Background: More recently, the association of different risk factors has been described as the metabolic syndrome. Different definitions are being used for the same syndrome. Regardless of the name or classification, it has been well established that a cardiovascular cluster including overweight/obesity, increased blood pressure, and lipid and glucose abnormalities are associated with an increased risk of atherosclerosis in adults.Objective: The aim of this study was to correlate body mass index percentiles with blood pressure, insulin resistance index, and lipid profiles in children and adolescents, which characterize a proatherosclerotic profile.Methods: Cardiovascular risk factor clusters were evaluated in 118 children and adolescents divided according to body mass index percentile (BMIP) quartiles: Q1 (n=23) with BMIP <50%, Q2 (n=30) with BMIP between 50 and 85%, Q3 (n=31) with BMIP between 85 and 93%, and Q4 (n=34) with the BMIP > 93%. Statistically significant differences were not observed for age (F=2.1; p=0.10); sex (chi-square test=3.0; p=0.38), and ethnicity (chi-square test=4.7; p=0.20) between different quartiles.Results: A statistically significant difference was observed for systolic BP (F=15.4; p<0.0001), diastolic BP (F=9.5; p<0.0001), glycemia (F=9.6; p<0.0001), insulin (F=12.9; p<0.0001), HOMAir (F=30.8; p<0.0001), and triglyceride levels (F=2.7; p=0.05) between the different quartiles.Conclusion: Excess weight evaluated by BMIP was associated with increased blood pressure, triglycerides, HOMAir index, and low HDL-cholesterol, a proatherosclerotic profile in children and adolescents.Key Words: Body mass índex; child; adolescent; risk factors.Mailing Address: Heno Ferreira Lopes • Av. Dr. Enéas de C. Aguiar, 44, Bloco II, 2ª andar, sala 8 -05403-000 -Cerqueira César -São Paulo, SP, Brazil E-mail: hipheno@incor.usp.br Manuscript received on 08/20/08; revised manuscript received on 10/02/08; accepted on 10/21/08. Body Mass Index Has a Good Correlation with Proatherosclerotic Profile in Children and Adolescents IntroductionAccording to the World Health Organization 1 , obesity is assuming epidemic proportions all over the world and is considered a chronic pediatric disease, more dangerous than malnutrition, as it is associated with a large number of comorbidities. The problems associated with obesity include psychosocial problems (low self-esteem, affecting academic ability and relationships), social problems (prejudice), and culminate in the association of central obesity, insulin resistance, hypertension, and dyslipidemia, which characterize a cluster of cardiovascular risk factors also called metabolic syndrome (MS). Metabolic syndrome is associated with an increased chance of atherosclerotic disease, steatohepatitis, gallstones found in sedentary subjects with overnutrition and genetic predisposition 2 . The prevalence of this situation is increasing in children and adolescents, and type 2 diabetes is appearing in this population more frequently 3 . There are other clinical situations associat...