Metabolomics reveals determinants of weight loss during lifestyle intervention in obese children

Wahl S, Holzapfel C, Yu Z, et al. Metabolomics reveals determinants of weight loss during lifestyle intervention in obese children. Metabolomics. 2013;9(6):1157-1167.The amount of weight loss in obese childrenduring lifestyle intervention differs strongly between indi-viduals. The metabolic processes underlying this variabilityare largely unknown. We hypothesize that metabolomicsanalyses of serum samples might help to identify metabolicpredictors of weight loss. In this study, we investigated 80obese children aged 6–15 years having completed the one-year lifestyle intervention program ‘Obeldicks’, 40 thatachieved a substantial reduction of their body mass indexstandard deviation score (BMI-SDS) during this interven-tion (defined as BMI-SDS reductionC0.5), and 40 thatdid not improve their overweight status (BMI-SDS reduc-tion\0.1). Anthropometric and clinical parameters weremeasured and baseline fasting serum samples of allchildren were analyzed with a mass spectrometry-basedmetabolomics approach targeting 163 metabolites. Bothunivariate regression models and a multivariate leastabsolute shrinkage and selection operator (LASSO)approach identified lower serum concentrations of long-chain unsaturated phosphatidylcholines as well as smallerwaist circumference as significant predictors of BMI-SDSreduction during intervention (p-values univariate models:5.3E-03 to 1.0E-04). A permutation test showed that theLASSO model explained a significant part of BMI-SDSchange (p=4.6E-03). Our results suggest a role ofphosphatidylcholine metabolism and abdominal obesity inbody weight regulation. These findings might lead to abetter understanding of the mechanisms behind the largeinter-individual variation in response to lifestyle interven-tions, which is a prerequisite for the development of indi-vidualized intervention programs