Effect of weight loss intervention on fat metabolism including adipocytokines and enzymes in children with simple obesity

OBJECTIVE: To investigate short-term changes in adipocytokines and fat-metabolism enzymes after a diet and exercise intervention in children with simple obesity. METHODS: Fifty-one children with simple obesity were screened; one did not provide an ELISA serum sample, leaving 50 children with obesity and 50 normal-weight controls for baseline analyses. Forty-four children with obesity completed the 3-month intervention. Leptin, thymic stromal lymphopoietin (TSLP), hormone-sensitive lipase (LIPE/HSL), and carnitine palmitoyltransferase 1A (CPT1A) were measured. Biomarker concentrations were log10-transformed. Baseline comparisons used Welch t tests, repeated measurements used paired t tests, and associations were assessed using Pearson correlation coefficients. RESULTS: At baseline, children with obesity had higher leptin and lower LIPE/HSL than controls, whereas TSLP and CPT1A did not differ significantly. Among the 44 completers, waist circumference, HDL cholesterol, fasting glucose, 25-hydroxyvitamin D, FT4, and CPT1A decreased, while total cholesterol and leptin increased. Leptin increased and CPT1A decreased in the weight maintenance/gain subgroup; no biomarker change reached statistical significance in the weight-loss subgroup. Baseline leptin was positively correlated with fasting glucose, and baseline CPT1A was positively correlated with triglycerides. Changes in CPT1A, leptin, and TSLP were associated with changes in HDL, insulin, and TSH, respectively. CONCLUSIONS: The 3-month home-based intervention produced a reduction in waist circumference without a significant mean reduction in body weight or BMI. Leptin increased and CPT1A decreased during follow-up, while the participant-level correlation findings were modest and should be considered exploratory.