Abstract
Introduction: Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular comorbidities. Very limited data are available regarding cardiometabolic risk factors among this group in Bangladesh. Objective: To observe the cardiometabolic risk factors in overweight and obese children. Methods: This cross-sectional study was carried out in 88 overweight and obese children recruited consecutively by using CDC percentile chart for body mass index (BMI) in children between January 2017 and March 2018 in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. After completing a questionnaire and relevant clinical examination, blood was collected for fasting plasma glucose (FPG), insulin, HbA1c, lipid profile and C-reactive protein (CRP). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to determine insulin resistance. Results: Central obesity (100%), dyslipidaemia (88.6%), raised CRP (81.8%) and metabolic syndrome (69.3%) were the most common cardiometabolic risk factors. Children with grade 3 obesity had significantly higher systolic blood pressure (115.57 ± 11.60 vs 105.71 ± 8.84 mmHg, p = 0.043) and insulin resistance (7.15 ± 4.97 vs 3.53 ± 2.04, p = 0.017) than grade 1 obesity. Blood pressure, insulin resistance and CRP increased while high density lipoprotein (HDL) decreased with increasing severity of obesity. BMI z score was a significant predictor of systolic blood pressure; waist circumference was an independent predictor of diastolic blood pressure and HDL; waist height ratio best predicted insulin resistance, CRP and total cholesterol in overweight/obese children. Conclusions: We have observed a high frequency of cardiometabolic risk factors in overweight and obese children and they increased worsened with increasing grade of obesity.
Highlights
Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular co-morbidities
body mass index (BMI) z score was a significant predictor of systolic blood pressure; waist circumference was an independent predictor of diastolic blood pressure and high density lipoprotein (HDL); waist height ratio best predicted insulin resistance, C-reactive protein (CRP) and total cholesterol in overweight/obese children
We have observed a high frequency of cardiometabolic risk factors in overweight and obese children and they increased worsened with increasing grade of obesity
Summary
Worldwide prevalence of childhood obesity has increased greatly over the past two to three decades. Childhood obesity has more than quadrupled in adolescents aged 12 - 19, increasing from 5% in 1980 to nearly 21% in 2012 [1]. It represents one of the most important public health issues due to its associated metabolic and cardiovascular comorbidities [2]. A number of studies have demonstrated that risk factors for cardiovascular disease such as high blood pressure, dyslipidaemia, diabetes and overweight/obesity cluster together in children and are significantly inter-correlated [4]. Obesity represents the major risk factor for the development of insulin resistance [5] and metabolic syndrome [6] in children and adolescents. The aim of this study was to look into cardiometabolic risk factors in overweight and obese children
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