What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health?
What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health?
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DOI：
10.1136/adc.2009.165340
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发表时间：
2010-04-01
影响因子：
5.2
通讯作者：
Shield, Julian P. H.
中科院分区：
文献类型：
--
作者：
Ford, Anna L.;Hunt, Linda P.;Shield, Julian P. H.
目的研究12个月内通过改变生活方式改善体重指数（BMI）SD评分（SDS）对代谢风险和身体成分的影响。设计前瞻性队列研究。地点：英国医院门诊体重管理诊所。患者88名青少年（40名男性，86%白人），中位年龄12.4岁（范围9.1-17.4）和平均（SD）BMI SDS 3.23根据年龄和性别对基线和12个月时的BMI进行校正，使用英国1990年生长参考数据提供BMI SDS。用生物阻抗法测定身体成分。标准口服葡萄糖耐量试验（OGTT）检查葡萄糖代谢。结果BMI SDS降低≥ 0.5时，体成分的重要指标显著改善，平均腰围SDS降低0.74个单位，体脂SDS降低0.60个单位，同时关键代谢危险因素也显著降低（甘油三酯（~ 30%）、低密度脂蛋白-胆固醇（~ 15%）、HsCRP（~ 45%））。较小的降低>= 0.25改善胰岛素敏感性、总胆固醇/高密度脂蛋白比率和血压。BMI SDS降低越大，胰岛素敏感性改善越好。最胰岛素敏感的人在基线最有可能实现BMI SDS的变化>= 0.5，无论基线BMI SDS.Conclusions改善身体成分和心脏代谢风险可以看到与BMI SDS减少>= 0.25的肥胖青少年，而更大的好处累积从失去至少0.5 BMI SDS。对胰岛素最敏感的人似乎最能影响这些变化。
Objective To study the impact of body mass index (BMI) SD score (SDS) improvement through lifestyle modification on metabolic risk and body composition over 12 months.Design Prospective cohort study.Setting Hospital outpatient weight management clinic in the UK.Patients 88 adolescents (40 males, 86% Caucasian) of median age 12.4 years (range 9.1-17.4) and mean (SD) BMI SDS 3.23 (0.49).Main outcome measures BMI at baseline and 12 months was adjusted for age and gender providing BMI SDS using British 1990 growth reference data. Body composition was measured by bioimpedance. A standard oral glucose tolerance test (OGTT) examined glucose metabolism. Fasting lipid profiles, high sensitivity C-reactive protein (HsCRP) and blood pressure (BP) were measured.Results Reducing BMI SDS by >= 0.5 achieved significant improvements in important measures of body composition with mean waist circumference SDS reducing by 0.74 units and body fat SDS by 0.60 units, while also leading to significant reductions in key metabolic risk factors (triglycerides (-30%), low-density lipoprotein-cholesterol (-15%), HsCRP (-45%)). A lesser reduction of >= 0.25 improved insulin sensitivity, total cholesterol/high-density lipoprotein ratio and BP. The greater the BMI SDS reduction, the better the improvement seen in insulin sensitivity. The most insulin-sensitive individuals at baseline were most likely to achieve BMI SDS changes of >= 0.5 regardless of baseline BMI SDS.Conclusions Improvement in body composition and cardiometabolic risk can be seen with BMI SDS reductions of >= 0.25 in obese adolescents, while greater benefits accrue from losing at least 0.5 BMI SDS. The most insulin-sensitive individuals seem best able to effect these changes.