C. B. Cummins1, B. Hughes1, O. Nunez-Lopez1, J. Prochaska2, E. Lyons3, D. Jupiter2, K. Perino3, A. Glaser4, R. Radhakrishnan1,4, K. Bowen-Jallow1 1University Of Texas Medical Branch,Department Of Surgery,Galveston, TX, USA 2University Of Texas Medical Branch,Department Of Preventive Medicine And Community Health,Galveston, TX, USA 3University Of Texas Medical Branch,Department Of Nutrition And Metabolism,Galveston, TX, USA 4University Of Texas Medical Branch,Department Of Pediatrics,Galveston, TX, USA
Introduction:
The prevalence of childhood obesity has nearly tripled in the past 50 years, with current estimates of ~ 20% in school-aged children. Multiple biomarkers associated with obesity have been identified and studied recently, including gamma-glutamyltransferase (GGT) and C-reactive protein (CRP). GGT has been shown to be associated with central obesity, increased risk of cardiovascular disease, and metabolic syndrome in adults and adolescents. CRP has been linked to the low-grade systemic inflammatory response in obese adults and children. In this study we examined the short-term outcomes of our intensive multidisciplinary pediatric weight loss program exploring the anthropometric and clinical factors as well as obesity-related biomarkers.
Methods:
Patients were seen in the multidisciplinary clinic every 4-6 weeks by a pediatric surgeon, a pediatric gastroenterologist, a dietician, and a fitness instructor. Referrals were made to a pediatric psychiatrist as needed. Anthropometric and clinical data were obtained at each visit. Obesity-related biomarkers were collected at the initial visit and at selected subsequent visits when clinically indicated. Biomarkers collected included HcbA1C, total cholesterol, triglycerides, HDL, LDL, GGT, CRP, and insulin levels.
Results:
A total of 70 patients have been evaluated for an initial visit with a total of 25 patients available for 3 month short-term outcome follow-up. Mean baseline weight was 108.5 kg with a mean baseline BMI of 39.5. Mean weight loss and mean BMI change at 3 months were -0.99 kg (p<0.000005) and -0.84 (p<0.00001), respectively, confirming short term success of the weight loss program. 6 patients had GGT follow up at 3 months with a mean loss of -1.67 U/L (p<0.00001). 4 patients had CRP follow up at 3 months with a mean loss of -0.12 mg/dL (p<0.00001). Additionally, trends in decreased waist circumference, decreased insulin levels, and decreased triglyceride levels were seen but the study is currently under-powered to provide statistical significance.
Conclusion:
An intensive multidisciplinary approach to weight loss in the pediatric population led to both a short-term decrease in weight and BMI and a decrease in obesity-related biomarkers CRP and GGT. Further studies will be necessary to report long-term outcomes as well as confirm trends currently observed in the data.