OBESITY AND CARDIOVASCULAR RISK FACTORS IN CHILDREN AND ADOLESCENTS: PP.34.366

Abstract

Association between overweight and cardiometabolic risk factors has been reported in adults, but very little is known about this association in paediatric age. Objective: To assess the prevalence of cardiometabolic factors in overweight children and adolescents. Design and Methods: 298 overweight, Caucasian children and adolescents (130 females), of European origin, 6 to 18 years of age (mean age 10.9 2.8) were selected. Subjects with BMI from the 85th to 97th percentile were defined as overweight while those higher than the 97th as obese. A validated oscillometric method was employed to measure ambulatory BP (Spacelabs 90207) over 24 hours. Fasting glucose and insulin were measured, and the HOMA index (HI) was calculated. Lipid profile was also assessed. Hypertension and metabolic abnormalities were defined following the ESH Guidelines in Children and Adolescents (J Hypertens, 2009). Insulin resistance was considered when the HOMA index was greater than or equal to 4.5. Factors associated with the number of clustered cardiometabolic risk factors were assessed by multiple regression analysis. Results: The prevalence of cardiometabolic risk factors was the following: 1) Office HTN 2.8% and ambulatory HTN 11.8% (isolated SBP 19 cases, isolated DBP 3 cases and SBP-DBP HTN 12 cases); 2) High HOMA index 33%; 3) Hypercholesterolemia 5.1%; 4) HypoHDL 0.7%; 5) Hypertriglyceridemia 10.5%. The percentage of subjects with one or more risk factors associated with overweight was: one factor 33%, two factors 8.6%, three factors 1.7% and four factors 0.3%. Factors associated with the number of clustered cardiometabolic risk factors were BMI z-score (p < 0.001) and age (p < 0.001) in a multivariate analysis. Hypertension was associated with a high prevalence of abnormal HOMA index and with hypercholesterolemia and hypertriglyceridemia. Abnormal HOMA index was associated with hypertriglyceridemia. Conclusions: Practically half the overweight children and adolescents have one or more cardiometabolic risk factors. The association is greater in subjects with hypertension than it is in normotensives. The potential impact of overweight in cardiovascular disease operates early in life.