ОЦЕНКА РЕЗУЛЬТАТОВ ПРЕВЕНТИВНЫХ ВМЕШАТЕЛЬСТВ ПО ИЗМЕНЕНИЮ ОБРАЗА ЖИЗНИ У ДЕТЕЙ С ИЗБЫТОЧНЫМ ВЕСОМ И ОЖИРЕНИЕМ
Abstract
Obesity is associated with serious health problems in children and is a major and early risk factor for morbidity and mortality in adults. The direct health effects of obesity include hyperlipidemia, hypertension, and glucose tolerance. Purpose of the study: assessment of leptin and adiponectin levels before and after lifestyle changes in children with obesity and overweight and determining their role as biomarkers. Material and methods: One hundred and four overweight and obese children (51 boys and 53 girls) were included in this study and constituted the main group. Fifty-four children with normal body weight without endocrine, cardiovascular, gastrointestinal, or liver diseases constituted the study's control group. Of the first 104 children, 48 returned for re-examination after a year of lifestyle changes. Anthropometric indicators were assessed in these children at the initial stage, as well as after one year. Lifestyle intervention is included in the educational program, which includes changes in nutrition and physical activity. Children and their parents are advised to switch to a normal calorie diet based on a balanced distribution of carbohydrates (55%), proteins (15%), and lipids (total 30%, saturated fats less than 10%). When changing the form of physical activity, it is recommended to perform aerobic exercises three to five times a week for no less than 45-60 minutes. Results: Clinical and biochemical characteristics were determined in children with obesity and excess body weight (group A, n=104) at the initial stage compared to the control group (group B, n=54), at the initial stage (group C, n=48) and after 1 year of intervention (group D, n=48). After 1 year of preventive intervention, 48 children were re-examined. Children with unchanged body weight and those who lost weight were compared. Children with obesity and excess weight did not have statistical differences in many parameters, including insulin levels, HOMA-IR, and adiponectin levels, compared to children who lost weight and had normal weight, which once again indicates the positive effect of lifestyle changes on children. However, the level of leptin was still higher in children with obesity and excess body weight than in children with normal weight, which allows us to assume that, despite the "normalization" of metabolic status, leptin did not change in accordance with these positive changes. Conclusions: our study confirms the positive effect of simple dietary recommendations and physical activity on metabolic and clinical parameters in children with obesity and excess body weight. The level of leptin was significantly increased in children who did not lose weight, but in children who actually lost weight, there were no significant changes compared to the baseline level, which allows us to assume that leptin is not directly related to the change in body weight. Adiponectin is the best and simplest marker for assessing the positive results of prevention and treatment of obesity and excess weight in children, monitoring metabolic changes, and their detection.