Inpatient long-term therapy for extremely obese adolescents and young adults: reduction of the visceral fat and improvement of cardiovascular risk profile
InstitutionUKU. Klinik für Kinder- und Jugendmedizin
UKU. Klinik für Innere Medizin I
Ressourcen- / MedientypDissertation, Text
Datum der Erstveröffentlichung2017-10-12
The aim of this study was to investigate how an inpatient obesity treatment of adolescent and young adult patients, focusing on lifestyle modification, diet and physical exercise can reduce visceral fat and how this influences cardiovascular risk factors. Comparisons were made between male/female patients as well as short-term (<3 months) and long-term (>3 months) treatment. Data from 125 consecutively admitted patients aged 12 to 31 years who took part in a therapy at the Obesity Rehabilitation Center Insula in Bischofswiesen were enrolled into a prospective non-randomized study from January 2007 to October 2008. Parameters beside visceral fat measured by sonography were body weight, BMI and fat mass (measured via bio impedance analysis), waist circumference, blood pressure, intima-media thickness, a glucose tolerance test, HOMA index and serum concentrations of triglycerides, cholesterol, HDL, LDL, insulin, adiponectin, interleukin 6, CRP, yGT, uric acid and creatinine. Male and female patients showed significant correlations between visceral fat reduction and therapy duration, reduction in body weight, BMI, waist circumference and CRP. Only female patients showed a significant correlation between visceral fat reduction and reduction of fat mass, uric acid and creatinine. In contrast, only male patients showed a significant correlation between visceral fat reduction and reductions in serum insulin, interleukin 6 and HOMA index. In short- and long-term treatment groups a significant correlation between visceral fat reduction and reduction of body weight and BMI was seen. Only short-term patients showed a significant correlation between visceral fat reduction and reduction of LDL and yGT. In contrast, only long-term patients showed a significant correlation between visceral fat reduction and reduction of waist circumference, systolic blood pressure, glucose tolerance test, therapy duration and serum levels of insulin, interleukin 6, CRP, uric acid and HOMA index. The therapy at the Obesity Rehabilitation Center Insula led to a significant weight reduction. The mean reduction in body weight for all patients was 23.3 kg ± 14.5 (min: 2.5 kg, max: 93.8 kg). The mean reduction in BMI for all patients was 8.2 kg/m2 ± 4.7 (min: 0.9 kg/m2, max: 33.8). This effect was more pronounced in male patients than in female patients. A long-term therapy led to a significantly higher weight reduction than the short-term therapy. Associated with the weight reduction was a significant reduction of the visceral fat tissue. The mean reduction in visceral fat for all patients was 17.7 mm ± 15.7 (min: -30.5 mm, max: 72.8 mm). The reduction of visceral fat was significantly higher in long-term patients than in short-term patients. There were significant differences in regard to the visceral fat reduction and its influence on other cardiovascular risk factors between male and female as well as between short- and long-term patients.