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[The development of lipid and anthropometric parameters in the treatment of pre-pubertal obese patients].

OBJECTIVE
Relationships have been found between obesity and changes in serum lipid levels which may lead to antherogenic lipid profiles. There are few studies treating obesity and showing the possibility of improving lipid abnormalities in prepubertal obese patients.


PATIENTS AND METHODS
One hundred and three obese patients ranging from 5.3 to 9.9 years old have been studied. Anthropometric (height, weight, body mass index-BMI-, and subscapular and triceps skinfolds) and lipid (total and lipoprotein cholesterol, triglycerides, apoprotein A1 and B) parameters were measured both at the beginning of the study and after six months of diet treatment. Patients were included in three groups according to their response to treatment: good response (GR), no response (NR) and bad response (BR), if the difference in BMI was less than 1 point (< 1), between -1 and +1 and more than 1 point (> 1), respectively.


RESULTS
Forty-one patients (39.8%) were noncompliant. Of the remaining sixty-two, 41 (66%) had a GR, 16 (25.8% NR and 5 (8%) BR. The obese patients showed a significantly lower HDL-C (38.8 +/- 15.6 vs 48.3 +/- 10.2 mg/dl, p < 0.01) in comparison to the control group. GR patients showed a statistically significant increase in HDL-C (48.2 +/- 9.1 vs 54.9 +/- 12.0 mg/dl, p < 0.01) and apoprotein A1 (126.7 +/- 17.3 vs 136.0 +/- 17.4 mg/dl, p < 0.05) levels at the end of the study. There was no statistically significant difference in serum lipid levels in the other two groups. There was no statistically significant correlation between serum lipid levels and anthropometric parameters. The difference between final minus initial value in both lipid and anthropometric parameters were not correlated. Sixteen patients (17.7%) had pathological serum lipid levels, 15 of them showing hypertriglyceridemia, that disappeared in GR patients.


CONCLUSIONS
Prepubertal obese patients show alterations in lipid profiles and this is not correlated with anthropometric parameters. The improvement in these anthropometric parameters improve the lipid profile. Initial pathologic serum lipid levels in GR patients become normalized.