Obesity Clinical Trial
Official title:
ADIposity and Bone Metabolism: Effects of eXercise-induced Weight Loss in Obese Adolescents
The present protocol is mainly involved in the understanding of the local interaction
between the released products by fat tissue and hormones production of bone tissue. These
complex interactions between adipocyte and osteocyte activities could explain the mechanisms
of the body responses to the strategies of weight loss that include diet and/or physical
activity program, as well as the side effects encountered by these interventions.
Adolescence is a period of development characterized by many metabolic and somatic changes
that may influence weight. Weights bearing physical activities are a key factor allowing
body composition changes (i.e. fat and bone tissue). The difficulties of managing weight and
the onset of overweight and obesity during this very important growth spurt lead to various
hormonal dysregulation. The specific mechanisms of the evolution and interactions between
these two parameters (fat and bone tissue) are not yet elucidated; therefore our aim is to
analyze the possible connections between fat tissue and the quality of the skeleton in order
to reduce related risks of the consequence of weight loss in obese individuals.
The complex consequences of childhood obesity represent major concerns in most developed
countries, largely contributing to metabolic complications with costly repercussions for the
burden of disease. The burden is exemplified by high prevalence rates of overweight or
obesity.
The ADIBOX protocol was designed to provide a better understanding of the bone-adipocyte
cross-talk in adolescents with obesity and the effects of physical activity-induced weight
loss on this cross-talk.
Obesity effectively leads to hormonal alterations favoring the accumulation of fat mass and
loss of bone mass. Advancing the knowledge of the complex interactions between adipocyte and
osteocyte activities may contribute to the mechanistic understanding of the body's responses
to weight loss during adolescence and prevent cardiovascular risk. Indeed, the adipose-bone
tissue cross-talk has been recently linked with cardiovascular diseases. Similarly as
adipose tissue, released-products from bone tissue may act directly or indirectly on
cardiovascular risk and diseases.
The ADIBOX study, a 40 weeks longitudinal study (LS) with repeated measures on four
occasions (baseline and every fourteen weeks), will allow us to understand the effects of
physical activity-induced weight loss on this cross-talk in obese adolescents.
Data will be analyzed using Stata (StataCorp, College Station, USA) and IBM Statistics SPSS
version 22 (IBM Corp, 2013, Chicago, IL, USA) and significance will be accepted at a
two-sided alpha level of p<0.05. After testing for normal distribution (Shapiro-Wilk test),
data will be treated either by parametric or non-parametric analyses according to
statistical assumptions.
Student t tests or Mann-Whitney U test will be performed to compare adipose tissue (total,
subcutaneous, visceral) variation reported to bone mass variation at lumbar spine between
groups at baseline. Pearson (or Spearman when appropriate) correlation coefficient will be
used and compared with Fisher test (command corcor Stata) to measure the link between
exercise-inducing weight loss on adipose tissue and bone mass variations. Longitudinal data
will be treated using a mixed model analyses in order to treat fixed effects group, time and
group x time interaction taking into account between and within participant variability.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label
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