Obesity linked to CVD risk in children

The Endocrine Society's 91st Annual Meeting

Obesity was associated with future risk for cardiovascular disease without the presence of features of metabolic syndrome. In children and adolescents, obesity alone was linked to certain blood abnormalities that can predispose individuals to developing cardiovascular disease in early adulthood.

"[Physicians] often do not treat obesity in children aggressively enough now unless they have other features of metabolic syndrome; this practice should be reconsidered," said principal investigator Nelly Mauras, MD, chief of pediatric endocrinology at Nemours Children's Clinic in Jacksonville, Fla.

The researchers conducted a study to determine if abnormalities inflammatory or thrombotic markers were present in children with obesity without other metabolic syndrome features during prepuberty and puberty as compared with lean children.

After screening more than 600 children, they enrolled 115 obese children and 87 lean children aged 7 to 18. Half were prepubertal and half were in late puberty. At baseline, children had normal fasting blood glucose, blood pressure, cholesterol and triglycerides. The lean children had to have no first degree relatives with obesity, elevated BP or lipids and diabetes. These criteria made recruitment very difficult, Mauras said.

Children with obesity without other features of metabolic syndrome had a 10-fold higher C-reactive protein and significantly higher fibrinogen concentrations than prepubertal and pubertal lean children (P<.001). C-reactive protein and fibrinogen concentrations were significantly correlated with waist circumference and percent fat mass.

In addition, the researchers reported higher levels of interleukin-6, plasminogen activator inhibitor-6 and lower levels of adiponectin in obese children compared with lean controls.

These abnormalities occurred in obese children as young as age 7, long before the onset of puberty.

“Our study findings suggest that we need more aggressive interventions for weight control in obese children, even those who do not have the comorbidities of metabolic syndrome and even in those who have not entered puberty," Mauras said during a press conference.

“Further studies will determine if these abnormalities are reversible with early therapeutic interventions,” she added. – by Christen Haigh

For more information:

DelGiorno C. #OR18-4. Presented at: The Endocrine Society’s 91st Annual Meeting; June 10-13, 2009; Washington, D.C.