A study conducted in Brazil with 92 adolescents shows that girls are more likely than boys to develop metabolic changes related to obesity, such as: B. High blood pressure and excessive levels of cholesterol and triglycerides in the blood (dyslipidemia).
The study was carried out with the support of FAPESP by scientists affiliated with the Institute of Biomedical Sciences of the University of São Paulo (ICB-USP) and the Faculty of Medicine of Santa Casa de Misericórdia de São Paulo (FCM-SCMSP). The results are in one items in Frontiers in Nutrition magazine.
According to the authors, the obese girls showed a pattern of changes in lipid profile that was not observed in girls without obesity and a greater propensity to develop cardiovascular disease in adulthood. “We found that girls have a much greater tendency to undergo the changes typical of obesity, such as high blood pressure and dyslipidemia. In our study, they had elevated levels of triglycerides and LDL, called “bad cholesterol”, while HDL, “good cholesterol”, was lower than eutrophic ones [normal weight] Girl ”said Estefania Simoes, First author of the article.
The lipid profile of the obese boys included in the study showed no significant differences from that of boys of normal weight, according to the researchers.
Childhood obesity is a growing problem with health officials and scientists in the field. The World Health Organization (WHO) estimates that around 340 million children between the ages of 5 and 19 worldwide were overweight or obese in 2016. It is known that obesity in children is linked to a higher likelihood of metabolic disorders and cardiovascular disease in adulthood.
A considerable amount of research shows this, but the differences between boys and girls in terms of the effects of obesity have not been thoroughly studied. “We compared obese and non-obese girls and boys between the ages of 11 and 18 while studying anthropometry, lipid and lipoprotein profile, and hormone and neuropeptide levels, with an emphasis on gender-dependent responses. To the best of our knowledge, this is the first study to take this multifactor approach, ”said Simoes.
The study was funded by FAPESP through two projects: “Cerebral Anatomy, Inflammatory Mediators, and Appetite Regulatory Hormones in Obese Pediatric Patients: A Neurobiological Study of Obesity” and “Systemic Inflammation in Patients with Cachectic Cancer: Mechanisms and Therapeutic Strategies, a Translational Medical Approach”.
The study was carried out in collaboration with Ricardo Riyoiti Uchida, a neurologist and psychiatrist who served as the lead researcher who recruited the 92 participants in the Child Obesity Outpatient Clinic at Santa Casa de Misericórdia Hospital in São Paulo. Uchida uses neuroimaging to find out if there are changes in the areas of the brain associated with satiety and appetite in obese people. “An article on this subject is nearing publication and focuses on characterizing the central nervous system in obese patients. Uchida has been researching adolescent obesity for many years, ”said Simoes.
The SCMSP team took the subjects’ blood pressure and collected blood samples to measure the fasting serum concentrations of total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) and very low density lipoprotein cholesterol (VLDL) and triglycerides ( TG).
The researchers also looked for binge eating and addictions to high-sugar and high-fat foods using special questionnaires. They also measured neuropeptides associated with neuro-humoral changes and found significant changes in obese subjects. Neuropeptides are released in response to peripheral signals such as hormones to regulate appetite and energy levels. “In addition, leptin and insulin interact with the neuropeptides NPY, MCH and a-MSH and regulate not only appetite but also the sympathetic nervous system, which can contribute to the high blood pressure associated with obesity,” said Simoes.
The new data on differences between the hormone, cytokine and neuropeptide profiles of girls and boys indicate the need for personalized treatment. “As much as we want to develop a single therapy strategy based on drugs or supplements, our results show that girls and boys should not be treated the same, even if they are the same weight and age, as their organisms respond differently to treatment . Said Simoes.
According to Joanna Correia-Lima As the second author of the article, two more articles were written using the data collected from the same group of volunteers. The first, published in the International Obesity Magazine, focuses on the characterization of the inflammatory process, as systemic chronic inflammation is important in obese individuals.
“In the laboratory under the direction of Professor Marília Seelaender As a co-author of both articles, we’ve long been researching a disorder that is the opposite of obesity: cachexia [extreme weight loss and muscle wasting, frequently in cancer and AIDS patients]. Systemic inflammation plays a key role in both, ”said Correia-Lima. “We focused first on inflammation and then on the role of hormones and how they relate to predisposition to develop cardiovascular disease.”
Most of the scientific publications on childhood obesity focus on a single specific change such as inflammation or a hormone, or on a particular consequence of obesity such as high blood pressure. “Our research aims to connect the dots. We have a large cohort and a large amount of data so that we can characterize the links in this group and show how all the changes in the obese organism are related. The most important aspect of our work is to show these connections, ”said Correia-Lima.
According to Simoes, it was the researchers’ statistical analysis of the data that pointed to these links. “Elevated levels of hormones like insulin and leptin [the satiety hormone] can be the cause of high blood pressure, for example, ”she said. “This type of information should be taken into account when treating obesity. Doctors often prescribe anti-inflammatory drugs that, while they can alleviate one aspect of the disease, treatment will be more complete knowing other factors. ”
Obesity is a multifactor disease and treatment cannot be uniform. Diet and exercise are important, but medication, surgery and psychotherapy may also be needed. “Questionnaire-based assessments suggest eating disorders on a psychological level in these girls and boys,” said Simoes. “As much as we show that there are changes in neuropeptides and hormones, as well as high blood pressure, inflammation, etc., ultimately the child has not only an organic but also a psychological problem. Therefore, it is important that obesity studies are conducted in children to support an early diagnosis and seek timely treatment before complications occur in adults. ”
About the São Paulo Research Foundation (FAPESP)
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