S162 For author confl ict of interest information, see page xxx VOLUME 16 SUPPLEMENT 1 | OCTOBER 2008 | www.obesityjournal.org
TOS 2008 ABSTRACT SUPPLEMENT
POSTER SESSION 1 ABSTRACTS
399-P
Increased Incidence of Follicular Development in Obese Women Using Subcutaneous Depomedroxyprogesterone Acetate (DMPA-SC) Contraception
Penina Segall-Gutierrez, DeShawn Taylor, Stanley Azen Los Angeles, CA Background: Contraceptive failure with several hormonal methods, such as the contraceptive pill or patch, and complications of pregnancy may occur more frequently in obese women. Subcutaneous Depomedroxyprogesterone Acetate (DMPA-SC) is a progestin-only contraceptive method, administered by injection every 3 months, that works mainly by suppression of ovula-tion. The effi cacy of DMPA-SC on suppression of ovulation and follicular development has not been studied in women with a BMI ≥40kg/m². The pur-pose of this 26-week prospective experimental study was to determine inci-dence of ovulation and follicular development after DMPA-SC administation among women with a BMI ≥40kg/m², compared to normal weight and obese women. Methods: Six subjects with BMI= 18.5-24.9 kg/m² , 5 subjects with BMI= 30-39.9 kg/m² and 4 subjects with BMI ≥ 40 kg/m² received injections of DMPA-SC at baseline and 12 weeks. Weekly progesterone levels (P4), bimonthly estradiol (E2), and monthly medroxyprogesterone acetate (MPA) levels were measured by immunoassay methods for 26 weeks. Results: One subject with a BMI ≥ 40 kg/m² conceived during the trial. Among subjects completing the 26 week trial, no subject had P4 ≥3 ng/mL on subsequent fol-low up visits after the fi rst week of DMPA-SC. There was large inter-subject and intra-subject variability in E2 among subjects with BMIs = 30-39.9 kg/m² and ≥ 40 kg/m² , including one subject (BMI ≥ 40 kg/m² ) with E2 ranging from <10pg/mL to 266pg/mL. No subject with a BMI = 18.5-24.9 kg/m² ever had E2 >100pg/mL. Median MPA levels were consistently lower among subjects with a BMI ≥ 40 kg/m² compared to those with a BMI=18.5-24.9 kg/m² at each time point. Conclusion: Ovulation did not occur after the fi rst week following DMPA-SC administration as evident by suppressed P4 in all subjects. During the 26 week trial, fl uctuating E2 refl ective of follicular development occured only in subjects with BMIs = 30-39.9 kg/m² and ≥ 40 kg/m² when compared to subjects with a BMI= 18.5-24.9 kg/m² . While remaining above the contraceptive threshold, median MPA levels were lower among subjects with a BMI ≥ 40 kg/m2 compared to those with a BMI= 18.5-24.9 kg/m² at each time point. Further studies should address the phar-macokinetics and effi cacy of DMPA-SC in women with a BMI ≥ 40kg/m². Physical Activity and/or Diet - Pediatric
400-P
Evaluation of the Activity Questionnaire Applied to Mothers and Caregivers of Preschool Children
Montserrat Bacardi-Gascon, Claudia Reveles-Rojas, Arturo Jimenez-Cruz, Gail Woodward-Lopez, Patricia Crawford Tijuana, Baja California, Mexico; Rosarito,
Baja California, Mexico; Berkeley, CA
Background: It seems certain that decreased physical activity is contributing to the increase in childhood overweight. Little is known about the physical activ-ity behavior of preschool-aged children in Mexico.
Objective: The aim of this study was to assess the validity of a physical activ-ity (PA) questionnaire applied to mothers and caregivers of preschool children. Methods: To assess the validity of the PA questionnaire we compared the results on time spent in different intensity PA from the questionnaire with the time spent in those activities as measured by the GT1M ActiGraph accelerom-eter. PA of 45 children was quantifi ed based on data collected during weekdays (home and preschool) and weekends (home). ActiGraph was programmed to record activity counts in 15-second intervals. The 35 participants (3-5 years of age) (51% girls) who wore the accelerometer for at least 10 hours daily on 3 weekdays and one weekend day were included in the analyses. Time spent in different intensity activities was calculated by applying the MET prediction allowing the triglyceride to leak out into the interstitial space. We performed
studies to elucidate the mechanism of the two types of local fat reduction. Methods: We measured the lipolytic response and appearance of human fat cells in culture to PC and DC exposure. We exposed human fat cells in culture to laser light or an ambient light condition in the presence of serum, heat inactivated serum, or no serum. We also evaluated human fat cells in culture for metabolic activity and cell viability when exposed to LL or ambient light. Results: PC stimulated lipolysis 2.3 fold compared to assay buffer (p<0.001). DC, a detergent destroyed all the human fat cells at 10-1 M, destroyed half the cells at 10-2 M, at 10-3 M, the fat cells were not destroyed. Exposure to serum and heat inactivated serum both destroyed the human fat cells in response to either LL or ambient light, confi rming that the creation of pores in the fat cells was by a non-complement mediated mechanism. Human fat cells in culture exposed to LL and to ambient light had the same number of non-viable cells, but cells exposed to LL had lower metabolism, consistent with the stress of hav-ing pores in the cell membrane (p<0.0001).
Conclusions: The combination of PC and DC destroys fat cells by a detergent action based on the DC content. At low concentrations of DC, PC can act as a lipolytic stimulator to reduce fat by a non-ablative mechanism. LL opens pores in fat cells and allows egress of the triglycerides contained within them. LL open pores in the fat cells by a non-complement dependent mechanism, but does decrease fat cell metabolism without affecting the viability of the fat cells. Other - Mixed Population/Other
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Clinical Observation on Laser Acupuncture for Treatment of Obesity
Wen-Long Hu, Yu-Chiang Hung, Chih-Hao Chang Kaohsiung County, Taiwan;
Kaohsiung, Taiwan
Background: To observe and evaluate objective therapeutic effect of laser acupuncture on simple obesity. Methods: 117 females aged from 16 to 77 y/o and 29 males aged from 14 to 76 y/o with simple obesity were included during January 2004 and November 2005 whose body mass index (BMI) > 27 kg/m². We treated them with gallium-arsenic handylaser (50 mW in maximal power, 785 nm in wave length, pulsed wave) which supplied 0.25 joule/cm² to each of the following points 3 times a week, Stomach and Hunger (auricular points), ST25 (Tianshu), ST28 (Shuidao), SP15 (Daheng), CV9 (Shuifen), and ST40ïFenglongï. The changes of body weight (BW) and BMI were observed before and after 4 weeks of laser acupuncture. Paired t-tests were used to examine the changes. All P-values were two-tailed and the Î level of signifi cance was set at 0.05. Daily intake energy was recommended for obese females as the following formula, (height in cm – 70) x 0.6 x 30 kcal; and (height in cm – 80) x 0.7 x 30 kcal for obese males. Results: The mean BW loss in kg (P<0.001), % of BW loss, BMI reducing (P<0.001), and % of BMI reducing in 117 obese females were 2.4(1.5=s.d.), 3.0(1.9), 0.9(0.6), and 3.0(2.1) respectively. The mean BW loss in kg (P<0.001), % of BW loss, BMI reducing (P<0.001), and % of BMI reducing in 29 obese males were 3.2(2.3), 3.2(2.1), 1.1(0.8), and 3.2(2.1) respectively. Conclusions: Laser acupuncture can suppress the appetite, reduce the calories uptake, and promote the metabolism to achieve weight loss. It can be a complement-ary alternative treatment of obesity.
