human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention design ed to improve insulin sensitivity ( SI ) , adiposity , and inflammation in obese African-American and Latino adolescents . A total of 100 participants ( African Americans : n = 48 , Latino : n = 52 ; age : 15.4 ± 1.1 years , BMI percentile : 97.3 ± 3.3 ) were r and omly assigned to interventions : control ( C ; n = 30 ) , nutrition ( N ; n = 39 , 1 × /week focused on decreasing sugar and increasing fiber intake ) , or nutrition + strength training ( N+ST ; n = 31 , 2 × /week ) . The following were measured at pre- and postintervention : strength , dietary intake , body composition ( dual-energy X-ray absorptiometry/magnetic resonance imaging ) and glucose/insulin indexes ( oral glucose tolerance test (OGTT)/intravenous glucose tolerance test ( IVGTT ) ) and inflammatory markers . Overall , N compared to C and N+ST reported significant improvements in SI ( + 16.5 % vs. -32.3 % vs. -6.9 % respectively , P < 0.01 ) and disposition index ( DI : + 15.5 % vs. -14.2 % vs. -13.7 % respectively , P < 0.01 ) . N+ST compared to C and N reported significant reductions in hepatic fat fraction ( HFF : -27.3 % vs. -4.3 % vs. 0 % respectively , P < 0.01 ) . Compared to N , N+ST reported reductions in plasminogen activator inhibitor-1 ( PAI-1 ) ( -38.3 % vs. + 1.0 % , P < 0.01 ) and resistin ( -18.7 % vs. + 11.3 % , P = 0.02 ) . There were no intervention effects for all other measures of adiposity or inflammation . Significant intervention by ethnicity interactions were found for African Americans in the N group who reported increases in total fat mass , 2-h glucose and glucose incremental areas under the curve ( IAUC ) compared to Latinos ( P 's < 0.05 ) . These interventions yielded differential effects with N reporting favorable improvements in SI and DI and N+ST reporting marked reductions in HFF and inflammation . Both ethnic groups had significant improvements in metabolic health ; however some improvements were not seen in African Americans Adiponectin is an adipose-specific plasma protein whose plasma concentrations are decreased in obese subjects and type 2 diabetic patients . This protein possesses putative antiatherogenic and anti-inflammatory properties . In the current study , we have analyzed the relationship between adiponectin and insulin resistance in rhesus monkeys ( Macaca mulatta ) , which spontaneously develop obesity and which subsequently frequently progress to overt type 2 diabetes . The plasma levels of adiponectin were decreased in obese and diabetic monkeys as in humans . Prospect i ve longitudinal studies revealed that the plasma levels of adiponectin declined at an early phase of obesity and remained decreased after the development of type 2 diabetes . Hyperinsulinemic-euglycemic clamp studies revealed that the obese monkeys with lower plasma adiponectin showed significantly lower insulin-stimulated peripheral glucose uptake ( M rate ) . The plasma levels of adiponectin were significantly correlated to M rate ( r = 0.66 , P < 0.001 ) . Longitudinally , the plasma adiponectin decreased in parallel to the progression of insulin resistance . No clear association was found between the plasma levels of adiponectin and its mRNA levels in adipose tissue . These results suggest that reduction in circulating adiponectin may be related to the development of insulin resistance CONTEXT Hypoadiponectinemia and chronic sub clinical inflammation in adults are associated with the development of diabetes and cardiovascular disease . The potential relationship between adiponectin and inflammation and its modulation by lifestyle intervention in the pediatric obese population remain unclear . OBJECTIVES The objectives were to investigate in adolescents 1 ) the relationship between adiponectin and obesity-related inflammatory factors , C-reactive protein , and IL-6 ; and 2 ) the effect of a lifestyle intervention on adiponectin and whether these effects are related to changes in inflammatory factors . RESEARCH METHODS AND PROCEDURES Twenty-one obese and age-matched lean adolescents ( age , 14 - 18 yr ; Tanner stage , > or = IV ) were studied cross-sectionally . Fifteen obese adolescents also underwent a r and omized , controlled physical activity-behavior-diet-based lifestyle intervention for 3 months . Associations among adiponectin , fat mass , insulin resistance , and inflammatory factors at baseline as well as after the intervention were assessed . RESULTS Plasma adiponectin concentration was lower ( P < 0.001 ) in the obese vs. age-matched lean adolescents . Significant inverse relationships were observed between adiponectin and inflammatory factors , insulinemia , insulin resistance , and fat mass . Intervention produced a 34 % increase in adiponectin concentration ( P = 0.0004 ) despite negligible weight loss but with reductions in fat mass , hyperinsulinemia , insulin resistance , and inflammatory factors ( all P < 0.01 ) . CONCLUSIONS The data suggest that in adolescents , obesity-related hypoadiponectinemia is associated with sub clinical inflammation , and a short-term lifestyle intervention augments adiponectin concentrations . These effects appear to be related to reductions in fat mass and inflammatory factors . Based on our current underst and ing of adiponectin physiology , reversal of hypoadiponectinemia in obese adolescents may protect against risks for cardiovascular disease and diabetes Background Obesity is significant problem involving eating behavior and peripheral metabolic conditions . The effect of carbohydrate and fat restriction on appetite regulation , fibroblast growth factor 21 ( FGF21 ) and leptin in children has not been defined . Our objective was to compare the effect of both diets . Methods One hundred and twenty children with body mass index ( BMI ) higher than the equivalent of 30 kg/m2 for an adult , as corrected for gender and age were r and omly assigned to ( n = 60 ) a low-carbohydrate ( L-CHO ) diet or ( n = 60 ) a low-fat ( L-F ) diet for 2 months . Fifty-three ( 88.3 % ) subjects on the low-carbohydrate-diet and 45 ( 75 % ) on the low-fat diet completed the study .  Anthropometric measures , leptin and FGF21 levels were measured before and after the intervention . Comparison of the data for both of the diet groups was carried out using the t-test for independent variables . Intragroup comparisons before and after of each of the dietary treatments were performed using ANOVA for repeated measures . Factors associated with FGF21 , leptin levels and satiety , were analyzed by multiple regression . Results After both of the diets , weight , leptin , food responsiveness , and enjoyment of food significantly decreased and high density lipoprotein cholesterol ( HDL ) increased , but FGF21 decreased . Before and after both of the interventions FGF21 was associated with triglycerides . Before the diet , satiety was associated with lower screen time ( p < 0.04 ) and insulin levels ( p < 0.05 ) . Conclusions Both dietary restrictions improved the metabolic and hormonal parameters of obese children . FGF21 is an indicator of a beneficial metabolic response in younger children . After 2 months an adaptation of the eating behavior to food restriction was observed BACKGROUND Gut hormones change with weight loss in adults but are not well studied in obese youth . OBJECTIVE The primary aim was to evaluate how gut hormones and subjective appetite measure change with dietary weight loss in obese adolescents . METHODS Participants were a subset of those taking part in the ' Eat Smart Study ' . They were aged 10 - 17 years with body mass index ( BMI ) > 90th centile and were r and omized to one of three groups :  wait-listed control , structured reduced carbohydrate or structured low-fat dietary intervention for 12 weeks . Outcomes were fasting glucose , insulin , leptin , adiponectin , total amylin , acylated ghrelin , active glucagon-like peptide-1 , glucose-dependent insulinotropic polypeptide ( GIP ) , pancreatic polypeptide ( PP ) and total peptide tyrosine-tyrosine . Pre- and postpr and ial subjective sensations of appetite were assessed using visual analogue scales . RESULTS Of 87 ' Eat Smart ' participants , 74 participated in this sub- study . The mean ( st and ard deviation ) BMI z-score was 2.1 ( 0.4 ) in the intervention groups at week 12 compared with 2.2 ( 0.4 ) in the control group . Fasting insulin ( P = 0.05 ) and leptin ( P = 0.03 ) levels decreased , while adiponectin levels increased ( P = 0.05 ) in the intervention groups compared with control . The intervention groups were not significantly different from each other . A decrease in BMI z-score at week 12 was associated with decreased fasting insulin ( P < 0.001 ) , homeostatic model of assessment -insulin resistance ( P < 0.001 ) , leptin ( P < 0.001 ) , total amylin ( P = 0.03 ) , GIP ( P = 0.01 ) , PP ( P = 0.02 ) and increased adiponectin ( P < 0.001 ) . There was no significant difference in appetite sensations . CONCLUSIONS Modest weight loss in obese adolescents leads to changes in some adipokines and gut hormones that may favour weight regain Little is known about the effects of different intensities of physical training on plasma leptin . This study examined the effect of two intensities of physical training on leptin in obese teenagers , and explored correlates at baseline and in response to 8 months of physical training . The participants were 55 obese youths 12 - 16 years of age who completed both baseline and posttesting . The youths were r and omized to engage in lifestyle education only ( LSE ) , moderate-intensity physical training and LSE , or high-intensity physical training and LSE .  Baseline leptin was positively associated with fat mass . Girls had higher leptin levels at lower levels of fasting insulin than boys . The 8-mo physical training doses prescribed to obese teenagers did not result in significant group differences in mean change in leptin , although there was large variability in individual response . The change in leptin was inversely associated with baseline leptin and change in cardiovascular fitness . Diet , physical activity level , visceral adiposity , and glucose concentrations were not associated with leptin , neither at baseline nor in response to physical training . At baseline , total fat mass rather than visceral adiposity was associated with higher leptin levels . Over the 8-mo intervention period , regardless of group membership , youths who had the lowest increase in cardiovascular fitness tended to have the highest increase in leptin Objective : A high-protein diet may decrease food intake through regulating satiety and appetite hormones and can be an effective strategy for weight loss . Few studies exist on obese Chinese adolescents . Methods and Material s : 156 obese Chinese adolescents were enrolled and r and omly assigned to one of two isoenergetic breakfasts , either with egg or steamed bread . Subsequent lunchtime food intake was recorded 4 h later . Appetite was assessed with a visual analog scale . Anorexigenic hormones peptide YY ( PYY ) , glucagon-like peptide-1 ( GLP-1 ) and orexigenic hormone ghrelin were determined with radioimmunoassay at 0 , 30 , and 180 min . Body weight was recorded . The tests were repeated 3 months later . Analysis was performed between two tests and then two groups . Pearson 's correlation was used for association analysis . Results : Subsequent lunchtime food intake and body weight were decreased while satiety was increased in subjects on an egg breakfast , which is associated with an increase of serum PYY and GLP-1 ( p < 0.001 , respectively ) . There were strong correlations between weight loss , appetite , subsequent food intake and changes of appetite hormones . Conclusion : A high-protein breakfast promotes weight loss in obese Chinese adolescents , possibly through its regulation of satiety , subsequent food intake and appetite hormones Abstract The objective of this study is to evaluate the effect of interdisciplinary therapy in the parameters of the oxidative stress and the anti-inflammatory responses of obese adolescents . We selected 57 participants , who were r and omly divided into 2 groups : interdisciplinary therapy group and a control group . After 6 months of intervention , 17 participants of the interdisciplinary therapy group and 8 of the control group returned for re-evaluation . The interdisciplinary therapy group participated in a treatment with 4 weekly sessions of exercise , a weekly group therapy session and a weekly nutritional education session .  Blood parameters 
    Output:
    
agent
Leptin levels decreased as BMI decreased .
Evidence regarding the relationships of ghrelin and adiponectin with BMI was inconclusive .
Conclusions : Despite known effects of maturation on hormones , studies did not consistently differentiate findings by maturational stage .
BMI and leptin levels have a positive relationship , but evidence on ghrelin and adiponectin was inconclusive
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention design ed to improve insulin sensitivity ( SI ) , adiposity , and inflammation in obese African-American and Latino adolescents . A total of 100 participants ( African Americans : n = 48 , Latino : n = 52 ; age : 15.4 ± 1.1 years , BMI percentile : 97.3 ± 3.3 ) were r and omly assigned to interventions : control ( C ; n = 30 ) , nutrition ( N ; n = 39 , 1 × /week focused on decreasing sugar and increasing fiber intake ) , or nutrition + strength training ( N+ST ; n = 31 , 2 × /week ) . The following were measured at pre- and postintervention : strength , dietary intake , body composition ( dual-energy X-ray absorptiometry/magnetic resonance imaging ) and glucose/insulin indexes ( oral glucose tolerance test (OGTT)/intravenous glucose tolerance test ( IVGTT ) ) and inflammatory markers . Overall , N compared to C and N+ST reported significant improvements in SI ( + 16.5 % vs. -32.3 % vs. -6.9 % respectively , P < 0.01 ) and disposition index ( DI : + 15.5 % vs. -14.2 % vs. -13.7 % respectively , P < 0.01 ) . N+ST compared to C and N reported significant reductions in hepatic fat fraction ( HFF : -27.3 % vs. -4.3 % vs. 0 % respectively , P < 0.01 ) . Compared to N , N+ST reported reductions in plasminogen activator inhibitor-1 ( PAI-1 ) ( -38.3 % vs. + 1.0 % , P < 0.01 ) and resistin ( -18.7 % vs. + 11.3 % , P = 0.02 ) . There were no intervention effects for all other measures of adiposity or inflammation . Significant intervention by ethnicity interactions were found for African Americans in the N group who reported increases in total fat mass , 2-h glucose and glucose incremental areas under the curve ( IAUC ) compared to Latinos ( P 's < 0.05 ) . These interventions yielded differential effects with N reporting favorable improvements in SI and DI and N+ST reporting marked reductions in HFF and inflammation . Both ethnic groups had significant improvements in metabolic health ; however some improvements were not seen in African Americans Adiponectin is an adipose-specific plasma protein whose plasma concentrations are decreased in obese subjects and type 2 diabetic patients . This protein possesses putative antiatherogenic and anti-inflammatory properties . In the current study , we have analyzed the relationship between adiponectin and insulin resistance in rhesus monkeys ( Macaca mulatta ) , which spontaneously develop obesity and which subsequently frequently progress to overt type 2 diabetes . The plasma levels of adiponectin were decreased in obese and diabetic monkeys as in humans . Prospect i ve longitudinal studies revealed that the plasma levels of adiponectin declined at an early phase of obesity and remained decreased after the development of type 2 diabetes . Hyperinsulinemic-euglycemic clamp studies revealed that the obese monkeys with lower plasma adiponectin showed significantly lower insulin-stimulated peripheral glucose uptake ( M rate ) . The plasma levels of adiponectin were significantly correlated to M rate ( r = 0.66 , P < 0.001 ) . Longitudinally , the plasma adiponectin decreased in parallel to the progression of insulin resistance . No clear association was found between the plasma levels of adiponectin and its mRNA levels in adipose tissue . These results suggest that reduction in circulating adiponectin may be related to the development of insulin resistance CONTEXT Hypoadiponectinemia and chronic sub clinical inflammation in adults are associated with the development of diabetes and cardiovascular disease . The potential relationship between adiponectin and inflammation and its modulation by lifestyle intervention in the pediatric obese population remain unclear . OBJECTIVES The objectives were to investigate in adolescents 1 ) the relationship between adiponectin and obesity-related inflammatory factors , C-reactive protein , and IL-6 ; and 2 ) the effect of a lifestyle intervention on adiponectin and whether these effects are related to changes in inflammatory factors . RESEARCH METHODS AND PROCEDURES Twenty-one obese and age-matched lean adolescents ( age , 14 - 18 yr ; Tanner stage , > or = IV ) were studied cross-sectionally . Fifteen obese adolescents also underwent a r and omized , controlled physical activity-behavior-diet-based lifestyle intervention for 3 months . Associations among adiponectin , fat mass , insulin resistance , and inflammatory factors at baseline as well as after the intervention were assessed . RESULTS Plasma adiponectin concentration was lower ( P < 0.001 ) in the obese vs. age-matched lean adolescents . Significant inverse relationships were observed between adiponectin and inflammatory factors , insulinemia , insulin resistance , and fat mass . Intervention produced a 34 % increase in adiponectin concentration ( P = 0.0004 ) despite negligible weight loss but with reductions in fat mass , hyperinsulinemia , insulin resistance , and inflammatory factors ( all P < 0.01 ) . CONCLUSIONS The data suggest that in adolescents , obesity-related hypoadiponectinemia is associated with sub clinical inflammation , and a short-term lifestyle intervention augments adiponectin concentrations . These effects appear to be related to reductions in fat mass and inflammatory factors . Based on our current underst and ing of adiponectin physiology , reversal of hypoadiponectinemia in obese adolescents may protect against risks for cardiovascular disease and diabetes Background Obesity is significant problem involving eating behavior and peripheral metabolic conditions . The effect of carbohydrate and fat restriction on appetite regulation , fibroblast growth factor 21 ( FGF21 ) and leptin in children has not been defined . Our objective was to compare the effect of both diets . Methods One hundred and twenty children with body mass index ( BMI ) higher than the equivalent of 30 kg/m2 for an adult , as corrected for gender and age were r and omly assigned to ( n = 60 ) a low-carbohydrate ( L-CHO ) diet or ( n = 60 ) a low-fat ( L-F ) diet for 2 months . Fifty-three ( 88.3 % ) subjects on the low-carbohydrate-diet and 45 ( 75 % ) on the low-fat diet completed the study .  Anthropometric measures , leptin and FGF21 levels were measured before and after the intervention . Comparison of the data for both of the diet groups was carried out using the t-test for independent variables . Intragroup comparisons before and after of each of the dietary treatments were performed using ANOVA for repeated measures . Factors associated with FGF21 , leptin levels and satiety , were analyzed by multiple regression . Results After both of the diets , weight , leptin , food responsiveness , and enjoyment of food significantly decreased and high density lipoprotein cholesterol ( HDL ) increased , but FGF21 decreased . Before and after both of the interventions FGF21 was associated with triglycerides . Before the diet , satiety was associated with lower screen time ( p < 0.04 ) and insulin levels ( p < 0.05 ) . Conclusions Both dietary restrictions improved the metabolic and hormonal parameters of obese children . FGF21 is an indicator of a beneficial metabolic response in younger children . After 2 months an adaptation of the eating behavior to food restriction was observed BACKGROUND Gut hormones change with weight loss in adults but are not well studied in obese youth . OBJECTIVE The primary aim was to evaluate how gut hormones and subjective appetite measure change with dietary weight loss in obese adolescents . METHODS Participants were a subset of those taking part in the ' Eat Smart Study ' . They were aged 10 - 17 years with body mass index ( BMI ) > 90th centile and were r and omized to one of three groups :  wait-listed control , structured reduced carbohydrate or structured low-fat dietary intervention for 12 weeks . Outcomes were fasting glucose , insulin , leptin , adiponectin , total amylin , acylated ghrelin , active glucagon-like peptide-1 , glucose-dependent insulinotropic polypeptide ( GIP ) , pancreatic polypeptide ( PP ) and total peptide tyrosine-tyrosine . Pre- and postpr and ial subjective sensations of appetite were assessed using visual analogue scales . RESULTS Of 87 ' Eat Smart ' participants , 74 participated in this sub- study . The mean ( st and ard deviation ) BMI z-score was 2.1 ( 0.4 ) in the intervention groups at week 12 compared with 2.2 ( 0.4 ) in the control group . Fasting insulin ( P = 0.05 ) and leptin ( P = 0.03 ) levels decreased , while adiponectin levels increased ( P = 0.05 ) in the intervention groups compared with control . The intervention groups were not significantly different from each other . A decrease in BMI z-score at week 12 was associated with decreased fasting insulin ( P < 0.001 ) , homeostatic model of assessment -insulin resistance ( P < 0.001 ) , leptin ( P < 0.001 ) , total amylin ( P = 0.03 ) , GIP ( P = 0.01 ) , PP ( P = 0.02 ) and increased adiponectin ( P < 0.001 ) . There was no significant difference in appetite sensations . CONCLUSIONS Modest weight loss in obese adolescents leads to changes in some adipokines and gut hormones that may favour weight regain Little is known about the effects of different intensities of physical training on plasma leptin . This study examined the effect of two intensities of physical training on leptin in obese teenagers , and explored correlates at baseline and in response to 8 months of physical training . The participants were 55 obese youths 12 - 16 years of age who completed both baseline and posttesting . The youths were r and omized to engage in lifestyle education only ( LSE ) , moderate-intensity physical training and LSE , or high-intensity physical training and LSE .  Baseline leptin was positively associated with fat mass . Girls had higher leptin levels at lower levels of fasting insulin than boys . The 8-mo physical training doses prescribed to obese teenagers did not result in significant group differences in mean change in leptin , although there was large variability in individual response . The change in leptin was inversely associated with baseline leptin and change in cardiovascular fitness . Diet , physical activity level , visceral adiposity , and glucose concentrations were not associated with leptin , neither at baseline nor in response to physical training . At baseline , total fat mass rather than visceral adiposity was associated with higher leptin levels . Over the 8-mo intervention period , regardless of group membership , youths who had the lowest increase in cardiovascular fitness tended to have the highest increase in leptin Objective : A high-protein diet may decrease food intake through regulating satiety and appetite hormones and can be an effective strategy for weight loss . Few studies exist on obese Chinese adolescents . Methods and Material s : 156 obese Chinese adolescents were enrolled and r and omly assigned to one of two isoenergetic breakfasts , either with egg or steamed bread . Subsequent lunchtime food intake was recorded 4 h later . Appetite was assessed with a visual analog scale . Anorexigenic hormones peptide YY ( PYY ) , glucagon-like peptide-1 ( GLP-1 ) and orexigenic hormone ghrelin were determined with radioimmunoassay at 0 , 30 , and 180 min . Body weight was recorded . The tests were repeated 3 months later . Analysis was performed between two tests and then two groups . Pearson 's correlation was used for association analysis . Results : Subsequent lunchtime food intake and body weight were decreased while satiety was increased in subjects on an egg breakfast , which is associated with an increase of serum PYY and GLP-1 ( p < 0.001 , respectively ) . There were strong correlations between weight loss , appetite , subsequent food intake and changes of appetite hormones . Conclusion : A high-protein breakfast promotes weight loss in obese Chinese adolescents , possibly through its regulation of satiety , subsequent food intake and appetite hormones Abstract The objective of this study is to evaluate the effect of interdisciplinary therapy in the parameters of the oxidative stress and the anti-inflammatory responses of obese adolescents . We selected 57 participants , who were r and omly divided into 2 groups : interdisciplinary therapy group and a control group . After 6 months of intervention , 17 participants of the interdisciplinary therapy group and 8 of the control group returned for re-evaluation . The interdisciplinary therapy group participated in a treatment with 4 weekly sessions of exercise , a weekly group therapy session and a weekly nutritional education session .  Blood parameters 
    Output:
    