Tuesday, September 18, 2012

Obesity Research

The following is some information from Dr. Miller, one of the most-recognized PWS experts in the country. Dean is a patient of hers. She is conducting some research about the effects of obesity (in people with PWS and others) on the brain. I knew that obesity directly affects the lungs and heart, among other organs, but I had no idea it affects the brain as well.

Image courtesy of http://research.pediatrics.med.ufl.edu

Research Overview:
More than a billion people worldwide are affected by obesity. Over the past 30 years the frequency of overweight in children, defined as a body mass index (BMI) greater than the 85th percentile for age and sex, has tripled.

More than 30% of children in the United States are overweight or obese. Data from the International Obesity Task Force indicate that 22 million of the world's children under 5 years of age are overweight or obese. The most devastating statistic, however, is that even the very young are being affected by this epidemic - almost 12% of infants ages 6 to 23 months are classified as overweight. Determination of the etiology and consequences of childhood obesity is crucial to the understanding and ultimate treatment of this condition.

My research, in collaboration with Daniel Driscoll, PhD, MD, focuses on evaluating the effects of early-onset obesity (i.e. obesity occurring before age 4) on the developing brain. We study 3 groups of individuals - those with Prader-Willi syndrome (PWS - a genetic condition known to cause early-onset obesity), those with idiopathic early-onset obesity, and normal weight control siblings from both of those groups. Because PWS can be diagnosed at birth with currently available genetic testing and can be treated with growth hormone to increase muscle mass and decrease fat mass, parents can be given prospective counseling to help them keep the child's weight normal for height through childhood. However, without the appropriate environmental controls instituted by the parents, the natural history of PWS is for children to become obese at 18-36 months of age. Thus, individuals with PWS are an excellent model to discover the effects of early obesity on the brain.

Obesity in adults has been shown to be associated with white matter lesions and brain atrophy on MRI scans. Our group is the first to identify similar brain MRI findings in children and adolescents with early-onset obesity. Currently we are performing brain MRI scans on children over 8 years of age with PWS, early-onset obesity, and their normal weight siblings to identify risk factors and potential causes of these brain abnormalities in children with early-onset obesity. Additional research studies focus on detailing the natural history of both PWS and early-onset morbid obesity, identifying brain satiety response to different sized meals, investigating the effects of early growth hormone treatment in infants with PWS.

Dr. Miller is an Assistant Professor in the division of pediatric endocrinology. She graduated with her M.D. from the University of Florida in 1998, and her M.S. in Clinical Investigation from the University of Florida in 2005. She has done all of her training in pediatrics and pediatric endocrinology at the University of Florida.

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