Key Points
Question
Will fecal microbiome transfer (FMT) lead to weight loss among adolescents with obesity?
Findings
In this randomized clinical trial of 87 adolescents with obesity, FMT alone did not lead to weight loss at 6 weeks. FMT alone was associated with a reduction in android-to-gynoid-fat ratio sustained for at least 26 weeks, particularly in female adolescents; changes in the overall gut microbiome composition; and a resolution of metabolic syndrome by 26 weeks in participants who had this undiagnosed condition at baseline.
Meaning
FMT alone is not an effective treatment for weight loss but may reduce visceral adiposity and improve health.
Increased IR and oxidative stress are already present in prepubertal normal-weight SGA and LGA children with a continuous alteration in relation to obesity, suggesting that BW and adiposity represent 2 independent risk factors for degenerative diseases.
BackgroundSubjects born small (SGA) and large (LGA) for gestational age have an increased risk of cardio-metabolic alterations already during prepuberty. Nevertheless, the progression of their cardio-metabolic profile from childhood to adolescence has not been fully explored. Our aim was to assess potential changes in the cardio-metabolic profile from childhood to adolescence in subjects born SGA and LGA compared to those born appropriate (AGA) for gestational age.MethodsThis longitudinal study included 35 AGA, 24 SGA and 31 LGA subjects evaluated during childhood (mean age (±SD) 8.4±1.4 yr) and then re-assessed during adolescence (mean age 13.3±1.8 yr). BMI, blood pressure, insulin resistance (fasting insulin, HOMA-IR) and lipids were assessed. A cardio-metabolic risk z-score was applied and this consisted in calculating the sum of sex-specific z-scores for BMI, blood pressure, HOMA-IR, triglycerides and triglycerides:high-density lipoprotein cholesterol ratio.ResultsFasting insulin and HOMA-IR were higher in SGA and LGA than AGA subjects both during childhood (all P<0.01) and adolescence (all P<0.01). Similarly, the clustered cardio-metabolic risk score was higher in SGA and LGA than AGA children (both P<0.05), and these differences among groups increased during adolescence (both P<0.05). Of note, a progression of the clustered cardio-metabolic risk score was observed from childhood to adolescence within SGA and within LGA subjects (both P<0.05).ConclusionsSGA and LGA subjects showed an adverse cardio-metabolic profile during childhood when compared to AGA peers, with a worsening of this profile during adolescence. These findings indicate an overtime progression of insulin resistance and overall estimated cardiovascular risk from childhood to adolescence in SGA and LGA populations.
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