Insulin Resistance and Cognitive Dysfunction in Obese Adolescents: Pilot Study
Condition: Obesity
MeSH terms: Insulin Resistance; Cognitive Dysfunction
Study type: Interventional

Summary: 
      Obese Adolescents will be evaluated for insulin resistance and cognitive dysfunction.
    

Detailed description: 
      The short-term goal of this project is to conduct a feasibility study at Winthrop University
      Hospital to determine how well extremely obese (BMI > 99%tile corrected for age) children and
      adolescents can be recruited into an exercise program and evaluated in an efficient fashion,
      and to identify particular strategies (e.g., medical examination feedback) that can serve as
      potential benefits to research subjects and their families. In addition investigators will
      evaluate the effect of the exercise program on physical fitness, insulin resistance, and
      neurocognitive functioning as well as the relationship between insulin sensitivity and
      neurocognitive function among adolescents who participate in the exercise program.

      The long-term goal of this project is to evaluate a large, multi-ethnic sample of
      adolescents, 14 to 19 years of age, to systematically assess cognitive function and school
      performance, fitness and examine the relationship between performance on those outcome
      variables and a variety of biomedical and psychosocial factors that may directly or
      indirectly influence brain function and test-taking performance.

      High body mass index (BMI) among children and adolescents continues to be a public health
      concern in the United States. The most recent figures from the National Health and Nutrition
      Examination Survey (NHANES) for 2007-2008 report that 18.1% (95% CI, 14.5%-21.7%) of 12-
      through 19-year-old adolescents were at or above the 95th percentile of BMI for age. Children
      with high BMI often become obese adults, and obese adults are at risk for many chronic
      conditions. High BMI in children may also have immediate consequences, such as elevated lipid
      concentrations and blood pressure.

      It now appears that neurocognitive dysfunction is also more common in obese children and
      adolescents. In a large population study of 2,519 children, 8 to 16 years of age, a brief
      neuropsychological assessment showed a statistically significant, albeit modest relationship
      between cognitive test scores and BMI that persisted after adjusting for confounding
      variables. Obesity is also associated with several conditions which known to affect brain
      function, including sleep apnea, insulin resistance, hypertension, and chronic inflammatory
      factors (e.g., by these variables cannot be determined, unfortunately, because those
      variables were not measured.

      It is important to note, however, that there is not complete agreement on linkages between
      obesity and cognition.
    

Intervention name(s): Exercise Program
Intervention type(s): Other
Intervention description(s): Exercise Program for Obese Adolescents
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care