Abstract
Childhood obesity has increased worldwide, and many clinical and public interventions have attempted to reduce morbidity. We aimed to determine the metabolomic signatures associated with weight control interventions in children with obesity. Forty children from the “Intervention for Children and Adolescent Obesity via Activity and Nutrition (ICAAN)” cohort were selected according to intervention responses. Based on changes in body mass index z-scores, 20 were responders and the remaining non-responders. Their serum metabolites were quantitatively analyzed using capillary electrophoresis time-of-flight mass spectrometry at baseline and after 6 and 18 months of intervention. After 18 months of intervention, the metabolite cluster changes in the responders and non-responders showed a difference on the heatmap, but significant metabolites were not clear. However, regardless of the responses, 13 and 49 metabolites were significant in the group of children with obesity intervention at 6 months and 18 months post-intervention compared to baseline. In addition, the top five metabolic pathways (D-glutamine and D-glutamate metabolism; arginine biosynthesis; alanine, aspartate, and glutamate metabolism; TCA cycle (tricarboxylic acid cycle); valine, leucine, and isoleucine biosynthesis) including several amino acids in the metabolites of obese children after 18 months were significantly changed. Our study showed significantly different metabolomic profiles based on time post obesity-related intervention. Through this study, we can better understand and predict childhood obesity through metabolite analysis and monitoring.
Highlights
The prevalence of childhood obesity has increased worldwide [1]
We identified significant metabolite changes associated with long-term childhood obesity weight intervention
These results suggest that long-term weight-loss intervention itself may induce metabolic changes, independent of effect of intervention (i.e., body mass index (BMI) z-score changes) in children and adolescents
Summary
The prevalence of childhood obesity has increased worldwide [1]. According to the Korean Ministry of Education, the Korean childhood obesity rate in 2018 reached 25%, increasing rapidly from 8.4% in 2008 [2]. Adolescent obesity is associated with several cancers and cardiovascular diseases in adulthood [4,5]. Anthropometric measurements, such as the body mass index (BMI) or waist–hip ratio, and circulating biomarkers, such as insulin or adiponectin, are currently used as general “obesity biomarkers” to identify disease risk due to obesity [6]. There is an unmet need to identify the most effective methods to control childhood obesity, monitor treatment effects before and after intervention, and select responsive candidates for treatment
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