Cardiovascular risk factors in childhood obesity

Abstract

Childhood obesity is a major cardiovascular risk factor (CV). Adverse effects of obesity: 1. Increased insulin resistance; 2. Hypertension; 3. Atherogenic dyslipidemia, increased homocysteine values (Hcy); 4. Abnormal LV geometry: LV, systolic and diastolic dysfunction; 5. Endothelial dysfunction; 6. Increased systemic inflammation (subclinical inflammation from atherosclerosis) and the association of high values of high sensitive CRP: increased risk of CV damage and prothrombotic status; increase in carotid intima-media thickness (c-IMT) – marker of subclinical atherosclerosis; 7. Heart failure; 8. Coronary heart disease; 9. Atrial fibrillation; 10. Obstructive sleep apnea. In obese children: early signs of CV dysfunction, independent of other comorbidities associated with obesity. Study of the usefulness of researching some biochemical parameters for detecting the risk of CV in obesity in school children. Clinical study: patients (pts): 42 obese children (7–16 years); control group: 15 healthy children (similar ages), normal weight, without CVD. Investigation of CV dysfunction: by echocardiography (echo) and some markers for CV risk factors in obese school children. Elevated Hcy values (48% pts), correlated with BMI and hypertension (6 pts), normal values at control: 8.9 ± 1.92 μmol/L vs. 6.1 ± 2.4 μmol/L; dyslipidemia (54% pts); increased values c-IMT (44% pts): 0.71 mm vs. 0.38 mm (control); hs CRP (mg%): pts; 0.61 ± 1.08 vs. 0.05 ± 0.18 (control); echo: HLV (67% pts), diastolic dysfunction of LV (34% pts). Cardiological investigation is necessary in all obese school children to highlight CV dysfunction and CV risk factors, for the early establishment of CV prevention measures.