Teen-LABS study explores safety, health effects of surgical weight loss procedures

Cardiovascular risks of severe pediatric obesity, assessed among adolescents participating in the "Teen Longitudinal Assessment of Bariatric Surgery" (Teen-LABS) study, were published this week in JAMA Pediatrics. Teen-LABS is a multi-center clinical study funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) that is examining the safety and health effects of surgical weight loss procedures. Teen-LABS is being conducted at five clinical centers in the U.S., including Cincinnati Children's Hospital, Nationwide Children's Hospital, Texas Children's Hospital, the University of Alabama at Birmingham, and the University of Pittsburgh Medical Center. The study's Chair, Thomas H. Inge, MD, PhD, is located at Cincinnati Children's Hospital Medical Center.

Marc P. Michalsky, MD, FACS, FAAP, surgical director of the Center for Healthy Weight and Nutrition at Nationwide Children's, is the lead author for the article published this week which focuses on cardiovascular risk factors within the study population.

"This NIH-funded study will add important knowledge to the field of severe obesity during adolescence and the effects of bariatric surgery," said Dr. Michalsky, also an Associate Professor of Clinical Surgery and Pediatrics at The Ohio State University College of Medicine. "Collaborating with colleagues around the country in a study of this magnitude to gather critical data defining cardiovascular disease (CVD) and other health risks, is both gratifying and hugely important. The results of this study will improve our understanding of the significant medical challenges faced by severely obese teens as well as document outcomes following surgical weight loss."

In this most recent publication from the Teen-LABS research study, investigators note that while pediatric obesity is more common now than in previous decades, very little is known about the CVD risks in the most severely obese teens. The main goal of the current publication was to assess the baseline prevalence and predictors of CVD risks among severely obese adolescents before undergoing weight-loss surgery.

The authors of this publication found that severely obese adolescents carry not only excess weight, but also have much higher risk for CVD than previously realized. Of the 242 participants in the Teen-LABS cohort, 95 percent had at least one CVD risk factor. Seventy-five percent had elevated blood pressure (including hypertension and pre-hypertension), 50 percent had unhealthy cholesterol levels, and nearly three-quarters of the group were insulin resistant. Importantly, the study also confirmed that increasing weight in teenagers is associated with increases in blood sugar and blood pressure.

While the majority of study participants are female, researchers found an interesting link between gender and CVD. "We found that adolescent boys were at a markedly higher risk compared with adolescent girls for abnormal triglyceride levels," said Dr. Michalsky. "Among severely obese adolescents, recognition and treatment of CVD risk factors is important to help limit further progression of disease."

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