Treatment of Childhood Syndrome X
Weight Loss Study Aim
Hyperinsulinemia, hyperlipidemia, hypertension, and coronary artery disease
comprise a quartet known as Syndrome X. This syndrome was first described
in adults, but has recently been described in children and adolescents.
The purpose of our study was to determine if diet or exercise is able
to change the clinical profile of Syndrome X in children. We recruited
36 obese ( percent ideal body weight = 170.3 +/- 31.1), children (9 to
12 yrs old) known to have high fasting cholesterol levels (177.5 +/- 33.5
mg/dL). Each participated in a 6-week protocol in one of three groups:
control (C), diet (D), or exercise (E). Twenty-five of the patients completed
the study with full compliance. At the beginning and end of the study,
we measured weight, height, blood pressure, serum insulin, and a lipid
profile including: cholesterol, low density lipoprotein, high density
lipoprotein (HDL), triglycerides, and apolipoprotein A (ApoA). All subject
groups were similar before the study. The D group had the greatest attrition
(40 percent) and all of the E group completed the study.
Weight Loss Study Results
After the 6-week study period, there was no significant weight loss or
change in body mass index for any group. There was no significant change
in blood pressure and there was no significant decline of fasting cholesterol
or low density lipoprotein levels in any of the groups. HDL levels were
low in all groups and did not significantly change with treatment. There
was a significant decline in the triglyceride levels in both the diet
and exercise groups after the study. Both the D and E groups also demonstrated
a significant decrease in ApoA levels. Most impressively, fasting insulin
levels significantly decreased with both diet and exercise, but did not
change in controls during the 6 weeks.
Weight Loss Study Conclusions
The findings of this study are consistent with previous studies describing
the presence of Syndrome X in childhood. Both diet and exercise were effective
in lowering triglyceride, ApoA levels, and insulin levels. However, due
to the large rate of noncompliance in the diet group, exercise seems to
be the best treatment for improvement in Syndrome X in children.
Source: Hardin DS, Hebert JD, Bayden T,
Dehart M, Mazur L. Department of Pediatrics, University of Texas Health
Science Center, Houston, TX 77030, USA. 1998
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