Does weight loss in obese children correlate with improved metabolic syndrome components?
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Abstract
Introduction: Obesity is an endemic disease. Excess weight can be associated with conditions such as dyslipidemia, type 2 diabetes mellitus (DM2) and systemic arterial hypertension (SAH), which favor the occurrence of cardiovascular diseases (CVD). Objective: To verify the correlation between anthropometric indices and metabolic markers of risk for CVD in children with excess weight after at least one year of nutritional intervention, observing if there was a correlation between weight loss and improvement of CVD risk factors. Method: Longitudinal study with 68 overweight children (33 boys and 35 girls) from the general pediatric outpatient clinic of a university hospital. With a difference of at least one year of nutritional intervention and orientation regarding physical activity, the median Z score of BMI (ZIMC), waist at the midpoint between the last rib and the iliac crest (WMP), waist at the iliac crest (ICC), systolic blood pressure (SBP), diastolic (DBP), triglyceride (TG), total cholesterol (TC), LDL, HDL, glucose, insulin and HOMA-IR were compared. The differences (deltas) of these medians were calculated at both times. Correlated by simple linear regression deltas of: ZIMC with HDL; HOMA-IR with WMP, ICC, SBP and DPB. Result: Medians of the first x second measures; medians of the deltas: ZIMC 3 X 2.82; -0.22 (p = 0.0001); HDL 43.5 X 46 mg / dL; 2.5 (p = 0.03); LDL 104.3 X 107mg / dL; -5.5 (p = 0.20); ICC 89 X 89.1 cm; 3.90 (p = 0.001); WMP 80.25 X 86.75cm; 4.65 (p = 0.0001); SBPS 100 X 107.5mmHg; 10.0 (p = 0.003); DBP 60 X 68mmHg; 0.0 (p = 0.04); insulin 13.2 X 20.2μIU / mL; 1.8 (p = 0.17); HOMA-IR 2.6 X 4.92; 1.055 (p = 0.001); TC 170 X 174.5 mg / dL; 1.0 (p = 0.80); TG 94.5 X 98 mg / dL; -0.5 (p = 0.49). Simple linear regression showed a correlation between delta ZIMC and delta HDL (p = 0.017; adjusted R² 0.0812). There is no correlation between the HOMA-IR delta and the WMP, ICC, SBP and DBP deltas. Conclusion: After one year of nutritional intervention, there was a decrease in ZIMC indices and an increase in HDL in the participants. For each 1U increase in the ZIMC delta variation, there is a 4.3U decrease in the HDL delta variation. On the other hand, there was a worsening of other anthropometric indices and metabolic risk markers for CVD. We emphasize that traditional intervention, nutritional recommendations, and physical activity is effective in weight loss for obese children, but not in fighting all risk factors for CVD.
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