title: Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescents.
abstract: OBJECTIVE
  The purpose of the present study was to assess the dietary fat intake, glucose, insulin, Homeostasis model assessment for insulin resistance HOMA-IR, and endotoxin levels and correlate them with adipokine serum concentrations in obese adolescents who had been admitted to long-term interdisciplinary weight-loss therapy.
  
  
  METHODS
  The present study was a longitudinal clinical intervention of interdisciplinary therapy. Adolescents (n = 18, aged 15-19 y) with a body mass index > 95th percentile were admitted and evaluated at baseline and again after 1 year of interdisciplinary therapy. We collected blood samples, and IL-6, adiponectin, and endotoxin concentrations were measured by ELISA. Food intake was measured using 3-day diet records. In addition, we assessed glucose and insulin levels as well as the homeostasis model assessment for insulin resistance (HOMA-IR).
  
  
  RESULTS
  The most important finding from the present investigation was that the long-term interdisciplinary lifestyle therapy decreased dietary fat intake and endotoxin levels and improved HOMA-IR. We observed positive correlations between dietary fat intake and endotoxin levels, insulin levels, and the HOMA-IR. In addition, endotoxin levels showed positive correlations with IL-6 levels, insulin levels and the HOMA-IR. Interestingly, we observed a negative correlation between serum adiponectin and both dietary fat intake and endotoxin levels.
  
  
  CONCLUSIONS
  The present results indicate an association between dietary fat intake and endotoxin level, which was highly correlated with a decreased pro-inflammatory state and an improvement in HOMA-IR. In addition, this benefits effect may be associated with an increased adiponectin level, which suggests that the interdisciplinary therapy was effective in improving inflammatory pathways.
authors.affiliation: Departamento de Fisiologia, Rua Botucatu nÂº 862 Vila Clementino, São Paulo, Brazil. fabioslira@gmail.com
authors.forename: Fábio S
authors.initials: FS
authors.lastname: Lira
authors.forename: Jose C
authors.initials: JC
authors.lastname: Rosa
authors.forename: Gustavo D
authors.initials: GD
authors.lastname: Pimentel
authors.forename: Ronaldo V
authors.initials: RV
authors.lastname: Santos
authors.forename: June
authors.initials: J
authors.lastname: Carnier
authors.forename: Priscila L
authors.initials: PL
authors.lastname: Sanches
authors.forename: Aline
authors.initials: A
authors.lastname: de Piano
authors.forename: Claudio T
authors.initials: CT
authors.lastname: de Souza
authors.forename: Lian
authors.initials: L
authors.lastname: Tock
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.forename: Marco T
authors.initials: MT
authors.lastname: de Mello
authors.forename: Marília
authors.initials: M
authors.lastname: Seelaender
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Oller do Nascimento
authors.forename: Lila M
authors.initials: LM
authors.lastname: Oyama
authors.forename: Ana R
authors.initials: AR
authors.lastname: Dâmaso
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000293:Adolescent; D015992:Body Mass Index; D004041:Dietary Fats / Q000008:administration & dosage; D004731:Endotoxins / Q000097:blood*; D002149:Energy Intake; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000097:blood / Q000628:therapy*; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult
chemical_list: D052242:Adiponectin; D004041:Dietary Fats; D004731:Endotoxins; D007328:Insulin; D015850:Interleukin-6