This study aimed to explore short-term variations in adipocytokines and fat-metabolism enzymes following a diet and exercise intervention in children diagnosed with simple obesity.
A total of 51 children with simple obesity were initially screened. Out of these, one child was excluded due to the lack of an ELISA serum sample, resulting in a final cohort of 50 children with obesity and a matched group of 50 normal-weight controls for baseline analysis. Among those with obesity, 44 completed a 3-month intervention that included dietary and exercise components. Key biomarkers such as leptin, thymic stromal lymphopoietin (TSLP), hormone-sensitive lipase (LIPE/HSL), and carnitine palmitoyltransferase 1A (CPT1A) were measured, and statistical analyses were performed using Welch t-tests and Pearson correlation coefficients.
At baseline, the children with obesity exhibited significantly higher levels of leptin and lower LIPE/HSL activity compared to their healthy counterparts. However, TSLP and CPT1A levels did not show significant differences. Among the 44 participants who completed the intervention, notable reductions in waist circumference and levels of HDL cholesterol, fasting glucose, 25-hydroxyvitamin D, and CPT1A were observed. Conversely, levels of total cholesterol and leptin displayed an increase. Leptin levels increased, while CPT1A levels decreased in the weight maintenance or gain subgroup; however, no substantial biomarker changes were observed in the weight loss subgroup. Furthermore, a positive correlation existed between baseline levels of leptin and fasting glucose, as well as between baseline CPT1A and triglycerides.
The 3-month home-based intervention demonstrated a reduction in waist circumference without a significant change in mean body weight or BMI. The findings indicated an increase in leptin levels and a decrease in CPT1A during the follow-up, although correlations noted were modest and should be regarded as exploratory.
Obesity in childhood is a growing global health concern linked to various metabolic, endocrine, cardiovascular, respiratory, and psychosocial issues. While monogenic or endocrine disorders account for a small percentage of cases, the majority are influenced by lifestyle factors such as excessive calorie intake, reduced physical activity, and increased sedentary behavior. Early onset of obesity often persists into adulthood, contributing to chronic disease risk later in life.
Adipose tissue is recognized as an active endocrine organ secreting adipocytokines that play roles in energy homeostasis, insulin sensitivity, and lipid metabolism. Leptin, primarily produced by adipocytes, reflects fat mass and has been identified as a potential biomarker for obesity in children and for assessing the success of weight-loss strategies. Nevertheless, the effects of short-term lifestyle changes on leptin levels in children are inconsistent and may depend on various factors including developmental stage and dietary adherence.
Thymic stromal lymphopoietin (TSLP) has been implicated in immune regulation and may affect adipocyte loss, although studies in children with obesity are limited. Lipolysis and mitochondrial fatty acid oxidation are regulated by enzymes such as lipase and CPT1A, which play critical roles in the balance of lipid synthesis and catabolism. This investigation examined the serum levels of leptin, TSLP, LIPE/HSL, and CPT1A in children with simple obesity before and after a structured 3-month weight management intervention, and their associations with various anthropometric and metabolic parameters.
The study received ethical clearance from the Wuhan Children’s Hospital, with informed consent obtained from all participants and their guardians. Children were recruited from a local primary school and a pediatric outpatient clinic. All participants had to be aged between 7-14 years with a BMI at or above the 97th percentile as per the International Obesity Task Force criteria. A matched control group consisting of healthy children was also included.
The dietary intervention was formulated by a team of nutrition and endocrinology experts, focusing on education regarding obesity, balanced nutrition, and the importance of physical activity. Recommended daily caloric intake ranged from 800 to 1200 kcal depending on age. Exercise guidelines included moderate activity three times weekly under parental supervision.
Anthropometric data and body composition were assessed using a specialized analyzer. Measurements taken included height, weight, body fat percentage, and waist circumference, following strict protocols to ensure accuracy.
Statistical analyses were conducted to compare baseline and post-intervention measurements, assessing significance and exploring correlations among variables.