Childhood obesity is an increasing health care problem associated with
insulin resistance and low-level systemic
inflammation, which can ultimately lead to diabetes. Evidence for efficacy of therapeutic intervention programs on the early development of
obesity associated sequelae is moderate. This paper investigates the effect of a multidisciplinary short-term intervention program on
insulin resistance and metaflammation in
childhood obesity. Two hundred and 36
overweight or obese children and adolescents between the ages of 10 and 14 were included in a prospective 5 months intervention study, which included sports, psychotherapy, and nutritional counseling. Primary endpoints were the effects on body mass index standard deviation score (BMI-SDS) and homeostatic model assessment of
insulin resistance (HOMA-IR), key secondary endpoints were the levels of
C-reactive protein (CRP),
leptin, and
adiponectin. At baseline, a substantial proportion of participants showed signs of
insulin resistance (mean HOMA-IR 5.5 ± 3.4) despite not meeting the diagnostic criteria for diabetes, and low-level
inflammation (mean CRP 3.9 mg/l ± 3.8 mg/l). One hundred and 95 participants (83%) completed the program resulting in a significant reduction in BMI-SDS, HOMA-IR, CRP, and
leptin and a significant increase in
adiponectin (mean change compared to baseline -0.14, -0.85, -1.0 mg/l, -2.8 ng/ml, and 0.5 μg/ml, respectively; p < 0.001 each). Effects on BMI-SDS, HOMA-IR, CRP, and
adiponectin were largely independent whereas
leptin was positively correlated with BMI-SDS and total fat mass before and after intervention (r = 0.56 and 0.61, p < 0.001 each). Short-term multidisciplinary intervention successfully improved body composition,
insulin sensitivity, low-level systemic
inflammation, and the
adipokine profile in
childhood obesity. Our findings highlight the immediate connection between
obesity and the pathophysiology of its sequelae, and emphasize the importance of early intervention. Continued lifestyle modification is likely necessary to consolidate and augment the long-term effects.