Evaluation of clinical and laboratory markers of cardiometabolic risk in overweight and obese children and adolescents

Abstract

OBJECTIVE:This study analyzed the frequency of cardiometabolic risk markers and metabolic syndrome occurrence in overweight and obese children and adolescents.METHODS:The participants included 161 overweight (n=65) and obese (n=96) individuals aged between 5 and 19 years. Clinical markers were assessed (body mass index, body fat percentage, waist circumference, acanthosis, systolic and diastolic blood pressures, laboratory parameters [glucose, insulin, cholesterol (total and fractions) and triglyceride levels and homeostasis model assessment of insulin resistance (HOMA-IR) index] and leptin and adiponectin levels). The frequency of changes, odds ratios and correlations among markers were determined. Metabolic syndrome was assessed according to International Diabetes Federation criteria.RESULTS:A high frequency of acanthosis (51.6%); increased waist circumference (45.4%), systolic blood pressure / diastolic blood pressure (8.1% / 9.3%), glucose (10%), insulin (36.9%) and HOMA-IR (44.3%) values; and reduced high-density lipoprotein levels (47.2%) were observed. Leptin levels were increased in 95% of obese and in 66% of overweight subjects. Adiponectin was decreased in 29.5% of obese and in 34% of overweight subjects. An odd ratio analysis revealed a greater probability of increased waist circumference (9.0), systolic blood pressure (4.1), triglyceride (2.3) and insulin (2.9) levels and HOMA-IR (3.0) in the obese group than in the overweight group. The clinical and laboratory parameters and leptin levels exhibited significant correlations, whereas adiponectin was negatively correlated with systolic blood pressure. The occurrence rate of metabolic syndrome was 13.6%.CONCLUSIONS:The high frequency of changes in clinical, laboratory and adipokine markers indicates the need for early interventions aimed at preventing cardiometabolic complications in adulthood.

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity

“…The percentage was comparable to that of severely children affected by obesity who were 10 years of age and over and had MetS. Fortunately, this prevalence is much lower than that reported in a school-based study by Palhares et al ( 37 ), with 13.6% of obese Brazilian children having MetS (using the same definition of MetS).…”

Leptin trajectories from birth to mid-childhood and cardio-metabolic health in early adolescence

“…We used logistic regression for dichotomous outcomes, and thus calculated odds ratios (OR) for childhood pre-HTN/HTN (vs. normal BP) and childhood obesity (BMI >95 th vs. <=95 th percentile) for each distinct leptin trajectory. Although we performed separate models for each of our outcomes, we did not explicitly account for multiple testing as the correlation between leptin and cardio-metabolic risks have been well established [32][33][34][35] and there are high correlations among our early adolescence cardio-metabolic outcomes. Rather, we have focused on patterns of associations consistent within each other outcomes and were conservative about isolated significant findings.…”

Sobrepeso como riesgo cardiovascular comparado con obesidad y obesidad severa en niños de 2 a 14 años de edad

“…Este estudio clasificó el grado de exceso de peso según el IMC y las tablas del CDC en sobrepeso, obesidad y obesidad extrema; aunque definieron obesidad extrema un IMC mayor al p99 y los pacientes fueron de mayor edad (10-16 años). Palhares y col. 24 compararon 65 pacientes con sobrepeso versus 96 obesos y también encuentran diferencias en la prevalencia de factores de RCV clínicos y bioquímicos, pero en algunas de ellas sin diferencias significativas como el colesterol total, HDL-C, LDL-C y glucosa basal; sin embargo, sí hubo diferencias significativas con respecto al aumento de triglicéridos, insulina basal y HOMA-IR. Reinehr y col. 25 utilizando los criterios de la OITF tampoco encuentra diferencias significativas en la prevalencia de factores de RCV (colesterol total, LDL-C y HDL-C) entre los pacientes con sobrepeso, obesos y obesos extremos; pero sí encuentra una mayor prevalencia de hipertensión a mayor grado de exceso de peso y mayor prevalencia de aumento de triglicéridos entre los obesos extremos en comparación al grupo de sobrepeso y obesidad juntos, pero éstos dos grupos tuvieron la misma prevalencia de aumento de triglicéridos (16%).…”