Abstract 1415: Sustained Reductions in C-reactive Protein, Retinol Binding Protein-4 and Leptin: One-Year Randomized Controlled Family Based Lifestyle Intervention in Obese Children
Elevated circulating levels of CRP, leptin and RBP4 confer increased risk for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD). Alterations in these potential etiological risk factors are evident even at an early age in the clinical course of obesity and their favorable modification by short-term lifestyle changes in obese adolescents has been reported. However, long-term prospective studies have not been well documented in children. Therefore, the primary aim of this study was to determine the long-term effects in a Family Based Intervention (FBI) program on cardiometabolic risk factors in obese children.
METHODS: Overweight children (N=149), with an age-adjusted BMI ≥85%tile were recruited for a 1-year randomized controlled outpatient FBI-program that included enhanced physical activity and dietary counseling and behavior modifications. Anthropometry, psychological factors, OGTT, fasting serum leptin, RBP4 and CRP were measured at baseline, 6 and 12-months of intervention.
RESULTS: 49 subjects (age:10.1±1.1 years; BMI%tile: 97.7±2.3), who completed all the studies (baseline, 6 and 12-months) are included in the analyses. Data show significant and sustained reductions in the concentrations of leptin, RBP4 and CRP (ANOVA for repeated measures, P<0.01 for all) in the intervention group as opposed to a steady increase in these factors in the obese control group.
CONCLUSIONS: The results suggest that:
obesity-related cardiometabolic risk factors in children are enhanced in a less physically active, obesogenic environment;
family-based lifestyle intervention in obese children is durable and ameliorates the alterations in cardiometabolic risk factors;
these beneficial changes in cardiometabolic risk factors are sustained for at least a year. Further the results from this study underscore the need for early and long-lasting family-based prevention and/or intervention programs in order to curtail the alarming increase in the development of obesity-related co-morbidities such as, T2D and CVD in children.