October 01, 2015
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Severe obesity worsens cardiometabolic risk factors in children, young adults

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Children and young adults with severe obesity were more likely to have cardiometabolic risk factors such as low HDL, high BP, high triglycerides and high HbA1c levels in a study published in The New England Journal of Medicine.

The association was most pronounced in young men and boys, according to the researchers.

They analyzed 8,579 children or young adults aged 3 to 19 years with overweight or obesity (BMI ≥ 85th percentile; 52% boys or young men; 53.7% white) included in the National Health and Nutrition Examination Survey between 1999 and 2012.

The researchers stratified participants based on severity of obesity — overweight (46.9%), class I obesity (36.4%), class II obesity (11.9%) or class III obesity (4.8%) — and analyzed the relationship between severity of obesity and the following cardiometabolic risk factors: total cholesterol, HDL, LDL, triglycerides, systolic BP, diastolic BP, HbA1c and glucose.

Asheley C. Skinner, PhD, and colleagues found that average values for the following variables were higher (or lower, in the case of HDL) for those with more severe obesity: total cholesterol (P < .001), HDL (P < .001), triglycerides (P < .001), systolic BP (P < .001), diastolic BP (P = .004), HbA1c (P < .001) and glucose (P = .003), and that the values were higher (or lower, in the case of HDL) for men than for women.

When Skinner, from the departments of pediatrics and health policy and management, University of North Carolina, Chapel Hill, and colleagues adjusted for age, race/ethnicity and sex, they found that greater severity of obesity conferred higher risk for the following variables:

  • low HDL (RR for class III obesity vs. class I obesity = 1.89; 95% CI, 1.35-2.66);
  • high triglycerides (RR for class III obesity vs. class I obesity = 1.63; 95% CI, 1.08-2.47);
  • high systolic BP (RR for class III obesity vs. class I obesity = 2.24; 95% CI, 1.42-3.54);
  • high diastolic BP (RR for class III obesity vs. class I obesity = 4.57; 95% CI, 1.88-11.06); and
  • high HbA1c (RR for class III obesity vs. class I obesity = 2.59; 95% CI, 1.55-4.34).

“A high prevalence of abnormal values for certain variables among children and young adults with class II or class III obesity may provide important information beyond that identified with standard obesity classifications, especially for boys and young men,” Skinner and colleagues wrote. “Determination of the severity of obesity can help identify children and young adults who are at the greatest risk for the negative health effects associated with obesity.” – by Erik Swain

Disclosure: One researcher reports receiving personal fees from Nestle.