Hypertriglyceridemia in Obese Children and Adolescents

Abstract

The increasing prevalence of obesity in children and adolescents is a serious public health concern. Hypertriglyceridemia is common in obese children and adolescents, and elevated triglyceride (TG) level is a known biomarker of cardiometabolic risk. Results from genetic studies suggest that TG and TG-rich lipoproteins and, more specifically, remnant cholesterol are in the causal pathway of cardiovascular disease. However, simultaneous measurement of all remnants has not yet been established, and plasma TG level can be used as a useful marker of remnant cholesterol. Adipose tissue dysfunction, including impaired adipocyte TG storage and release of fatty acids, mediates the development of obesity-related complications. The prevalence of hypertriglyceridemia increases in overweight or obese children and is associated with other cardiometabolic risk factors. Recently, the TG/high-density lipoprotein cholesterol (HDL-C) ratio was recognized as a marker of structural vascular changes and insulin resistance in obese youth. Recent guidelines recommend universal lipid screening with nonfasting non-HDL-C measurement in children at 9–11 years of age; however, fasting lipid profiles should be measured in obese children and overweight adolescents and in those with high non-HDL-C in universal screening. The primary approach to lower TG in children includes dietary and lifestyle modifications; however, children with severe hypertriglyceridemia should also be referred to a pediatric lipid specialist.

Changing Trends of Obesity and Lipid Profiles Among Bangkok School Children After Comprehensive Management of the Bright and Healthy Thai Kid Project.

“…On the other hand, elevated TG levels were reported more commonly in participants with high WHtR (> 0.5) or in abdominally obese participants who might be more at risk of cardiovascular disease in the future. These results were also supported by other studies [24,25,26]. In addition, our previous study reported that a child's nutritional status was positively correlated with blood pressure.…”

Cross-talk between ANGPTL4 gene SNP Rs1044250 and weight management is a risk factor of metabolic syndrome

“…As universally acknowledged, lipid metabolism, especially triglyceride (TG) metabolism plays a central role in Mets pathogenesis [ 11 ]. TG elevation is one of the components of Mets and a risk factor for abdominal obesity [ 12 ], and the synthesis of TG is associated with glucose metabolism through the tricarboxylic acid cycle [ 13 ]. Consequently, the gene locus featured by TG regulation is expected to become the target of Mets gene-directed therapy.…”

Obesity Risk Assessment Tool for Low-Income Spanish Speaking Immigrant Parents with Young Children: Validity with BMI and Biomarkers of Obesity

“…As insulin is critical for cellular glucose uptake and to prevent efflux of fat from the adipose tissue, also known as lipolysis inhibition, children with insulin resistance are at risk of developing type 2 diabetes and cardiovascular complications at an earlier age. HOMA-IR (homeostatic model assessment of insulin resistance) and triglycerides to HDLC ratio (TGHDL) are valid clinical surrogates of insulin resistance and are predictors of metabolic syndrome and cardiovascular risks in children [ 12 , 13 ]. In children, high levels of leptin and insulin are often associated with low levels of adiponectin and high levels of resistin, as obesity is a condition that modulates the secretion of both adipokines, which exacerbates insulin resistance [ 14 , 15 ].…”