Abstract
BackgroundThe global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise.MethodsA total of 84 children, aged 8–12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry).DiscussionPrevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity.Trial registrationClinicalTrials.gov, ID: NCT03027726. Registered on 16 January 2017.
Highlights
The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D)
There is a need for studies examining the effect of family based multidisciplinary intervention programs on metabolic abnormalities closely associated to T2D risk in order to give appropriate treatment/prevention options for prediabetes and T2D in overweight/obese children
Research focusing on the prevention of T2D in pre-adolescent children is a high priority for public health
Summary
The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). Type-2 diabetes (T2D) is an important cause of premature death and disability as well as a costly disease affecting more than 415 million people worldwide [1] This chronic disease is an important risk factor for developing accelerated cardiovascular disease and is the leading cause of microvascular complications such as end-stage renal disease, blindness and limb amputations. Long-term success rates of lifestyle intervention programs focused on T2D prevention or treatment in children are usually less than 10% [11]. There is a need for studies examining the effect of family based multidisciplinary intervention programs on metabolic abnormalities closely associated to T2D risk in order to give appropriate treatment/prevention options for prediabetes and T2D in overweight/obese children
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