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CVD risk factors common in adolescents undergoing bariatric surgery
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Adolescents undergoing weight-loss surgery often have several apparent cardiovascular disease risk factors, according to recent study findings published in JAMA Pediatrics.
According to the researchers, it is important to recognize and treat CVD risk factors to limit further progression of the disease, even in adolescents with severe obesity.
“This NIH-funded study will add important knowledge to the field of severe obesity during adolescence and the effects of bariatric surgery,” Marc P. Michalsky, MD, FACS, FAAP, surgical director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Columbus, Ohio, said in a press release. “Collaborating with colleagues around the country in a study of this magnitude to gather critical data defining CVD and other health risks, is both gratifying and hugely important. The results of this study will improve our understanding of the significant medical challenges faced by severely obese teens as well as document outcomes following surgical weight loss.”
Marc P. Michalsky
Michalsky and colleagues evaluated data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study consisting of 242 adolescents aged 19 years or younger undergoing bariatric surgery to determine the prevalence and predictors of risk for CVD, as well as the association between risk and BMI.
CVD risk factors included fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein levels, impaired fasting glucose levels, dyslipidemia, elevated blood pressure and diabetes. Data were collected within the 30 days before bariatric surgery.
Overall, 75% of participants had elevated high-sensitivity C-reactive protein levels, followed by 74% fasting hyperinsulinemia, 50% dyslipidemia, 48% elevated BP and 14% diabetes.
Participants were divided into groups based on BMI: group 1 (BMI < 50 kg/m2), group 2 (BMI ≥ 50 to < 60 kg/m2) and group 3 (BMI ≥ 60 kg/m2). Compared with participants in the highest two BMI categories, those in the lowest group had a lower prevalence of IFG (P < 01). The lowest group also was less likely to have elevated BP compared with the highest two categories (P < .01).
With each 5-unit increase in BMI, the risk for IFG increased by 15%, elevated BP by 10% and elevated high-sensitivity C-reactive protein by 6%.
A higher risk for abnormal triglyceride levels (P = .01), triglyceride/LDL level ratio (P < .01), dyslipidemia (P < .01) and elevated BP (P < .01) were found among boys compared with girls. A higher risk for elevated triglyceride levels (P = .01), abnormal insulin levels (P = .02) and elevated homeostasis model assessment of insulin resistance (HOMA-IR) levels (P = .04), but a decreased risk for IFG (P = .01) was found among white participants compared with nonwhite participants.
“In general, the results of the current study demonstrate that severely obese teens who present for surgical weight reduction have a very high prevalence for certain CVD risk factors (ie, elevated BP, dyslipidemia, insulin resistance, diabetes, etc.) than previously believed,” Michalsky told Endocrine Today. “The observation that increasing BMI serves as a predictor for increased prevalence of certain risk factors supports the argument that early recognition and treatment of such risks may help to limit additional disease progression.” – by Amber Cox
For more information:
Marc. P. Michalsky, MD, FACS, FAAP, can be reached at marc.michalsky@nationwidechildrens.org.
Disclosure: Michalsky reports no relevant financial disclosures. See the full study for a list of all other authors’ relevant financial disclosures.
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