title: Alterations in downstream mediators involved in central control of eating behavior in obese adolescents submitted to a multidisciplinary therapy.
abstract: OBJECTIVE
  The aim of this study was to verify the effects of a multidisciplinary therapy (24 weeks) on neurohormonal control of food intake, specifically in orexigenic (total ghrelin, agouti-related protein [AgRP], neuropeptide Y [NPY], and melanin-concentrating hormone) and anorexigenic factors (leptin, insulin, and alpha-melanocyte stimulating hormone [α-MSH]), in obese adolescents.
  
  
  METHODS
  A total of 88 adolescents (38 boys and 50 girls), including 62 obese and 26 normal-weight, aged 15-19 years were recruited. Obese adolescents were submitted to a 24-week multidisciplinary therapy. AgRP, NPY, melanin-concentrating hormone, leptin, insulin, glucose, α-MSH, total ghrelin, and food intake were measured at three stages (at baseline, after 12 weeks, and after 24 weeks).
  
  
  RESULTS
  At baseline, obese adolescents showed hyperleptinemia (circulating leptin levels, which were, in boys and girls, 40 and 35 times higher than in normal-weight subjects, respectively). After 24 weeks, these values decreased in all obese patients. Our results showed no differences in ghrelin levels between obese and normal-weight adolescents, in both genders. However, obese boys reduced their plasma ghrelin concentration after 24 weeks of therapy (p < .05). The multidisciplinary therapy decreased NPY and AgRP values and increased α-MSH; simultaneously with these changes there was a decrease in total food intake after 24 weeks of therapy.
  
  
  CONCLUSIONS
  We can conclude that the multidisciplinary therapy was efficient to modulate neurohormonal control of food intake in obese adolescents.
authors.affiliation: Nutrition Postgraduate Program, Federal University of São Paulo/Paulista Medicine School, São Paulo, Brazil. wagner.prado@pq.cnpq.br
authors.forename: Wagner L
authors.initials: WL
authors.lastname: Prado
authors.forename: Lila M
authors.initials: LM
authors.lastname: Oyama
authors.forename: Mara C
authors.initials: MC
authors.lastname: Lofrano-Prado
authors.forename: Aline
authors.initials: A
authors.lastname: de Piano
authors.forename: Sérgio G
authors.initials: SG
authors.lastname: Stella
authors.forename: Cláudia M O
authors.initials: CM
authors.lastname: Nascimento
authors.forename: June
authors.initials: J
authors.lastname: Carnier
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Caranti
authors.forename: Lian
authors.initials: L
authors.lastname: Tock
authors.forename: Sérgio
authors.initials: S
authors.lastname: Tufik
authors.forename: Marco Túlio
authors.initials: MT
authors.lastname: de Mello
authors.forename: Ana R
authors.initials: AR
authors.lastname: Dâmaso
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D054369:Agouti-Related Protein / Q000097:blood; D001835:Body Weight; D003131:Combined Modality Therapy; D004038:Diet, Reducing / Q000379:methods*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D007028:Hypothalamic Hormones / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008543:Melanins / Q000097:blood; D009478:Neuropeptide Y / Q000097:blood; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000628:therapy*; D036361:Peptide Hormones / Q000097:blood*; D010907:Pituitary Hormones / Q000097:blood; D015431:Weight Loss; D000521:alpha-MSH / Q000097:blood
chemical_list: C515198:AGRP protein, human; D054369:Agouti-Related Protein; D054439:Ghrelin; D007028:Hypothalamic Hormones; D020738:Leptin; D008543:Melanins; D009478:Neuropeptide Y; D036361:Peptide Hormones; D010907:Pituitary Hormones; D000521:alpha-MSH; C019463:melanin-concentrating hormone