Published online May 8, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. e1111-e1118 (doi:10.1542/peds.2005-1532)
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Improvement in Risk Factors for Metabolic Syndrome and Insulin Resistance in Overweight Youth Who Are Treated With Lifestyle Intervention

Roshanak Monzavi, MDa, Daina Dreimane, MDa, Mitchell E. Geffner, MDa,b, Sharon Braun, MS, RD, CDEa, Barry Conrad, MPH, RD, CDEa, Mary Klier, RDa and Francine R. Kaufman, MDa,b

a Center for Diabetes, Endocrinology, and Metabolism, Los Angeles, California
b The Saban Research Institute, Childrens Hospital Los Angeles, Los Angeles, California

OBJECTIVE. To evaluate the prevalence of risk factors that are associated with the metabolic syndrome and insulin resistance in overweight youth and to determine the effect of a short-term, family-centered, lifestyle intervention on various associated anthropometric and metabolic measures.

METHODS. Overweight youth who were between 8 and 16 years of age participated in a 12-week, family-centered, lifestyle intervention program. Anthropometric and metabolic measures were assessed before the program in all participants (n = 109) and after the program in a subset of the participants (n = 43).

RESULTS. At baseline, 49.5% of youth had multiple risk factors associated with the metabolic syndrome, based on a modified definition of the National Cholesterol Education Program, and 10% had impaired fasting glucose and/or impaired glucose tolerance. Measures of insulin resistance correlated significantly with the risk factors of the metabolic syndrome. Forty-three youth had pre- and postintervention evaluations that showed statistically significant improvements in body mass index, systolic blood pressure, lipids (total, low-density lipoprotein cholesterol, and triglycerides), postprandial glucose, and leptin levels.

CONCLUSION. Overweight youth have multiple risk factors associated with the metabolic syndrome. A 12-week lifestyle program may have a positive effect on reducing risk factors for the metabolic syndrome and insulin resistance in overweight youth.

Key Words: overweight • obesity • BMI • lipid • glucose • type 2 diabetes • physical activity • nutrition

Abbreviations: IGT—impaired glucose tolerance • NCEP—National Cholesterol Education Program • NHANES III—Third National Health and Nutrition Examination Survey • BP—blood pressure • TG—triglycerides • HDL—high-density lipoprotein • IR—insulin resistance • KNF—Kids N Fitness • SDS—SD score • FPG—fasting plasma glucose • LDL—low-density lipoprotein • CV—coefficient of variation • IFG—impaired fasting glucose • HOMA—homeostasis model assessment • QUICKI—quantitative insulin sensitivity check index

Accepted Dec 14, 2005.




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