The effect of weight loss magnitude on pro-/anti-inflammatory adipokines and carotid intima-media thickness in obese adolescents engaged in interdisciplinary weight loss therapy

Background Obesity is a chronic disease defined by an excess amount of adipose tissue and presents a low-grade inflammatory state, increasing cardiovascular risk. Objective To assess the effect of weight loss magnitude on the inflammatory profile and carotid intima-media thickness (cIMT) in obese adolescents engaged in interdisciplinary therapy. Design and patients Seventy-seven postpubertal obese adolescents with a BMI greater than the 95th percentile (37 center dot 18 +/- 5 center dot 14), of both genders and between the ages of 14 and 19years (16 center dot 74 +/- 1 center dot 59) were subjected to a 1-year period of interdisciplinary intervention (nutrition, psychology, physical exercise and clinical support). Measurements Blood samples were collected to analyse glucose, lipid and adipokine concentrations. Body composition, anthropometric profiles and cIMT were measured. The results are presented according to quartiles of weight loss: 1st (5 center dot 80kg)=low; 2nd (5 center dot 80-10 center dot 90kg)=low to moderate; 3rd (10 center dot 90-15 center dot 90kg)=moderate; and 4th (>15 center dot 90kg)=massive. Results Leptin, the leptin/adiponectin ratio and plasminogen activator inhibitor 1 (PAI-1) were decreased significantly in the low-to-moderate weight loss. The cIMT was reduced in the moderate weight loss. Moreover, adiponectin was increased only in the massive weight loss. Additionally, weight loss was an independent predictor of changes in leptin level, the adiponectin/leptin ratio (A/L ratio) and PAI-1 when the data were adjusted for age and gender. BMI changes were predictors of changes in leptin and PAI-1 levels. A/L ratio was associated with lean body mass (%), independent of gender and age. In addition, changes in A/L ratio were independent predictors of cIMT alterations. Conclusions Interdisciplinary therapy may reduce cardiovascular risk factors among adolescents depending on their degree of weight loss (moderate to massive) and when correlated with their inflammatory profile, metabolic state and cIMT.