Background and aim of the work: High-sensiti- vity C-reactive protein (hsCRP) is a marker of low grade inflammatory state, which characterises an atherosclerotic process. The metabolic syndrome is associated with insulin resistance and a systemic low-grade inflammatory state. These disorders may arise at a very early age in obese children. We aimed to assess the utility of (hsCRP) as a marker of cardiovascular risk in obese children and adolescents. Patients and methods: This study was conducted on 100 obese child and adolescents (6-16 years). 50 apparently healthy children of matched age and sex served as control. All patients and controls were subjected to: 1-complete history taking. 2-anthropometric measurements and clinical examination including body height, weight, waist circumference, body mass index and blood pressure. 3-laboratory investigations in- cluding fasting glucose, lipid profile, apolipoprotiens and (hsCRP) were assessed. Metabolic syndrome patients had to meet three out of five criteria: concentration of triglycerides (TG) ≥ 110 mg/dL, high density lipoprotein cholesterol (HDL- C) ≤ 40 mg/dL, waist circumference ≥ 90th percentile, glucose concentration ≥ 110 mg/dL, and systolic or diastolic blood pressure ≥ 90th percentile. Results, height, weight BMI and blood pressure were significantly higher in the obese than the control. Obese group had significantly higher (hsCRP) levels than control group, (p < 0.01) and significantly higher LDL-C, triglyceride (TG), and lower HDL-C than the control group. Log (hsCRP) showed a positive correlation with BMI (p < 0.001), blood pressure, and TG. The pre- valence of the metabolic syndrome was 24%. Mean concentrations of (hsCRP) were higher among patients who had the metabolic syndrome. Among whom, 35% had a concentration of (hsCRP) > 3.0 mg/L, a concentration considered to place adults at high risk for cardiovascular disease. In multiple logistic regression analysis only abdominal obesity was significantly associated with (hsCRP). Conclusion: me- tabolic syndrome and abdominal obesity among our patients predispose to cardiovascular disease later in life through early low grade inflammation. (hsCRP) is one of the inflammatory markers that can be easily estimated in these patients
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