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The effect of a multidisciplinary weight loss program on renal circadian rhythm in obese adolescents

(2019) EUROPEAN JOURNAL OF PEDIATRICS. 178(12). p.1849-1858
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Abstract
Adolescent obesity is a serious health problem associated with many comorbidities. Obesity-related alterations in circadian rhythm have been described for nocturnal blood pressure and for metabolic functions. We believe renal circadian rhythm is also disrupted in obesity, though this has not yet been investigated. This study aimed to examine renal circadian rhythm in obese adolescents before and after weight loss. In 34 obese adolescents (median age 15.7 years) participating in a residential weight loss program, renal function profiles and blood samples were collected at baseline, after 7 months, and again after 12 months of therapy. The program consisted of dietary restriction, increased physical activity, and psychological support. The program led to a median weight loss of 24 kg and a reduction in blood pressure. Initially, lower diurnal free water clearance (- 1.08 (- 1.40-- 0.79) mL/min) was noticed compared with nocturnal values (0.75 (- 0.89-- 0.64) mL/min). After weight loss, normalization of this inverse rhythm was observed (day - 1.24 (- 1.44-1.05) mL/min and night - 0.98 (- 1.09-- 0.83) mL/min). A clear circadian rhythm in diuresis rate and in renal clearance of creatinine, solutes, sodium, and potassium was seen at all time points. Furthermore, we observed a significant increase in sodium clearance. Before weight loss, daytime sodium clearance was 0.72 mL/min (0.59-0.77) and nighttime clearance was 0.46 mL/min (0.41-0.51). After weight loss, daytime clearance increased to 0.99 mL/min (0.85-1.17) and nighttime clearance increased to 0.78 mL/min (0.64-0.93). Conclusion: In obese adolescents, lower diurnal free water clearance was observed compared with nocturnal values. Weight loss led to a normalization of this inverse rhythm, suggesting a recovery of the anti-diuretic hormone activity. Both before and after weight loss, clear circadian rhythm of diuresis rate and renal clearance of creatinine, solutes, sodium, and potassium was observed.What is Known:center dot Obesity-related alterations in circadian rhythm have been described for nocturnal blood pressure and for metabolic functions. We believe renal circadian rhythm is disrupted in obesity, though this has not been investigated yet.What is New:center dot In obese adolescents, an inverse circadian rhythm of free water clearance was observed, with higher nighttime free water clearance compared with daytime values. Weight loss led to a normalization of this inverse rhythm, suggesting a recovery of the anti-diuretic hormone activity.center dot Circadian rhythm in diuresis rate and in the renal clearance of creatinine, solutes, sodium, and potassium was preserved in obese adolescents and did not change after weight loss.
Keywords
Frederik Paulsen chair, Adolescent obesity, Circadian rhythm, Renal function, ANGIOTENSIN-ALDOSTERONE SYSTEM, AMBULATORY BLOOD-PRESSURE, URINE PRODUCTION, ADIPOSE-TISSUE, KIDNEY, HYPERTENSION, INSULIN, DISEASE

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MLA
Pauwaert, Kim, et al. “The Effect of a Multidisciplinary Weight Loss Program on Renal Circadian Rhythm in Obese Adolescents.” EUROPEAN JOURNAL OF PEDIATRICS, vol. 178, no. 12, 2019, pp. 1849–58.
APA
Pauwaert, K., Dejonckheere, S., Bruneel, E., Van der Jeugt, J., Keersmaekers, L., Roggeman, S., … Everaert, K. (2019). The effect of a multidisciplinary weight loss program on renal circadian rhythm in obese adolescents. EUROPEAN JOURNAL OF PEDIATRICS, 178(12), 1849–1858.
Chicago author-date
Pauwaert, Kim, Sarah Dejonckheere, Elke Bruneel, Jolien Van der Jeugt, Laura Keersmaekers, Saskia Roggeman, Ann De Guchtenaere, Johan Vande Walle, and Karel Everaert. 2019. “The Effect of a Multidisciplinary Weight Loss Program on Renal Circadian Rhythm in Obese Adolescents.” EUROPEAN JOURNAL OF PEDIATRICS 178 (12): 1849–58.
Chicago author-date (all authors)
Pauwaert, Kim, Sarah Dejonckheere, Elke Bruneel, Jolien Van der Jeugt, Laura Keersmaekers, Saskia Roggeman, Ann De Guchtenaere, Johan Vande Walle, and Karel Everaert. 2019. “The Effect of a Multidisciplinary Weight Loss Program on Renal Circadian Rhythm in Obese Adolescents.” EUROPEAN JOURNAL OF PEDIATRICS 178 (12): 1849–1858.
Vancouver
1.
Pauwaert K, Dejonckheere S, Bruneel E, Van der Jeugt J, Keersmaekers L, Roggeman S, et al. The effect of a multidisciplinary weight loss program on renal circadian rhythm in obese adolescents. EUROPEAN JOURNAL OF PEDIATRICS. 2019;178(12):1849–58.
IEEE
[1]
K. Pauwaert et al., “The effect of a multidisciplinary weight loss program on renal circadian rhythm in obese adolescents,” EUROPEAN JOURNAL OF PEDIATRICS, vol. 178, no. 12, pp. 1849–1858, 2019.
@article{8641455,
  abstract     = {Adolescent obesity is a serious health problem associated with many comorbidities. Obesity-related alterations in circadian rhythm have been described for nocturnal blood pressure and for metabolic functions. We believe renal circadian rhythm is also disrupted in obesity, though this has not yet been investigated. This study aimed to examine renal circadian rhythm in obese adolescents before and after weight loss. In 34 obese adolescents (median age 15.7 years) participating in a residential weight loss program, renal function profiles and blood samples were collected at baseline, after 7 months, and again after 12 months of therapy. The program consisted of dietary restriction, increased physical activity, and psychological support. The program led to a median weight loss of 24 kg and a reduction in blood pressure. Initially, lower diurnal free water clearance (- 1.08 (- 1.40-- 0.79) mL/min) was noticed compared with nocturnal values (0.75 (- 0.89-- 0.64) mL/min). After weight loss, normalization of this inverse rhythm was observed (day - 1.24 (- 1.44-1.05) mL/min and night - 0.98 (- 1.09-- 0.83) mL/min). A clear circadian rhythm in diuresis rate and in renal clearance of creatinine, solutes, sodium, and potassium was seen at all time points. Furthermore, we observed a significant increase in sodium clearance. Before weight loss, daytime sodium clearance was 0.72 mL/min (0.59-0.77) and nighttime clearance was 0.46 mL/min (0.41-0.51). After weight loss, daytime clearance increased to 0.99 mL/min (0.85-1.17) and nighttime clearance increased to 0.78 mL/min (0.64-0.93).
Conclusion: In obese adolescents, lower diurnal free water clearance was observed compared with nocturnal values. Weight loss led to a normalization of this inverse rhythm, suggesting a recovery of the anti-diuretic hormone activity. Both before and after weight loss, clear circadian rhythm of diuresis rate and renal clearance of creatinine, solutes, sodium, and potassium was observed.What is Known:center dot Obesity-related alterations in circadian rhythm have been described for nocturnal blood pressure and for metabolic functions. We believe renal circadian rhythm is disrupted in obesity, though this has not been investigated yet.What is New:center dot In obese adolescents, an inverse circadian rhythm of free water clearance was observed, with higher nighttime free water clearance compared with daytime values. Weight loss led to a normalization of this inverse rhythm, suggesting a recovery of the anti-diuretic hormone activity.center dot Circadian rhythm in diuresis rate and in the renal clearance of creatinine, solutes, sodium, and potassium was preserved in obese adolescents and did not change after weight loss.},
  author       = {Pauwaert, Kim and Dejonckheere, Sarah and Bruneel, Elke and Van der Jeugt, Jolien and Keersmaekers, Laura and Roggeman, Saskia and De Guchtenaere, Ann and Vande Walle, Johan and Everaert, Karel},
  issn         = {0340-6199},
  journal      = {EUROPEAN JOURNAL OF PEDIATRICS},
  keywords     = {Frederik Paulsen chair,Adolescent obesity,Circadian rhythm,Renal function,ANGIOTENSIN-ALDOSTERONE SYSTEM,AMBULATORY BLOOD-PRESSURE,URINE PRODUCTION,ADIPOSE-TISSUE,KIDNEY,HYPERTENSION,INSULIN,DISEASE},
  language     = {eng},
  number       = {12},
  pages        = {1849--1858},
  title        = {The effect of a multidisciplinary weight loss program on renal circadian rhythm in obese adolescents},
  url          = {http://dx.doi.org/10.1007/s00431-019-03456-y},
  volume       = {178},
  year         = {2019},
}

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