• Clinical and Experimental Pediatrics
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• 제59권5호
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• pp.231-238
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• 2016

Purpose: Lipopolysaccharide-binding protein (LBP) is a 65-kDa acute phase protein, derived from the liver, which is present in high concentrations in plasma. Data regarding the association between circulating plasma LBP levels and obesity-related biomarkers in the pediatric population are scarce. We aimed to determine whether there was a difference in plasma LBP levels between overweight/obese and normal-weight adolescents and to assess the correlation of circulating LBP levels with anthropometric measures and obesity-related biomarkers, including insulin resistance, liver enzyme levels, and lipid profiles. Methods: The study included 87 adolescents aged 12-13 years; 44 were overweight/obese and 43 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), blood pressure, insulin resistance, liver enzyme levels, and lipid profiles. Plasma LBP levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was $12.9{\pm}0.3$ years. Circulating plasma LBP levels were significantly increased in overweight/obese participants compared with those in normal-weight participants ($7.8{\pm}1.9{\mu}g/mL$ vs. $6.0{\pm}1.6{\mu}g/mL$, P<0.001). LBP levels were significantly and positively associated with BMI, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose and insulin, and insulin resistance as indicated by the homeostatic model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, BMI and HOMA-IR were independently and positively associated with plasma LBP levels. Conclusion: LBP is an inflammatory biomarker associated with BMI and obesity-related insulin resistance in adolescents. The positive correlation between these parameters suggests a potentially relevant pathophysiological mechanism linking LBP to obesity-related insulin resistance in adolescents.

• Journal of Preventive Medicine and Public Health
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• 제43권5호
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• pp.396-402
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• 2010

Objectives: Self-reported anthropometric values, such as height and weight, are used to calculate body mass index (BMI) and assess the prevalence of obesity among adolescents. The aim of this study was to evaluate the validity of selfreported height, weight, and BMI of the Korea Youth Risk Behavior Web-based Survey questionnaire. Methods: A convenience sample of 137 middle school students and 242 high school students completed a selfadministered questionnaire in 2008. Body height and weight were directly measured after self-reported values were obtained from the questionnaire survey. Sensitivity, specificity, and kappa statistics were computed in order to evaluate the validity of the prevalence of obesity (BMI $\geq$ 95th percentile or $\geq$ $25;kg/$m^2$) based on self-reported data. Results: Self-reported weight and BMI tended to be underestimated. Self-reported height tended to be overestimated among middle school females and high school males. Obese adolescents tended to underestimate their weight and BMI and overestimate their height more than non-obese adolescents. The prevalence estimate of obesity based on selfreported data (10.6%) was lower than that based on directly measured data (15.3%). The estimated sensitivity of obesity based on self-reported data was 69.0% and the specificity was 100.0%. The value of kappa was 0.79 (95% confidence interval, 0.70 - 0.88). Conclusions: This study demonstrated that self-reported height and weight may lead to the underestimation of BMI and consequently the prevalence of obesity. These biases should be taken into account when self-reported data are used for monitoring the prevalence and trends of obesity among adolescents nationwide.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.192-200
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• 2013

Objectives: To measure the prevalence of behavioural risk factors for obesity among urban adolescent school children in Chennai, India. Methods: This study was performed as a cross-sectional study using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for India) among adolescent school children studying in 30 randomly selected secondary and higher secondary schools in Chennai city. 1842 adolescents studying in the VIII to XII standards were randomly selected for the study. Results: In the present study, 40.7% of the students ate fruit one or more times per day and 74.5% of the students ate vegetables one or more times per day. Nearly 20% of the students ate fast food items on 4 to 7 days during the previous week. Among the students, 30.4% watched television for more than two hours per day. Nearly 68% of the girls and 22% of the boys did not participate in outdoor sports activities. When the pattern of physical activity of the students was assessed, it was observed that 15.6% were inactive, 43.4% were minimally active, and the remaining 41.0% belonged to the category of health enhancing physical activity. Among the students, 6.2% were overweight and 5.2% were obese. Conclusions: The prevalence of risk factors for obesity was quite high among the adolescents. This study also showed that a great proportion of overweight/obese adolescents had a correct perception of their body weight and they were making efforts to modify risk factors such as television viewing, computer use, a sedentary lifestyle, and unhealthy dietary habits.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권1호
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• pp.54-64
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• 2021

Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68±2.32 kg/㎡), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO2peak), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion: HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.

• 비만대사연구학술지
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• 제3권1호
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• pp.27-34
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• 2024

The prevalence of obesity in children and adolescents is increasing worldwide. Obesity in children and adolescents not only increases the risk of transitioning to obesity in adulthood but also increases the risk of cardiometabolic diseases such as high blood glucose, high blood pressure, dyslipidemia, fatty liver, and hyperinsulinemia during childhood. The goal of treating obesity in children and adolescents is not to focus on weight loss but to help children reach a healthy weight while maintaining normal growth appropriate for their age and sex. To achieve this goal, regular physical activity and exercise, dietary modification, improvement of obesity-prone environmental factors, and behavioral changes are required for a healthy lifestyle. If appropriate weight control is not achieved through lifestyle modifications, pharmacotherapy may be considered for adolescents with severe obesity aged 12 and above. Recent clinical trials have reported the efficacy and safety of pharmacotherapy in severely obese adolescents. Currently, two medications can be prescribed in Korea for patients with obesity aged 12 and above: Orlistat and Liraglutide. However, despite effective weight control through drug treatment, body weight may increase again after treatment discontinuation. Therefore, it is crucial to evaluate adherence to health behaviors during visits and continue to educate on lifestyle modifications, even during pharmacotherapy, to minimize weight regain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.111-117
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• 2018

Purpose: The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. Methods: The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as "atherogenic indices." Results: Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. Conclusion: In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.

• Clinical and Experimental Pediatrics
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• 제54권7호
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• pp.292-297
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• 2011

Purpose: Our study aimed to evaluated sex differences in clinical features of obese high school students. Methods: One hundred three obese high school students (body mass index [BMI]${\geq}$85th percentile) and 51 control students (BMI<85th percentile) were enrolled in this study. Anthropometric measurements were performed. Fasting serum glucose, insulin, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and high-sensitive C-reactive protein were measured. Abdominal fat thickness, degree of fatty liver, and carotid intima-media thickness were measured by ultrasound. Results: In control and obese groups, waist circumference was significantly longer in boys but body fat mass was Significantly higher in girls. In the control group, total cholesterol and LDL-C were higher in girls. In the obese group, however, aspartate aminotransferase, alanine aminotransferase and triglyceride were higher and HDL-C was lower in boys. Preperitoneal fat thickness was significantly higher in obese girls. In obese group, the degree of fatty liver was significantly higher in boys. Carotid intima-media thickness was not significantly different between boys and girls. Conclusion: Obese adolescents had distinguishable sex differences in body measurements, metabolic abnormalities, abdominal fat thickness and fatty liver. We can infer that these characteristics may extend into adult obesity.

• 가정과삶의질연구
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• 제33권5호
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• pp.55-70
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• 2015

The purpose of the study is to examine the effect of personality style and emotional dysregulation on female adolescents' eating attitude, and the mediating effect of emotional dysregulation on the relationship between personality style and eating attitude. For this research, questionnaires on personality style, emotional dysregulation and eating attitude were administered to 1370 female high school students based in Seoul. Among 1370 questionnaires collected, 1239 were selected and statistically analyzed by frequency analysis, Pearson's correlation analysis, multiple regression analysis, and stepwise multiple regression analysis using SPSS Win 21.0. The main findings of the study are as follows: First, according to female adolescents' BMI, the level of their eating attitude differed significantly. Second, according to female adolescents' BMI, female adolescents' personality style and emotional dysregulation were found to affect their eating attitude significantly. Third, emotional dysregulation had a mediating effect on the relationship between female adolescents' personality style and eating attitude. To be more specific, for the normal weight group of female adolescents, emotional dysregulation was found to have a partial mediating effect on the relationship between sociotropy and eating attitude, and a full mediating effect on the relationship between autonomy and eating attitude. On the contrary, for the overweight and obese groups of female adolescents, emotional dysregulation was found to have a full mediating effect on the relationship between sociotropy and eating attitude, and a partial mediating effect on the relationship between autonomy and eating attitude. The results of the study show the ways in which personality and emotional traits contribute to female adolescents' eating attitude according to their BMI, and provide useful information for treatment of adolescents' eating disorder in clinical settings.

• 한국학교보건학회지
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• 제34권1호
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• pp.1-12
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• 2021

Purpose: Growing evidence indicates that adolescents from multicultural families are more vulnerable to drug use than those from non-multicultural families. This study aimed to compare the factors associated with the habitual drug use among adolescents from multicultural and non-multicultural families. Methods: A descriptive cross-sectional design was employed. Data were obtained from the 14~15th (2018~2019) Korea Youth Risk Behavior Web-based Survey. Overall, 91,443 multicultural (n=1,725) and non-multicultural adolescents (n=89,718) were included. Data were analyzed using descriptive statistics, univariate analysis, and logistic regression analysis. Results: The multicultural adolescents engaged in more habitual drug use than did non-multicultural adolescents. In both groups, those who currently drank, experienced violent victimization, had sexual experiences, and did not live with their family were at greater risk of engaging in habitual drug use. The odds ratios of these factors were higher in multicultural adolescents than in non-multicultural adolescents. In non-multicultural adolescents, those who were boys, had experienced depression and suicidal ideation, perceived their body image as normal, overweight, or obese, and had poor subjective health status were at greater risk of engaging in habitual drug use. Conclusion: These results highlight the need to develop customized strategies for adolescents from both multicultural and non-multicultural families to reduce and prevent their habitual drug use.

• 한국지역사회생활과학회지
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• 제25권4호
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• pp.473-486
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• 2014

This study examines the relationships between dietary self-efficacy, social support, depression, and weight-control behavior of children and adolescents. A total of 593 students (280 children and 313 adolescents) from schools in Seoul, Gyeonggi-do, Jeollabuk-do, and Daegu were surveyed using scales for dietary self-efficacy, social support, depression, and weight-control behavior. The data were analyzed through a frequency analysis, means and standard deviations, a t-test, a one-way ANOVA, the Tukey test, the Pearson's correlation, and a stepwise multiple regression analysis. According to the results, weight-control behavior was more likely in girls than boys, high-school students than elementary-school students, and obese/overweight students than normal/underweight students. The factors influencing children's weight-control behavior were general eating habits, the BMI, depression, food choice, and family support, in that order, and those influencing adolescents' weight-control behavior were general eating habits, gender, and the BMI, in that order. These results are expected to be useful as basic data for developing weight-control programs for children and adolescents.