OBJECTIVES: To study the relationship between skeletal muscle mass index (SMI) and metabolic phenotypes of obesity in adolescents, and to provide a basis for the prevention and control of adolescent obesity and related metabolic diseases. METHODS: A total of 1 352 adolescents aged 12 to 18 years were randomly selected by stratified cluster sampling in Yinchuan City from October 2017 to September 2020, and they were surveyed using questionnaires, physical measurements, body composition measurements, and laboratory tests. According to the diagnostic criteria for metabolic abnormalities and the definition of obesity based on the body mass index, the subjects were divided into four metabolic phenotypes: metabolically healthy normal weight, metabolically healthy obesity, metabolically unhealthy normal weight, and metabolically unhealthy obesity. The association between SMI and the metabolic phenotypes was analyzed using multivariate logistic regression. RESULTS: The SMI level in the metabolically unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity groups was lower than that in the metabolically healthy normal weight group (P<0.001). Multivariate logistic regression analysis showed that after adjusting for gender and age, a higher SMI level was a protective factors for adolescents to develop metabolic unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity phenotypes (OR=0.74, 0.60, and 0.54, respectively; P<0.001). CONCLUSIONS Increasing SMI can reduce the risk of the development of metabolic unhealthy/obesity.
Adolescent ; Humans ; Body Mass Index ; Metabolic Syndrome/metabolism* ; Muscle, Skeletal/metabolism* ; Obesity, Metabolically Benign/diagnosis* ; Pediatric Obesity ; Phenotype ; Risk Factors ; Child

Objective: To explore abdominal fat mass distribution and contents among obese children via magnetic resonance imaging (MRI), and analyze the correlations of abdominal adipose tissue with anthropometric and metabolic parameters. Methods: Cross-sectional study. There were 60 obese children admitted to the Children's Health Care Department and Endocrinology Department at Children's Hospital of Nanjing Medical University from July 2016 to December 2018. Children's gender, age, height, weight, body composition, waist circumference and blood pressure were recorded. The levels of fasting blood glucose, lipids, insulin were measured, and liver ultrasound was performed, and the body mass index Z score (BMI-Z), waist-to-height ratio (WHtR) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. In addition, contents of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and total abdominal adipose tissue (TAAT) were calculated according to feedback of abdominal MRI scan images. The associations between the contents of abdominal adipose tissue, physical examination status and metabolic disorders among obese children were analyzed through correlation analysis and regression analysis. Receiver operating characteristic (ROC) curve was used to compare the accuracy of fat mass in different parts of the abdomen in predicting their metabolic disorders. Results: A total of 60 children were enrolled in the study, included 44 boys and 16 girls, with age of (9.2±1.4) years. The contents of SAT, VAT and TAAT among the 60 children were positively associated with BMI-Z (r=0.60, 0.46, 0.59), body fat percentage (r=0.64, 0.67, 0.68) and waist-to-height ratio (r=0.60, 0.57, 0.61) (all P<0.01). Meanwhile, contents of SAT and TAAT were also positively correlated with systolic blood pressure (r=0.47, 0.49), triglyceride (r=0.33, 0.35) and HOMA-IR (r=0.33, 0.28)(all P<0.05). In order to adjust the confounding effects among various variables, regression analysis was applied and the result showed that the body fat percentage (β=0.59, 0.66, 0.65) and waist-to-height ratio (β=0.53, 0.63, 0.59) were most related to abdominal fat contents (all P<0.01), including SAT, VAT and TAAT among obese children. According to ROC, SAT had outstanding evaluation performances for the diagnosis of insulin resistance and metabolic syndrome, while VAT had excellent evaluation performances for non-alcoholic fatty liver disease (area under curve=0.68, 0.69, 0.69, 95%CI 0.54-0.82, 0.55-0.84, 0.53-0.85, P=0.017, 0.014, 0.019). Conclusions: As one of the best indexes, body fat percentage and WHtR can be used to predict the contents of SAT, VAT and TAAT among obese children. With the increase of abdominal SAT or VAT, the risks for insulin resistance, metabolic syndrome and non-alcoholic fatty liver disease would increase. Assessment of abdominal fat and metabolic risks in obese children should combine BMI-Z with waist circumference and body composition analysis.
Abdominal Fat/metabolism* ; Body Mass Index ; Child ; Cross-Sectional Studies ; Female ; Humans ; Insulin Resistance ; Magnetic Resonance Imaging ; Male ; Metabolic Diseases/metabolism* ; Metabolic Syndrome/metabolism* ; Non-alcoholic Fatty Liver Disease ; Pediatric Obesity/metabolism*

OBJECTIVE: To investigate the effects of 4-week moderate aerobic exercise plus diet control on serum levels of total insulin-like growth factor 1(IGF-1) and IGF-1 binding protein-3 (IGFBP-3) as well as IGF-1 activity (reflected by molar ratio of IGF-1/IGFBP-3) in female obese adolescents and youths, and their possible role on fat loss, and improvement of glucose and lipid metabolism. METHODS: Nine female obese youths (age:18~19 y) and 30 female obese adolescents (age:14~16 y) were recruited and undertook 4-week aerobic exercise such as swimming and jogging (6 days/week, twice a day, 2 h/time with 5 min rest per 30 min exercise) with gradual increase of intensity from low (heart rate immediately post-exercise of 1st week:100~120 beats/min) to moderate (heart rate immediately post-exercise of 2-4 weeks:120~140 beats/min) level, combined with a diet intervention (total daily energy intake of 1 400 or 1 600 kcal according to basal metabolism rate) in Shanghai Dianfeng weight loss enclosed camp. Nine normal weight young women and 9 female children matched at age and nationality were recruited as the normal control. Before and after the experimental period, anthropometric index (body weight, body mass index(BMI) and waist circumference), glucose and lipid metabolism parameters including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG); total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL), and serum levels of total IGF-1 and IGFBP-3 were measured, and IGF-1 activity was calculated in the obese and normal control female adolescents. RESULTS: ①Compared with normal control, the serum levels of total IGF-1 and IGFBP-3 were decreased in the female obese youths and adolescents, and IGF-1 activity was reduced only in the obese female adolescents. ②The serum level of IGFBP-3 was down-regulated and IGF-1 activity was up-regulated while no change of serum total IGF-1 was induced by 4-week moderate aerobic exercise plus diet control, accompanied with significant decreases of body weight, BMI and waist circumference as well as improvement of glucose and lipid metabolism in the female obese youths and adolescents. Except for a positive association between the increased IGF-1 activity and the decreased waist circumference was found in the female obese youths by Pearson's correlation analysis, there was no relation of the decreased IGFBP-3, the increased IGF-1 activity with the improvements of anthropometric index and glucose and lipid metabolism in female obese youths and adolescents. CONCLUSIONS The serum level of IGFBP-3 was down-regulated and the IGF-1 activity was up-regulated by 4-week moderate aerobic exercise plus diet control in female obese youths and adolescents. The increase of IGF-1 activity might be associated with the exercise-plus-diet-induced decrease of waist circumstance in female obese youths.
Adolescent ; Blood Glucose ; China ; Diet, Reducing ; Exercise ; Female ; Humans ; Insulin ; blood ; Insulin-Like Growth Factor Binding Protein 3 ; metabolism ; Insulin-Like Growth Factor I ; metabolism ; Pediatric Obesity ; therapy ; Young Adult

The purpose of this study was to assess the daily steps, physical activities and activity coefficient of the elementary school children in the rural area. Body weight, height and daily steps were measured and one-day activity diaries were collected by interviewing children. The average age of the subjects was 9.96+/-1.02 years. Average height, weight, obesity index, body fat and muscle of subjects were 136.2+/-8.9 cm, 35.2+/-8.5 kg, 99.6+/-18.8%, 22.9+/-8.5% and 35.8+/-6.0%, respectively. The average daily steps of the subjects was 17,584 and daily steps (19,314) of 3rd grade students was significantly higher than that (15,712) of 5th grade children. But there was no significant difference in daily steps and activity coefficients between boys and girls. Daily steps (23,347) of exercise group showed the significantly higher than that (16,144) of nonexercise group. Gender and grade of subjects did not have significant influence on activity coefficients, but there was a significant difference in activity coefficient on weekdays between the exercise group (1.82+/-0.30) and non-exercise group (1.50+/-0.21). Analysis of variance revealed stronger associations between daily steps and body fat (%) than between daily steps and BMI. Daily steps showed significant negative correlation with body fat (%) measured using two methods r =-0.321 and r = -0.365, respectively. Activity coefficient was significantly correlated (r = 0.436) with daily steps, thus increasing daily steps can prevent and treat childhood obesity by increasing the energy expenditure. The higher activity coefficients (weekday 1.56, weekend 1.53) of the subjects was caused by the fact that rural students spent more time outside and enjoyed stronger activities than urban students. The results of this study can be used to estimate energy requirements for Korean children based on exercise levels and living areas.
Adipose Tissue ; Body Weight ; Child* ; Energy Metabolism ; Female ; Humans ; Motor Activity* ; Obesity ; Pediatric Obesity

Background: Recently, the prevalence of childhood obesity has increased dramatically, but the cause still remains incompletely understood. The goal of this study was to present a direction for treatment and prevention of childhood obesity on the basis of the data of physical activity energy expenditure, inactive time and dietary habits of Korean children. Methods: A total of 56 children were selected from 8 elementary schools in Seoul and Gwacheon-city. Children's physical activity pattern and dietary habits were obtained by questionnaire. The children wore accelerometer on their wrists from Friday to Tuesday over the whole weekend. Then, we calculated the activity energy expenditure using the activity counts recorded on the accelerometer. Results: Neither the physical activity energy expenditure (kcal/kg) nor the activity pattern showed a significant difference between the normal weight group and the overweight group. The overweight children spent more time watching TV and using the computer. The overweight group did not have breakfast and ate much more and faster in terms of dietary habit. Conclusion: This study suggests that bad habituations in diet and increase of inactivity time can play more important role than physical activity in causing overweight in 7-year-old children.
Breakfast ; Child* ; Diet ; Energy Metabolism ; Food Habits* ; Humans ; Motor Activity* ; Overweight* ; Pediatric Obesity ; Prevalence ; Seoul ; Wrist ; Surveys and Questionnaires

PURPOSE: The aim of this study was to evaluate the influence of leptin on biochemical markers of bone metabolism in childhood obesity. METHODS: A total of 50 male children (25 obese and 25 controls) were recruited from the pediatric outpatient clinic at the Chosun University Hospital from November 1st 2005 to May 30th 2006. BMI, body fat percentage, serum leptin, bone-specific alkaline phosphatase (B-ALP), C-terminal propeptide of type 1 collagen (CICP), total deoxypyridinoline crosslinks (total DPD) were measured. The correlations of leptin with BMI, body fat percentage, B-ALP, CICP, total DPD were analyzed by Pearson's correlation. In a multiple stepwise regression analysis, leptin after correction for body weight was evaluated if there was a correlation with biochemical markers of bone formation and resorption respectively. RESULTS: The leptin levels of the obese group were significantly higher than those of the control group (p=0.012). In the obese group, the leptin level was significantly positively correlated with the BMI (r=0.551, p=0.01) and the percentage of body fat (r=0.584, p=0.018). In the obese group, of bone markers, B-ALP (r=-0.613, p=0.026) and CICP (r=-0.583, p=0.037) were negatively correlated with leptin. B-ALP (r=-0.728, p=0.007) and CICP (r=-0.684, p=0.014) were negatively correlated with leptin when corrected for body weight. In the control group, bone markers were not correlated with leptin. In the multiple stepwise regression analyses, there was a negative correlation between the leptin and B-ALP (Y=-39.653X+356.341, p=0.026), CICP (Y=-13.437X+116.013, p=0.037) respectively in the obese group. CONCLUSION: Leptin was a significant factor in the bone formation but not in bone resorption in childhood obesity.
Adipose Tissue ; Alkaline Phosphatase ; Ambulatory Care Facilities ; Biomarkers ; Body Weight ; Bone Resorption ; Child ; Collagen Type I ; Humans ; Leptin* ; Male ; Metabolism* ; Obesity ; Osteogenesis ; Pediatric Obesity*

BACKGROUND: Prader-Willi syndrome (PWS) is a congenital disorder, which is clinically characterized by a short stature, muscular hypotonia, hypogonadism, mental retardation and hyperphagia, leading to early childhood obesity. Impaired growth hormone (GH) secretion, hypogonadism, and obesity are common in patients with PWS. The purpose of this study was to find the effects of growth hormone treatment in patients with PWS. METHODS: Six patients with PWS confirmed by a genetic study were recruited, and treated with growth hormone(Eutropin(R))(0.8-1 IU/kg/week) divided into five or seven day doses per week for six months. The heights and weights of the subjects were evaluated. GH status were evaluated using the serum insulin-like growth factor (IGF)-I level, the L-dopa test, and insulin-induced hypoglycemia tess. Glucose metabolism was evaluated using the random serum glucose and HbA1c levels. RESULTS: GH was found to be deficient in 2 out of 6 subjects by the insulin test, in 3 out of 6 by the IGF-I level, and in 5 out of in 5 by the L-dopa test. After six months of GH treatment, the height percentile was increased and weight percentile decreased. The serum glucose and HbA1c levels remained unchanged. CONCLUSION: Six months of GH treatment in patients with PWS improved the height and degree of obesity. This study has shown the beneficial effects of GH treatment for patients with PWS, and without significant side effects.
Blood Glucose ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Glucose ; Growth Hormone* ; Humans ; Hyperphagia ; Hypoglycemia ; Hypogonadism ; Insulin ; Insulin-Like Growth Factor I ; Intellectual Disability ; Levodopa ; Metabolism ; Muscle Hypotonia ; Obesity ; Pediatric Obesity ; Prader-Willi Syndrome* ; Weights and Measures

Resistin, adiponectin, and leptin are hormones secreted by adipose tissue and are known to play an important role in adipose tissue metabolism. The purpose of this study was to evaluate the levels of adipocyte-derived hormones (resistin, adiponectin, leptin) in obese children aged 10-12 years. The subjects were 102 obese children with obesity index (OI) over 120% and 51 control children with obesity index less than 120% were included for comparison. Anthropometric variables and serological parameters were assessed. Height, weight, OI, body mass index (BMI) were significantly higher in obese group than in control. Obese children showed significantly higher serum concentrations of triglyceride (TG), total cholesterol (TC), and LDL-cholesterol and significantly lower HDL-cholesterol compared with control children, even though the values were within normal ranges for both groups. Concentrations of resistin and leptin were significantly higher in obese group than in control. Adiponectin and insulin levels were tended to lower in obese group even though the differences were not statistically significant. Resistin had significant positive correlation with OI and TG, and leptin with weight, OI, BMI, TG and TC. On the other hand, adiponectin showed significant negative correlations with height, OI and BMI. These finding showed that obese children had higher serum levels of resistin and leptin and lower adiponectin, and also these hormones had correlations with related factors of obesity, suggesting adipocyte-derived hormones has a role in child obesity.
Adiponectin* ; Adipose Tissue ; Body Mass Index ; Child* ; Cholesterol ; Hand ; Humans ; Insulin ; Leptin* ; Metabolism ; Obesity ; Pediatric Obesity ; Reference Values ; Resistin* ; Triglycerides

PURPOSE: Recently, there has been a marked increase in childhood obesity, and that has aroused social concern. Obesity increases several metabolic disease such as hypertension, diabetes, fatty liver, heart disease and the mortality rate. Complications of obesity are more closely related with the accumulation of visceral fat. Therefore, fundamental treatment of obesity Should be the reduction of body fat. Exercise is the best way to reduce body fat, especially to consume the free fatty acid released from adipocytes. However, it is anticipated that children's response to exercise could differ from adult's. This research was done to find the difference adaptations of energy metabolisms in exercises between children and adults. METHODS: Sprague-Dawley male rats were divided into a young group(two-three months old), adult group(six months old) and an old group(fifteen months old). At fed ad libitum, O2 consumption and CO2 production were measured before and after the exercise. Before and after fasting for 24 hours, O2 consumption and CO2 production were measured. After fasting for 24 hours, the blood was taken to analyse the plasma glucose and free fatty acid. RESULTS: The fasting oxygen consumption decreased only in young rats compared with that of the fed state. The fasting respiratory quotient was decreased in the young and adult rats compared with those of the fed state. The post exercise oxygen consumption was increased in the young and adult rats but not in the old rats. The post-exercise respiratory quotient was decreased only in the young rats. There was no significant change of plasma glucose and free fatty acid between fed and fasting state in the young rats, while the fasting glucose levels were increased in the adult and old rats. CONCLUSION: These results mean that the responses to fasting and exercise differ among rats of different age groups and young rats can burn fat more easily during exercise and fasting than those of the adult and old rats because of the better metabolic flexibility of young rats.
Adipocytes ; Adipose Tissue ; Adult ; Animals ; Blood Glucose ; Burns ; Child ; Energy Metabolism ; Exercise ; Fasting* ; Fatty Liver ; Glucose ; Heart Diseases ; Humans ; Hypertension ; Intra-Abdominal Fat ; Male ; Metabolic Diseases ; Mortality ; Obesity ; Oxygen Consumption ; Pediatric Obesity ; Pliability ; Rats* ; Rats, Sprague-Dawley

PURPOSE: The rising prevalence of childhood obesity may be due to an energy imbalance between food intake and energy expenditure. Recently, consumption of beverages in children has increased. The aim of this study is to provide useful information for the prevention and the control of childhood obesity by assessment of variable beverage consumption. METHODS: Fight hundred seventy seven children(M : F=1 : 1.02, mean age; 9.7 years) from two primary schools in Seoul in May 2003 were enrolled. Body mass index(BMI) was calculated and the degree of obesity was classified into normal, overweight and obese groups by BMI percentile. Parental BMI, socio-economic factor, 3-day dietary intake, calory intake and beverage intake were examined by questionnaires. We researched beverages and classified them into six categories, milk, other milk products, soda, sports beverage, other beverage. RESULTS: The prevalence of obesity was 7.2%. The parental BMI of the obese group were higher than those of the other groups. There was no significant difference in birth weight, or parents' intellectual and economic levels between the obese group and the other groups. There was no significant difference in daily total calory intake between the obese group and the other groups. The obese group of 7-9 year-old-males was higher than the other groups in sodas, and sports beverages intake. The obese group of 10-12 year-old-males was higher than the other groups in total beverage intake and other beverage intakes. The obese group of 10-12 year-old-females was higher than the other groups in other milk products. CONCLUSION: Excessive intake of beverages is associated with childhood obesity. Efforts to decrease intake of beverages may be important approaches to counter the rise in the prevalence of obesity.
Beverages* ; Birth Weight ; Body Mass Index ; Child ; Eating ; Energy Metabolism ; Fast Foods ; Humans ; Milk ; Obesity ; Overweight ; Parents ; Pediatric Obesity* ; Prevalence ; Surveys and Questionnaires ; Seoul ; Sports