Changes of cardiovascular risk factors in obese children effects of inpatient and outpatient interventions.
OBJECTIVE
The aim of the study was to compare the benefits of 2 different therapeutic approaches on cardiovascular risk factors (CVRF) in obese children and adolescents.


METHODS
We analyzed the changes of weight status (as standard deviation score-body mass index [SDS-BMI]), blood pressure, lipids, and insulin levels in obese children (age range, 10-14 years) during a 1-year outpatient intervention based on lifestyle changes (group A, n = 124) and during a 6-week inpatient intervention program with dietary restriction and exercise therapy (group B, n = 119). In addition, we studied these parameters in 65 obese children without intervention for 1 year (control group).


RESULTS
Age, degree of overweight, sex, and CVRF did not differ significantly between the control group and the intervention groups at baseline. During the observation period, CVRF did not change in the control group, whereas SDS-BMI slightly increased (+0.1 SDS-BMI). The SDS-BMI decreased significantly (P < 0.001) in group A (SDS-BMI, -0.40) and comparably in group B (SDS-BMI, -0.43). The decreases of total (P < 0.001) and low-density lipoprotein-cholesterol levels (P = 0.049) were significantly greater in group B, whereas triglyceride (P = 0.040) and insulin (P = 0.006) levels decreased significantly and were more pronounced in group A. High-density lipoprotein-cholesterol level increased significantly (P < 0.001) only in group A. Blood pressure decreased significantly (P < 0.01) and comparably in both intervention groups (A and B).


CONCLUSIONS
In contrast to obese children without intervention, CVRF improved in obese children with intervention. The 6-week inpatient intervention led to a significant greater decrease of total and low-density lipoprotein-cholesterol levels as compared with the 1-year outpatient intervention, although the outpatient intervention yielded a significantly greater improvement in insulin, triglycerides, and high-density lipoprotein-cholesterol levels.
Reinehr
Thomas
T
Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Witten, Germany. T.Reinehr@kinderklinik-datteln.de
de Sousa
Gideon
G
Wabitsch
Martin
M
D000293:Adolescent; D000553:Ambulatory Care; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D004035:Diet Therapy; D005081:Exercise Therapy; D015438:Health Behavior; D006760:Hospitalization; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000150:complications / Q000628:therapy*; D012307:Risk Factors; D040242:Risk Reduction Behavior
D007328:Insulin; D008055:Lipids