Effect of a 1-Year Obesity Intervention (KLAKS Program) on Preexisting Autonomic Nervous Dysfunction in Childhood Obesity

J Child Neurol. 2015 Aug;30(9):1174-81. doi: 10.1177/0883073814555190. Epub 2014 Nov 18.

Abstract

Childhood obesity may involve autonomic nervous system dysfunction. Whether it improves following weight loss remains unclear. Thirty-one obese children (body mass index standard deviation scores 2.33 ± 0.47; age 11.2 ± 2.0) completed a 1-year lifestyle intervention (KLAKS: Concept Leipzig: Adiposity Therapy for School-Aged Children). Anthropometric/biochemical parameters and autonomic nervous system function (heart rate variability, quantitative pupillography) were assessed at baseline and follow-up. A multivariate model for changes in body mass index standard deviation scores considered age, gender, and changes in autonomic nervous system function. Weight status (Δ body mass index standard deviation scores: 0.16 [0.05, 0.29], P = .008), glycemic control, and free fatty acids (all P < .05) improved after the intervention. Redilation velocity increased by 0.22 mm/s [0.06, 0.38] (P = .008), and changes tended to be negatively associated with Δ body mass index standard deviation scores (P = .08 [-0.61, 0.03]). Relative reflex amplitude (23.4 vs 26.3, P = .004) and constriction velocity (4.97 mm/s vs 5.47 mm/s, P < .001) also improved. Our data provide preliminary evidence that lifestyle-intervention induced improvement of weight status/metabolic risk factors may ameliorate some parameters of autonomic nervous system dysfunction in childhood obesity.

Keywords: KLAKS program; autonomic nervous dysfunction; childhood; obesity; weight loss.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anthropometry
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / therapy*
  • Blood Glucose
  • Body Mass Index
  • Fasting
  • Female
  • Follow-Up Studies
  • Hemoglobins / metabolism
  • Humans
  • Life Style*
  • Lipoproteins / blood
  • Male
  • Multivariate Analysis
  • Neurologic Examination
  • Pediatric Obesity / complications*
  • Pediatric Obesity / psychology
  • Pediatric Obesity / rehabilitation*

Substances

  • Blood Glucose
  • Hemoglobins
  • Lipoproteins