Papel de fatores anorexígenos e orexígenos na regulação do balanço energético em adolescentes com obesidade: análise longitudinal

Background: Deregulation of orexigenic and anorexigenic pathways occurs among adolescents with obesity. Alpha-melanocyte-stimulating hormone (α-MSH) is a key catabolic mediator of energy homeostasis and an important anorexigenic neuropeptide in the control of energy balance and thermogenesis. However, it was not well explored if α-MSH can modulate long-term weight loss therapy responses as dependent manner according to its concentration. We hypothesis is that high α-MSH concentration at baseline promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents. Methods: 110 post-pubertal obese adolescents (BMI >97th percentile), were submitted to 1 year of interdisciplinary therapy (clinical, nutritional, psychological, physical exercise and physiotherapy support). Body composition and plasma levels of Alpha-MSH, NPY, MCH, AgRP were measured before and after therapy. The volunteers were grouped by Tertiles of α-MSH concentration: Low (1.57 ng/ml). Significance was set as p1,57 ng/ml; n=36). O tratamento promoveu melhora da gordura corporal e da massa livre de gordura para todos os grupos. Apenas no Tercil 3 foi observado um aumento da relação α-MSH/NPY e diminuiçã concentração de MCH, em comparação com os Tercis 1 e 2. No grupo com maior concentração de α-MSH foram observadas correlações negativas entre Δα-MSH/NPY com ΔNPY/AgRP, NPY e MCH. Artigo 2 – 108 adolescentes completaram a terapia e foram analisados de acordo com a redução do peso corporal nos grupos baixa perda de peso (BPP: E-IID; n=30) ou diminuição (E-IID, enquanto no grupo