Cardiovascular Risk Factors in Obese Children and Adolescents

Abstract

The aim of the study was to analyze cardiometabolic risk factors andcarotid intima-media thickness (IMT) in obese children. We studied 122 obese children fulfilling the criteria of the International Obesity Task Force and 58 non-obese children. Anthropometric parameters, blood pressure, lipid profile, C-reactive protein, and adiponectin were assessed in all children. Glucose and insulin during the oral glucose tolerance test were assessed in obese children. The IMT was determined using ultrasound B-mode imaging in 81 obese and 32 non-obese children. We found that obese children had significantly higher levels of lipid andother non-lipid atherogenic indicators, but lower levels of adiponectin compared with non-obese children. The difference in the mean carotid IMT was insignificant in the two groups. Taking the combined groups, the level of adiponectin correlated negatively with body mass index and lipid atherogenic indicators. The IMT strongly correlated with systolic blood pressure in obese children. In the children fulfilling the criteria of metabolic syndrome, 17 out of the 84 obese children older than 10 years of age, IMT was greater than in those who did not fulfil these criteria. We conclude that the coexistence of abdominal obesity with abnormal lipid profile and hypertension leads to the early development of atherosclerosis accompanied by increased carotid intima-media thickness. Obesity initiates the atherosclerotic processes in early childhood.

Abdominal obesity and cardiometabolic risk in children and adolescents, are we aware of their relevance?

“…The excessive amount of visceral adipose tissue plays a role in the development of several metabolic disorders in pediatric population [36]. The importance of examining AO using low-cost anthropometric indices may contribute to identify cardiometabolic risk factors from adolescence through adulthood [34].…”

Adrenal hemorrhage in the neonatal intensive care unit: a four-year experience

“…Adrenal hemorrhage is a relatively common condition. Some cases may be completely asymptomatic and are diagnosed by chance [5]. It was in 1924 that Corcoran and Strauss [6] first reported a neonate was with massive adrenal hemorrhage; this neonate underwent surgery for sustained bleeding.…”

“…The right adrenal vein generally drains directly into the inferior vena cava, and is therefore more usually affected by changes in venous pressure [13]. In the literature, the frequency of bilateral hemorrhage has been reported to be between 8% and 38% [5]. Adrenal hemorrhage occurs more frequently in males, than in females [11,13].…”

“…It can be asymptomatic, or may be diagnosed by chance. The most frequent clinical signs include vomiting, persistent jaundice, unexplained anemia, poor nutrition, and abdominal mass [3][4][5]. Ultrasonography (USG) is a preferred method in the diagnosis and follow-up of the newborns, since it is non-invasive, rapidly applied, portable, sensitive, and it does not cause radiation [3].…”

In which group of children and adolescents should a family doctor look for metabolic syndrome?

“…In a study of obese children Polish, 17 out of 84 met the metabolic syndrome criteria. abdominal obesity, lipid disorders and hypertension contributed to the development of atherosclerosis, as confirmed by the measurement of intima-media thickness (IMt) of the carotid artery in obese Polish children [21]. obesity, particularly abdominal, is directly clinically and epidemiologically associated with the development of metabolic syndrome.…”