In the Journals

Metabolic abnormalities present in young children early after onset of overweight, obesity

Preschool-aged children who are overweight or obese display a variety of cardiometabolic risk factors, prompting researchers for a new study to suggest screening for cardiometabolic abnormalities at an earlier age than currently recommended.

For the Origin of Cardiovascular Risk in Overweight Preschool Children study, researchers reviewed the clinical medical records of 5,729 healthy children aged 2 to 5.8 years living in Rome who were enrolled from July 1, 2011, to July 30, 2012. From this cohort, 219 children whose BMI had changed from normal to overweight (n=123) or obese (n=96) within 12 months of enrollment were selected for further analysis.

The children underwent clinical laboratory tests to assess the presence and extent of CV risk factors. In addition to an oral glucose tolerance test and assessment of BP and cholesterol levels, participants underwent ultrasound imaging of the liver and measurement of intimal medial thickness of the common carotid arteries, subcutaneous fat and visceral fat. The researchers also calculated homeostatic assessment model algorithm-insulin resistance (HOMA-IR), overall insulin sensitivity and Insulinogenic Index for each patient.

In the original population of 5,729 children, growth monitoring indicated an increase in the percentage of overweight patients with age, from 7% among those aged 2 years to 16.9% among those aged 5.8 years. Obesity prevalence increased in a similar fashion, from 1.1% to 2.9%, respectively.

Of the 219 newly obese or overweight children studied, 86 displayed evidence of at least one metabolic abnormality. Dyslipidemia was observed in 55 children and hypertension was observed in 29 children. Seven patients had impaired fasting glucose levels and six were diagnosed with glucose intolerance. Sixty-eight of the new-onset overweight or obese children were diagnosed with nonalcoholic fatty liver disease, including 60 mild cases and eight moderate cases. Insulin resistance was observed in 77 patients.

Multiple linear regression analysis indicated significant associations between BMI and HOMA-IR (regression coefficient=0.448; 95% CI, 0.142-0.754) and levels of high-sensitivity C-reactive protein (coefficient=0.07; 95% CI, 0.005-0.134) or γ-glutamyltransferase (coefficient=0.145; 95% CI, 0.038-0.25). Researchers did not observe a correlation between BMI and BP or levels of glucose, uric acid, lipids, alamine aminotransferase or aspartate aminotransferase.

According to the researchers, these findings demonstrate that even in children, whose history of excess weight is generally short, weight gain can lead to the development of cardiometabolic risk factors.

“Future research should lead to a better understanding of the fine interplay among these factors and their progression into adulthood,” the researchers concluded. “For the present, our findings emphasize the need to start screening for cardiometabolic abnormalities using multidisciplinary strategies at an earlier age than is now recommended.”

Disclosure: The researchers report no relevant financial disclosures.

Preschool-aged children who are overweight or obese display a variety of cardiometabolic risk factors, prompting researchers for a new study to suggest screening for cardiometabolic abnormalities at an earlier age than currently recommended.

For the Origin of Cardiovascular Risk in Overweight Preschool Children study, researchers reviewed the clinical medical records of 5,729 healthy children aged 2 to 5.8 years living in Rome who were enrolled from July 1, 2011, to July 30, 2012. From this cohort, 219 children whose BMI had changed from normal to overweight (n=123) or obese (n=96) within 12 months of enrollment were selected for further analysis.

The children underwent clinical laboratory tests to assess the presence and extent of CV risk factors. In addition to an oral glucose tolerance test and assessment of BP and cholesterol levels, participants underwent ultrasound imaging of the liver and measurement of intimal medial thickness of the common carotid arteries, subcutaneous fat and visceral fat. The researchers also calculated homeostatic assessment model algorithm-insulin resistance (HOMA-IR), overall insulin sensitivity and Insulinogenic Index for each patient.

In the original population of 5,729 children, growth monitoring indicated an increase in the percentage of overweight patients with age, from 7% among those aged 2 years to 16.9% among those aged 5.8 years. Obesity prevalence increased in a similar fashion, from 1.1% to 2.9%, respectively.

Of the 219 newly obese or overweight children studied, 86 displayed evidence of at least one metabolic abnormality. Dyslipidemia was observed in 55 children and hypertension was observed in 29 children. Seven patients had impaired fasting glucose levels and six were diagnosed with glucose intolerance. Sixty-eight of the new-onset overweight or obese children were diagnosed with nonalcoholic fatty liver disease, including 60 mild cases and eight moderate cases. Insulin resistance was observed in 77 patients.

Multiple linear regression analysis indicated significant associations between BMI and HOMA-IR (regression coefficient=0.448; 95% CI, 0.142-0.754) and levels of high-sensitivity C-reactive protein (coefficient=0.07; 95% CI, 0.005-0.134) or γ-glutamyltransferase (coefficient=0.145; 95% CI, 0.038-0.25). Researchers did not observe a correlation between BMI and BP or levels of glucose, uric acid, lipids, alamine aminotransferase or aspartate aminotransferase.

According to the researchers, these findings demonstrate that even in children, whose history of excess weight is generally short, weight gain can lead to the development of cardiometabolic risk factors.

“Future research should lead to a better understanding of the fine interplay among these factors and their progression into adulthood,” the researchers concluded. “For the present, our findings emphasize the need to start screening for cardiometabolic abnormalities using multidisciplinary strategies at an earlier age than is now recommended.”

Disclosure: The researchers report no relevant financial disclosures.