TY - JOUR
T1 - The association of weight loss and cardiometabolic outcomes in obese children
T2 - Systematic review and meta-regression
AU - Rajjo, Tamim
AU - Almasri, Jehad
AU - Al Nofal, Alaa
AU - Farah, Wigdan
AU - Alsawas, Mouaz
AU - Ahmed, Ahmed T.
AU - Mohammed, Khaled
AU - Kanwar, Amrit
AU - Asi, Noor
AU - Wang, Zhen
AU - Prokop, Larry J.
AU - Murad, Mohammad Hassan
N1 - Publisher Copyright:
Copyright © 2017 by the Endocrine Society.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: Excess body weight in children is associated with multiple immediate and long-term medical comorbidities. We aimed to identify the degree of reduction in excess body weight associated with cardiometabolic changes (lipid panel, liver function tests, systolic blood pressure (SBP), diastolic blood pressure, glycosylated hemoglobin, and fasting blood glucose) in overweight and obese children. Methods: We conducted a comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus through February 12, 2015. We included randomized controlled trials and cohort studies that evaluated interventions to treat pediatric obesity (medication, surgery, lifestyle, and community-based interventions) with a 6-month follow-up. We used a random effects meta-regression approach to assess the association between body mass index (BMI)/weight and cardiometabolic changes. Results: We included 42 studies (37 randomized controlled trials and five cohorts) enrolling 3807 children (mean age, 12.2 years; weight, 74.7 kg; and BMI, 31.7 kg/m2). Studies had overall moderate to low risk of bias. A 1-mm Hg decrease in SBP was significantly associated with a decrease of 0.16 kg/m2 (P 5 .04) in BMI. A 1-mg/dL increase in HDL was significantly associated with a 0.74-kg decrease in weight (P 5 .02). A 1-mg/dL decrease in triglycerides was significantly associated with a 0.1-kg decrease in weight (P 5 .03). The remaining associations were not statistically significant. Conclusions: Weight reduction in children is associated with significant changes in several cardiometabolic outcomes, particularly HDL, SBP, and triglycerides. The magnitude of improvement may help in setting expectations and may inform shared decision-making and counseling.
AB - Background: Excess body weight in children is associated with multiple immediate and long-term medical comorbidities. We aimed to identify the degree of reduction in excess body weight associated with cardiometabolic changes (lipid panel, liver function tests, systolic blood pressure (SBP), diastolic blood pressure, glycosylated hemoglobin, and fasting blood glucose) in overweight and obese children. Methods: We conducted a comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus through February 12, 2015. We included randomized controlled trials and cohort studies that evaluated interventions to treat pediatric obesity (medication, surgery, lifestyle, and community-based interventions) with a 6-month follow-up. We used a random effects meta-regression approach to assess the association between body mass index (BMI)/weight and cardiometabolic changes. Results: We included 42 studies (37 randomized controlled trials and five cohorts) enrolling 3807 children (mean age, 12.2 years; weight, 74.7 kg; and BMI, 31.7 kg/m2). Studies had overall moderate to low risk of bias. A 1-mm Hg decrease in SBP was significantly associated with a decrease of 0.16 kg/m2 (P 5 .04) in BMI. A 1-mg/dL increase in HDL was significantly associated with a 0.74-kg decrease in weight (P 5 .02). A 1-mg/dL decrease in triglycerides was significantly associated with a 0.1-kg decrease in weight (P 5 .03). The remaining associations were not statistically significant. Conclusions: Weight reduction in children is associated with significant changes in several cardiometabolic outcomes, particularly HDL, SBP, and triglycerides. The magnitude of improvement may help in setting expectations and may inform shared decision-making and counseling.
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U2 - 10.1210/jc.2016-2575
DO - 10.1210/jc.2016-2575
M3 - Review article
C2 - 28359092
AN - SCOPUS:85015237231
SN - 0021-972X
VL - 102
SP - 758
EP - 762
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 3
ER -