Langfristige Ergebnisse einer stationären Rehabilitation wegen Adipositas bei Kindern und Jugendlichen – eine Katamnese über 2-5 Jahre: Verhaltenskorrelate erfolgreicher Gewichtsstabilisierung nach der stationären Rehabilitation von adipösen Kindern und Jugendlichen

Die Adipositas im Kindes- und Jugendalter ist durch eine in den letzten Jahren ansteigende Prävalenz gekennzeichnet. Da die Wahrscheinlichkeit auch im Erwachsenenalter die Adipositas beizubehalten sehr hoch ist, soll dieser Entwicklung durch eine an den Leitlinien der AGA (Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter) orientierte Adipositastherapie entgegengewirkt werden. Einem solchen Therapieprogramm unterzogen sich 335 Mädchen und 307 Jungen mit der Haupt- oder Nebendiagnose Adipositas, die zwischen 1995 und 1998 an einer Rehabilitationsmaßnahme in der Fachklinik Sylt für Kinder und Jugendliche teilnahmen. Zu den Erhebungszeitpunkten vor und nach der Rehabilitation sowie 2-5 Jahre später wurden Körpergewicht, Körpergröße und BMI-SDS bestimmt. Zum Follow-up-Zeitpunkt wurden zusätzlich verschiedene Aspekte des Essverhaltens erfragt. Von den 291 nachuntersuchten Kindern und Jugendlichen konnte die Hälfte der Teilnehmer ihr Übergewicht (BMI-SDS) im Katamnesezeitraum um mindestens 5% senken. Die Gruppe der erfolgreichen Abnehmer zeichnete sich insgesamt durch eine stärkere kognitive und flexiblere Kontrolle ihres Essverhaltens aus

FTO Genotype Interacts with Improvement in Aerobic Fitness on Body Weight Loss During Lifestyle Intervention

Objective: Not every participant responds with a comparable body weight loss to lifestyle intervention, despite the same compliance. Genetic factors may explain parts of this difference. Variation in fat mass and obesity-associated gene (FTO) is the strongest common genetic determinant of body weight. The aim of the present study was to evaluate the impact of FTO genotype differences in the link between improvement of fitness and reduction of body weight during a lifestyle intervention. Methods: We genotyped 292 healthy subjects for FTO rs8050136. Participants underwent a 9-month lifestyle intervention. Before and after intervention, aerobic fitness was tested by bicycle (VO2max) and treadmill spiroergometry (individual anaerobic threshold (IAT), subgroup of N = 192). Results: Participants lost body weight (p FTO genotype (p = 0.5). There was a significant correlation between improvement in VO2max and decrease in body weight (p FTO genotype interacted with this relationship (p = 0.0042 for VO2max, p = 0.0049 for IAT). When stratifying the cohort according to their improvement in VO2max, FTO obesity-risk A-allele carriers in the higher quartiles of improvement in fitness lost significantly less body weight. Conclusions: Our data reveal that genetic variation in FTO impacts on body weight reduction during lifestyle intervention only in subjects with marked improvement in aerobic fitness

Androgen receptor overexpression in prostate cancer in type 2 diabetes

Objective: While prostate cancer does not occur more often in men with diabetes, survival is markedly reduced in this patient group. Androgen signaling is a known and major driver for prostate cancer progression. Therefore, we analyzed major components of the androgen signaling chain and cell proliferation in relation to type 2 diabetes. Methods: Tumor content of 70 prostate tissue samples of men with type 2 diabetes and 59 samples of patients without diabetes was quantified by an experienced pathologist, and a subset of 51 samples was immunohistochemically stained for androgen receptor (AR). mRNA expression of AR, insulin receptor isoform A (IR-A) and B (IR-B), IGF-1 receptor (IGF1R), Cyp27A1 and Cyp7B1, PSA gene KLK3, PSMA gene FOLH1, Ki-67 gene MKI67, and estrogen receptor beta (ESR2) were analyzed by RT-qPCR. Results: AR mRNA and protein expression were associated with the tumor content only in men with diabetes. AR expression also correlated with downstream targets PSA (KLK3) and PSMA (FOLH1) and increased cell proliferation. Only in diabetes, AR expression was correlated to higher IR-A/IR-B ratio and lower IR-B/IGF1R ratio, thus, in favor of the mitogenic isoforms. Reduced Cyp27A1 and increased Cyp7B1 expressions in tumor suggest lower levels of protective estrogen receptor ligands in diabetes. Conclusions: We report elevated androgen receptor signaling and activity presumably due to altered insulin/IGF-1 receptors and decreased levels of protective estrogen receptor ligands in prostate cancer in men with diabetes. Our results reveal new insights why these patients have a worse prognosis. These findings provide the basis for future clinical trials to investigate treatment response in patients with prostate cancer and diabetes. Keywords: Prostate cancer, Androgen receptor, Insulin receptor, IGF-1 receptor, Cyp27A1, Cyp7B