Impact of Severe Obesity on Cardiovascular Risk Factors in Youth

Zabarsky, Gali; Beek, C.H.; Hagman, Emilia; Pierpont, Bridget; Caprio, Sonia; Weiss, Ram

doi:10.1016/j.jpeds.2017.09.066

Cited by 53 publications

(35 citation statements)

References 47 publications

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“…Weight was measured using a scale (Tanita Corp), and height was measured in triplicate with a wall-mounted stadiometer. Obesity categories according to age and sex-specific BMI percentiles were defined as: class I obesity (≥ 95th percentile to < 120% of the 95th percentile), class II obesity (≥ 120–< 140% of the 95th percentile), class III obesity (≥ 140–< 160% of the 95th percentile), and class IV obesity (≥ 160% of the 95th percentile) [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…While fasting indices of adipose insulin resistance have been studied in obese children [ 4 , 9 , 10 ], little is known about the prandial state, specifically in this context of obesity-related insulin resistance. Infiltration of adipose tissue by macrophages is probably one of the drivers of adipose IR playing a critical role in the establishment of the chronic inflammatory state and metabolic dysfunction [ 11 ], which are commonly detected in children with obesity and may be exacerbate during the developmental stage of puberty [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Relation of the degree of obesity in childhood to adipose tissue insulin resistance

et al. 2019

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Aims In this study, we investigated whether adipose tissue insulin resistance (IR) is affected by the degree of obesity during the fasting and post-prandial state, independent of glucose tolerance among obese children and adolescents. We also tested whether systemic subclinical inflammation is associated with adipose tissue IR. Methods Subjects were recruited to the Yale Pathophysiology of Type 2 Diabetes in Youth Study (NCT01967849). An oral glucose-tolerance test was performed to establish glucose-tolerance status and blood samples were drawn for measurement of free fatty acids (FFAs), to calculate the area under the curve (AUC) of FFA. Adipose tissue insulin resistance was calculated as the product of insulin and FFA concentrations. Results In total, 671 children and adolescents (58.6% females) were included with a mean age of 13.3(2.7) years and BMI Z score of 2.45(0.31). The degree of obesity emerged as an independent predictor of both fasting and post-prandial adipose IR, p < 0.0001. Higher degree of obesity was associated with greater AUC FFA (lower suppression) compared to lower degree of obesity, p = 0.01. Furthermore, higher levels of IL-6 were positively associated with post-prandial adipose tissue IR, p = 0.02. Conclusions The degree of obesity in childhood and adolescence is strongly associated with adipose tissue IR independent of glucose tolerance. This is reflected not only in calculated indices of adipose IR but also in lower suppression of FFAs during the OGTT regardless of glucose tolerance or fasting adipose tissue IR. Furthermore, markers of subclinical inflammation such as IL-6 are associated with adipose tissue IR, independent of other factors. Electronic supplementary material The online version of this article (10.1007/s00592-018-01285-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relation of the degree of obesity in childhood to adipose tissue insulin resistance

et al. 2019

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“…Éste está estrechamente relacionado con el crecimiento y la maduración puberal; aunque no siempre se relaciona con la obesidad central y no puede discriminar la masa muscular, la masa ósea y la grasa [45]. Grados de obesidad mórbida, tienen mayor magnitud de riesgo cardiovascular que aquellos con grados menores y que los pacientes con sobrepeso [46]. La predisposición genética y las enfermedades endocrinológicas no pueden explicar por sí solas el incremento de la frecuencia de obesidad, siendo necesaria la intervención de otros desencadenantes, especialmente los hábitos alimenticios y el estilo de vida [1], por lo que es necesario recalcar la importancia de los factores modificables de riesgo cardiovascular en la población pediátrica como la dislipidemia, la obesidad, el sedentarismo y la alimentación [47].…”

Section: Discussionunclassified

Hipertensión y obesidad en niños de un centro de educación preescolar de la ciudad de Popayán –Colombia: Un estudio descriptivo

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Cuastumal²,

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et al. 2018

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Objetivo: el objetivo de la presente investigación es describir la prevalencia de hipertensión y obesidad, como factores de riesgo cardiovascular en niños pertenecientes a un centro de educación preescolar la Ciudad de Popayán- Colombia. Materiales y métodos: Estudio descriptivo, de corte transversal. Se estimaron medidas antropométricas y de presión arterial en 45 preescolares. Resultados: la obesidad, de acuerdo a IMC, se presentó en un 11.1% de los preescolares, mientras que 6.6% de los individuos evaluados tuvieron mediciones de tensión arterial sistólica o diastólica, en rango de hipertensión arterial. Conclusiones: los hallazgos de la presente investigación sugieren que la aparición de factores de riesgo para la enfermedad cardiovascular, tiene lugar en edades muy tempranas. La generación de hábitos saludables podría prevenir la aparición y persistencia de dichos factores.

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“…The association between obesity and risk of premature mortality could be explained by several mediating factors of both somatic and non-somatic origin. Obesity in childhood has been linked to systemic low-grade inflammation [42], non-alcoholic fatty liver disease [43], insulin resistance [43], and impaired cardiovascular health, including thicker intima media thickness [44], elevated blood pressure [43], and impaired microvascular function [45]. Further, overweight and obesity have been associated with depression [7,9], discrimination, and bullying [11].…”

Section: Children and Adolescents With Obesity And Premature Deathmentioning

confidence: 99%

Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study

et al. 2020

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Background Pediatric obesity is associated with increased risk of premature death from middle age onward, but whether the risk is already increased in young adulthood is unclear. The aim was to investigate whether individuals who had obesity in childhood have an increased mortality risk in young adulthood, compared with a population-based comparison group. Methods and findings In this prospective cohort study, we linked nationwide registers and collected data on 41,359 individuals. Individuals enrolled at age 3-17.9 years in the Swedish Childhood Obesity Treatment Register (BORIS) and living in Sweden on their 18th birthday (start of followup) were included. A comparison group was matched by year of birth, sex, and area of residence. We analyzed all-cause mortality and cause-specific mortality using Cox proportional hazards models, adjusted according to group, sex, Nordic origin, and parental socioeconomic status (SES). Over 190,752 person-years of follow-up (median follow-up time 3.6 years), 104 deaths were recorded. Median (IQR) age at death was 22.0 (20.0-24.5) years. In the childhood obesity cohort, 0.55% (n = 39) died during the follow-up period, compared to 0.19% (n = 65) in the comparison group (p < 0.001). More than a quarter of the deaths among individuals in the childhood obesity cohort had obesity recorded as a primary or contributing cause of death. Male sex and low parental SES were associated with premature all-cause mortality. Suicide and self-harm with undetermined intent were the main cause of death in both groups. The largest difference between the groups lay within endogenous causes of death, where children who had undergone obesity treatment had an adjusted mortality rate ratio of 4.04 (95% CI 2.00-8.17, p < 0.001) compared with the comparison group. The main study limitation was the lack of anthropometric data in the comparison group.

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Impact of Severe Obesity on Cardiovascular Risk Factors in Youth

Cited by 53 publications

References 47 publications

Relation of the degree of obesity in childhood to adipose tissue insulin resistance

Relation of the degree of obesity in childhood to adipose tissue insulin resistance

Hipertensión y obesidad en niños de un centro de educación preescolar de la ciudad de Popayán –Colombia: Un estudio descriptivo

Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study

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