Results: The majority of obese adolescents (96.5%) had a low-quality of diet. There were 31.6% subjects experienced pre-metabolic syndrome and 68.4% had MetS, with the prevalence of MetS, was higher in male subjects. The diet quality, variety, adequacy scores and fiber intake of the pre-metabolic syndrome group were higher than MetS group. Variety and adequacy scores had significant negative correlation with TG (r = -0.374, p=0.004; r = -0.357, p=0.006, respectively). There was no significant relationship between diet quality score and the number of MetS risk factors (p=0.538), although they had a negative correlation (r = -0.083). Conclusion: Prevalence of pre-metabolic syndrome and MetS was 31.6% and 68.4%. Though there was no significant relationship, diet quality had a negative correlation with the number of MetS risk factors. Variety and adequacy scores had a significant relationship with triglyceride levels.

We have investigated the dynamics of various persistent organic pollutants (POPs) in the serum of 94 obese adolescents (34 boys and 60 girls: age range 11–19 years) before (0 M ) and after 5 months (5 M ) of undergoing weight loss treatment. Six groups of POPs, such as polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane and its metabolites (DDTs), chlordane compounds (CHLs), hexachlorocyclohexane isomers (HCHs), hexachlorobenzene (HCB) and polybrominated diphenyl ethers (PBDEs), were detected in all samples in the decreasing order of median levels: DDTs > PCBs > HCB > HCHs > CHLs > PBDEs. Levels and patterns of POPs between boys and girls at two time-points were similar. DDTs (0 M /5 M ; median: 31/42 ng/g lw) and PCBs (0 M /5 M ; median: 17/28 ng/g lw) were the major POPs. PCB 153 (0 M /5 M ; 33/34% of the sum PCBs) was the most dominant PCB congener, followed by PCB 138 (0 M /5 M ; 31/31%) and PCB 180 (0 M /5 M ; 13/12%), respectively. The most important PBDE congeners were BDE 47 and 153, although total PBDE levels were low and ranged between 0.63 and 0.88 ng/g lw. In general, levels of POPs in the obese adolescents were lower than previously reported in Belgian adolescents and adults. Due to weight loss, serum levels (except PBDEs) increased significantly thereafter combined with a body weight decrease (from 4 to 42 kg). Serum concentrations increased by 1–3.5% per kilogram weight loss and 1–2.5% per BMI z-score loss for most POPs. To our knowledge, this is the first report on the dynamics of POPs in obese adolescents during weight loss. Lipid-soluble contaminants were released from adipose tissue into the blood leading to redistribution into the body. Whether the increase in the internal exposure to POPs may adversely influence health remains to be determined. [ABSTRACT FROM AUTHOR]

Purpose To develop a reliable and reproducible automatic technique to segment and measure SAT and VAT based on MRI. Materials and methods Chemical-shift water-fat MRI were taken on twelve obese adolescents (mean age: 16.1 ± 0.6, BMI: 31.3 ± 2.3) recruited under the health monitoring program. The segmentation applied a spoke template created using Midpoint Circle algorithm followed by Bresenham's Line algorithm to detect narrow connecting regions between subcutaneous and visceral adipose tissues. Upon satisfaction of given constrains, a cut was performed to separate SAT and VAT. Bone marrow was consisted in pelvis and femur. By using the intensity difference in T2*, a mask was created to extract bone marrow adipose tissue (MAT) from VAT. Validation was performed using a semi-automatic method. Pearson coefficient, Bland-Altman plot and intra-class coefficient (ICC) were applied to measure accuracy and reproducibility. Results Pearson coefficient indicated that results from the proposed method achieved high correlation with the semi-automatic method. Bland-Altman plot and ICC showed good agreement between the two methods. Lowest ICC was obtained in VAT segmentation at lower regions of the abdomen while the rests were all above 0.80. ICC (0.98–0.99) also indicated the proposed method performed good reproducibility. Conclusion No user interaction was required during execution of the algorithm and the segmented images and volume results were given as output. This technique utilized the feature in the regions connecting subcutaneous and visceral fat and T2* intensity difference in bone marrow to achieve volumetric measurement of various types of adipose tissue in abdominal site. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the possible relationship among insulin resistance (IR), endothelial dysfunction, and alteration of adipokines in Mexican obese adolescents and their association with metabolic syndrome (MetS). Materials and methods: Two hundred and twenty-seven adolescents were classified according to the body mass index (BMI) (control: N=104; obese: N=123) and homeostasis model of the assessment-insulin resistance index (HOMA-IR) (obese with IR: N=65). The circulating concentrations of leptin, adiponectin, soluble intercellular adhesion molecule-1 (sICAM-1), and IR were determined by standard methods. Results: The obese adolescents with IR presented increased presence of MetS and higher circulating concentrations in sICAM-1 in comparison with the obese subjects without IR. The lowest concentrations of adiponectin were observed in the obese with IR. In multivariate linear regression models, sICAM-1 along with triglycerides, total cholesterol, and waist circumference was strongly associated with HOMA-IR (R2=0.457, P=0.008). Similarly, after adjustment for age, BMI-SDS, lipids, and adipokines, HOMA-IR remained associated with sICAM-1 (R2=0.372, P=0.008). BMI-SDS was mildly associated with leptin (R2=0.176, P=0.002) and the waist circumference was mild and independent determinant of adiponectin (R2=0.136, P=0.007). Conclusions: Our findings demonstrated that the obese adolescents, particularly the obese subjects with IR exhibited increased presence of MetS, abnormality of adipokines, and endothelial dysfunction. The significant interaction between IR and endothelial dysfunction may suggest a novel therapeutic approach to prevent or delay systemic IR and the genesis of cardiovascular diseases in obese patients. [ABSTRACT FROM AUTHOR]

Purpose Anti-Müllerian hormone (AMH) is proposed as a biomarker of polycystic ovary syndrome (PCOS). This study investigated: (1) AMH concentrations in obese adolescents with PCOS versus without PCOS; (2) the relationship of AMH to sex steroid hormones, adiposity, and insulin resistance; and (3) the optimal AMH value and the multivariable prediction model to determine PCOS in obese adolescents. Methods AMH levels were measured in 46 obese PCOS girls and 43 obese non-PCOS girls. Sex steroid hormones, clamp-measured insulin sensitivity and secretion, body composition, and abdominal adiposity were evaluated. Logistic regression and receiver-operating characteristic curve analyses were used, and multivariate prediction models were developed to test the utility of AMH for the diagnosis of PCOS. Results AMH levels were higher in obese PCOS versus non-PCOS girls (8.3 ± .6 vs. 4.3 ± .4 ng/mL, p < .0001), of comparable age and puberty. AMH concentrations correlated positively with age in both groups, total and free testosterone in PCOS girls only, abdominal adipose tissue in non-PCOS girls, with no correlation to in vivo insulin sensitivity and secretion in either groups. A multivariate model including AMH (cutoff 6.26 ng/mL, area under the curve .788) together with sex hormone–binding globulin and total testosterone exhibited 93.4% predictive power for diagnosing PCOS. Conclusions AMH may be a useful biomarker for the diagnosis of PCOS in obese adolescent girls. [ABSTRACT FROM AUTHOR]

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Summary Background & aims In vivo and in vitro evidence suggests that antioxidant vitamins and carotenoids may be key factors in the treatment and prevention of obesity and obesity-associated disorders. Hence, the objective of the present study was to determine the relationship between plasma lipid-soluble antioxidant vitamin and carotenoid levels and adiposity and cardio-metabolic risk markers in overweight and obese adolescents participating in a multidisciplinary weight loss programme. Methods A therapeutic programme was conducted with 103 adolescents aged 12–17 years old and diagnosed with overweight or obesity. Plasma concentrations of α-tocopherol, retinol, β-carotene and lycopene, anthropometric indicators of general and central adiposity, blood pressure and biochemical parameters were analysed at baseline and at 2 and 6 months of treatment. Results Lipid-corrected retinol ( P < 0.05), β-carotene ( P = 0.001) and α-tocopherol ( P < 0.001) plasma levels increased significantly, whereas lipid-corrected lycopene levels remained unaltered during the treatment. Anthropometric indicators of adiposity ( P < 0.001), blood pressure ( P < 0.01) and biochemical parameters ( P < 0.05) decreased significantly, whereas fat free mass increased significantly ( P < 0.001). These clinical and biochemical improvements were related to changes in plasma lipid-corrected antioxidant vitamin and carotenoid levels. The adolescents who experienced the greatest weight loss also showed the largest decrease in anthropometric indicators of adiposity and biochemical parameters and the highest increase in fat free mass. Weight loss in these adolescents was related to an increase in plasma levels of lipid-corrected α-tocopherol ( P = 0.001), β-carotene ( P = 0.034) and lycopene ( P = 0.019). Conclusions Plasma lipid-soluble antioxidant vitamin and carotenoid levels are associated with reduced adiposity, greater weight loss and an improved cardio-metabolic profile in overweight and obese adolescents. [ABSTRACT FROM AUTHOR]

Background: An association between cardiorespiratory fitness (CRF) and insulin resistance in obese adolescents, especially in those with various obesity categories, has not been systematically studied. There is a lack of knowledge about the effects of CRF on insulin resistance in severely obese adolescents, despite their continuous rise., Aim: To investigate the association between CRF and insulin resistance in obese adolescents, with special emphasis on severely obese adolescents., Methods: We performed a prospective, cross-sectional study that included 200 pubertal adolescents, 10 years to 18 years of age, who were referred to a tertiary care center due to obesity. According to body mass index (BMI), adolescents were classified as mildly obese (BMI 100% to 120% of the 95 th percentile for age and sex) or severely obese (BMI ≥ 120% of the 95 th percentile for age and sex or ≥ 35 kg/m 2 , whichever was lower). Participant body composition was assessed by bioelectrical impedance analysis. A homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Maximal oxygen uptake (VO 2 max) was determined from submaximal treadmill exercise test. CRF was expressed as VO 2 max scaled by total body weight (TBW) (mL/min/kg TBW) or by fat free mass (FFM) (mL/min/kg FFM), and then categorized as poor, intermediate, or good, according to VO 2 max terciles. Data were analyzed by statistical software package SPSS (IBM SPSS Statistics for Windows, Version 24.0). P < 0.05 was considered statistically significant., Results: A weak negative correlation between CRF and HOMA-IR was found [Spearman's rank correlation coefficient ( r s ) = -0.28, P < 0.01 for CRF TBW ; ( r s ) = -0.21, P < 0.01 for CRF FFM ]. One-way analysis of variance (ANOVA) revealed a significant main effect of CRF on HOMA-IR [F (2200) = 6.840, P = 0.001 for CRF TBW ; F (2200) ]. Subsequent analyses showed that obese adolescents with poor CRF had higher HOMA-IR than obese adolescents with good CRF ( P = 0.022 for CRF FFM ]. Subsequent analyses showed that obese adolescents with poor CRF had higher HOMA-IR than obese adolescents with good CRF ( P = 0.001 for CRF TBW ; P = 0.018 for CRF FFM ). Two-way ANOVA with Bonferroni correction confirmed significant effect of interaction of CRF level and obesity category on HOMA-IR [F (2200) ]. Severely obese adolescents had higher HOMA-IR than those who were mildly obese, with either good or poor CRF. However, HOMA-IR did not differ between severely obese adolescents with good and mildly obese adolescents with poor CRF.P = 0.039 for CRF TBW ]. Severely obese adolescents had higher HOMA-IR than those who were mildly obese, with either good or poor CRF. However, HOMA-IR did not differ between severely obese adolescents with good and mildly obese adolescents with poor CRF., Conclusion: CRF is an important determinant of insulin resistance in obese adolescents, regardless of obesity category. Therefore, CRF assessment should be a part of diagnostic procedure, and its improvement should be a therapeutic goal., Competing Interests: Conflict-of-interest statement: The authors declare having no conflicts of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background Metabolic syndrome (MS) is one of the long-term consequences of obesity which can be found in adolescents. MS is caused by excessive visceral fat accumulation. The visceral fat thickness (VFT) itself can be measured by using waist circumference (WC) measurement and abdominal ultrasonography. Until now, there are no WC and VFT cut-off points to predict MS in children and adolescents. This study used MS criteria based on National Cholesterol Education Program – Adult Treatment Panel III (NCEP-ATP III) which specifically modified. Objective The objectives of this study are (a) to determine the MS ocurrence based on modified NCEP-ATP III in obese adolescents; (b) to measure the VFT by using abdominal ultrasonography in obese adolescent with MS and obese adolescent without MS. Methods We conducted a cross-sectional study from March to May 2006. Fifty obese adolescents were recruited from several junior and senior high schools in Jakarta. Results Of those 50 obese adolescents, there were 34 subjects with WC>P 80 and 16 subjects with WC P 80 , 17 subjects had MS and the others had no MS. All the 16 subjects with WC P 80 who had MS was 5.19 cm (SD 2.07 cm). The VFT in 17 subjects with WC>P 80 who had no MS was 3.94 cm (SD 1.62 cm). The VFT in all 16 subjects with WC P 80 and they also had visceral fat which was thicker than obese adolescents without MS. Conclusions All obese adolescents with MS have WC>P 80 and thicker visceral fat than obese adolescents without MS; the VFT of obese adolescents without MS, who had WC>P 80 was 3.94 cm (SD 1.62 cm), and the VFT of obese adolescents without MS, who had WC