Changes in Body Composition and Cardiometabolic Risk Factors in Relation to the Reduction in Body Mass Index in Adolescents with Obesity

Abstract Background. There are controversial data in relation to the reduction in BMI-SDS needed to improve adiposity in the pediatric population with obesity. The aim of this work is to determine the minimum variation in body mass index standard deviation score (BMI-SDS) required to improve the values of adiposity markers and cardiometabolic risk factors in growing adolescents with obesity. Methods . A longitudinal study consisting in clinical evaluation (waist circumference, waist-to-height ratio and fat mass index, and blood pressure) and blood testing (insulin resistance and lipid profile) was conducted in 350 adolescents with obesity (152 boys and 198 girls), aged 10.2–14.3 years, that went through a combined intervention (12 months). Results. A decrease in SDS-BMI ≤0.5 was not associated with any significant improvement in the clinical features and blood testing recorded. A decrease in BMI-SDS >0.5, and especially if >1.0, was linked to a significant improvement in adiposity markers. A decrease in BMI-SDS >0.5 was associated with a significant improvement in insulin resistance, and a decrease in BMI-SDS >1.0 was associated with a significant decrease in the percentage of patients who showed high values of systolic blood pressure, HOMA-IR and lipid profile Conclusions. Improvement in body composition, insulin resistance and lipid profile can be observed with reductions in BMI-SDS of ≥0.5 in obese adolescents, while extended benefits are obtained by losing at least 1.0 BMI-SDS.