OR20-1 Increasing Values of Cardiometabolic Risk Markers Are Associated with Severity of Obesity in Adolescents: Findings from the ERICA Study

Abstract

Overweight and obesity in adolescents have exponentially increased in the last decades and are considered a primary driver of other chronic diseases, such as diabetes and hypertension. Cardiometabolic risk factors, if not early managed, tend to persist in adult life, and some studies suggest different prevalences according to obesity category. This association among young people, however, is still unclear. The aim of this study was to evaluate the association of severity of obesity and known cardiometabolic risk factors in a representative sample of Brazilian adolescents from ERICA (Study of Cardiovascular Risk in Adolescents), a multicenter, school-based cross-sectional study composed of 75,000 students. For this analysis, we used data from students with overweight or obesity according to the IOTF reference values for body mass index: overweight ≥ 25kg/m²; class I obesity ≥ 30kg/m²; class II ≥ 35kg/m²; class III ≥ 40kg/m². Prevalences of abnormal cardiometabolic risk factors according to the severity of obesity were calculated for overall sample and stratified by sex and age groups (12-14 or 15-17 years). Adjusted Wald’s test for trends and Poisson regression models were used. From the 8,708 adolescents with excess weight, 71.6% were classified with overweight, 23.2% with class I obesity, 4.1% with class II and 1.2% with class III. As severity of obesity increased, there was an increase in the prevalence of higher levels of blood pressure, total and LDL-cholesterol, triglycerides, glycated hemoglobin, fasting glucose, insulin and metabolic syndrome (p≤0.05). Prevalence of low HDL-cholesterol levels was inversely proportional to increase in severity of obesity (p≤0.01). Increasing severity of obesity was associated with higher prevalence of all cardiometabolic risk factors in both age groups, except for fasting glucose in 15-17 years adolescents. After adjustment for sex, age, skin color and socioeconomic status, individuals with class III obesity had the highest prevalence of all the evaluated cardiometabolic variables, such as high levels of blood pressure [odds ratio (OR) compared to overweight = 2.4; 95%CI 1.5 - 3.8), triglyceride (OR = 2.99; 95%CI 1.8 - 4.9), LDL-cholesterol (OR = 2.5; 95%CI 1.2 – 5.3), glycated hemoglobin (OR = 2.0; 95%CI 1.3 - 3.2) and insulin (OR = 8.3; 95%CI 6.3 – 10.8). Metabolic syndrome in class III obese adolescents, when compared to overweight and class I obese, was 2 and 9 times more frequent, respectively. Our study involving Brazilian youth shows a positive association between severity of obesity and prevalence of cardiometabolic risk factors, indicating the need to further stratify them in this population. Investigating the association between severity of obesity and cardiometabolic risk factors can help us to identify the individuals at higher risk groups and develop public health strategies against obesity related outcomes early in life. Support: CAPES