Novel findings on treatments for childhood obesity and early polycystic ovary syndrome (PCOS) in young girls

New research findings presented this week in New Orleans during ENDO 2004, the 86th Annual Meeting of The Endocrine Society, could help keep kids healthier. The five studies, which were presented in a press conference on kid's health on Wednesday, June 16 at 1:00 p.m. CT, highlight novel findings on treatments for childhood obesity and early polycystic ovary syndrome (PCOS) in young girls.

The new research also examines how much teenagers are using anabolic steroids and body-shaping drugs. Non-athlete teens and boys more likely to use anabolic steroids According to new research, high school boys are more likely to use anabolic steroids (AS), while high school girls use more body-shaping, athletic-enhancing drugs (BSD). The same researchers found that female athletes are less likely to use BSD than female non-athletes. To assess the use of AS and BSD by high school students, Dr. Linn Goldberg and researchers at Oregon Health and Sciences University asked students at 13 Oregon high school districts to complete a questionnaire, which indicated personal use of AS and BSD by estimating the number of times they students took the drug(s) on a continuum. In one study, the researchers analyzed the results from 2,036 females, while in another study they looked at results from 4,100 students.

According to the findings, high school students -- both athletes and non- athletes -- use anabolic steroids and body shaping drugs on a regular basis. Male athletes and non-athletes appear to be the most common users of anabolic steroids; while females are more likely to use body shaping drugs, such as amphetamines, methamphetamines, pseudoephedrine and diet pills. Additionally, students with a higher grade-point average tend to use less drugs. Compared with non-athletes, student athletes were also less likely to use steroids, alcohol, cocaine, cigarettes, pseudoephedrine and diet pills.

"Our findings indicate an increase in anabolic steroid use among high school non-athletes, which may be one of the reasons for the national increase in steroid use among teens," explained Dr. Goldberg. "Also, while high school females use less alcohol and other drugs, they use more body-shaping and athletic-enhancing drugs than their male counterparts." Since drug use in Oregon mirrors the national rates, Dr. Goldberg notes that these findings could mean that athletic and body shaping substances could be used by nearly two million high school students.

Drug helps obese teens lose weight

Obese teens taking sibutramine, a diet drug marketed as Meridia in the United States, for six months experienced substantial weight loss without harmful side effects. The new study is one of the first to show the effectiveness of drug therapy on obese adolescents. Dr. Amelio Godoy Matos and colleagues in Brazil treated 60 obese boys and girls, 14 to 18 years old with either sibutramine or placebo for six months. Both groups also participated in a controlled diet, moderate exercise and counseling.

After six months, patients taking sibutramine lost an average of 28 lbs while those taking the placebo lost only about 11 lbs. Also, more than six times as many adolescents taking sibutramine reduced their initial body weight by at least 10 percent, compared with the placebo group. Also, 50 percent of the sibutramine group reduced their body weight by at least 15 percent, compared with none in the placebo group.

"Patients in the sibutramine group, not only lost more weight, but they also experienced significant improvements in good cholesterol, HDL, and insulin levels," explained Dr. Godoy Matos. "Based on our findings, sibutramine appears to be a safe and effective treatment for obesity in adolescents. Larger and longer studies are needed to confirm these findings."

Research could help doctors determine appropriate exercise level for obese kids

A new study could help doctors determine how much exercise obese and non- obese children need to remain healthy and avoid cardiovascular disease. The findings also show that severely obese kids are at risk for developing cardiovascular disease, but the correct amount of regular exercise could improve this condition. Dr. Constanze Steinborn and researchers in Germany used treadmill exercise to measure cardiovascular state and determine the level at which children should perform regular exercise to maintain a healthy weight.

"With obesity affecting as much as 25 percent of children, it is important to understand how much exercise is necessary to help obese kids lose weight in order to avoid serious health problems later in life. Our findings could help doctors determine appropriate exercise levels for obese children to lose weight and also help non-obese children know how much to exercise to avoid weight gain," explains Dr. Steinborn."

Growth, weight, blood pressure, heart rate and blood were tested in sixteen obese children with an average body mass index (BMI) of more than 26. Dr. Steinhorn and her team used a cardiopulmonary exercise test (CPET) and measured CO2 release to identify the anaerobic threshold, or level of exercise that burns the maximum amount of fat, for each subject. Researchers also measured the corresponding heart rate to this level.

Researchers found a direct correlation between high BMI and poor cardiovascular state in the children. They also note that physical activity close to the optimal fat consumption rate can improve metabolic and cardiovascular health in obese children.

Low doses of metformin can prevent girls with insulin resistance from developing PCOS

According to new findings, early use of metformin -- an insulin sensitizer -- in girls with insulin resistance can decrease the progression of PCOS. In young girls, early signs of PCOS, which can increase the risk of cardiovascular disease and diabetes as they age, include hyperinsulinemia, exaggerated increase in adrenal gland activity, high cholesterol and upper- body obesity. The new study is the first to show that intervention in young girls can prevent the development of PCOS.

Dr. Lourdes Ibanez and researchers at the University of Barcelona in Spain, treated two groups of low birth weight (LBW) girls with early signs of PCOS. In one group of 28 non-obese, eight-year-old girls who were born with LBW, researchers studied the effects of beginning metformin (425 mg/day) before puberty. The group was randomized to receive metformin or no therapy. In a second group of 13 year old girls, Dr. Ibanez and her team examined the effects of discontinuing metformin therapy after 12 months and watched the metabolic results over the next six months. Again, this group was randomized to receive metformin or no therapy for 12 months.

The results showed that metformin treatment greatly benefits young girls with early insulin resistance. The untreated girls developed more upper body fat and experienced a worsening of endocrine-metabolic markers. Girls who were treated with metformin experienced a reduction in abdominal fat and a normalization of several PCOS markers including cholesterol.

"In the girls who stopped treatment with metformin, all beneficial effects reversed within six months," noted Dr. Ibanez, the lead investigator on the study. "Additionally, girls who began treatment with metformin experienced a rapid improvement in their condition. These results indicate that prepubertal girls can benefit from metformin treatment. At the same time, in both young girls and older adolescents, the discontinuation of metformin treatment can result in a rapid decline in clinical benefits.