Obesity and Risk of Type 2 Diabetes and Cardiovascular Disease in Children and Adolescents

Abstract

Overweight/obesity continues to increase in children and adolescents, and annual obesity-related hospital costs in 6-17 yr olds have reached 127 million dollars per year. Overweight children and adolescents are now being diagnosed with impaired glucose tolerance and type 2 diabetes, and they show early signs of the insulin resistance syndrome and cardiovascular risk. Several risk factors have been identified as contributors to the development of type 2 diabetes and cardiovascular risk in youth. These factors include increased body fat and abdominal fat, insulin resistance, ethnicity (with greater risk in African-American, Hispanic, and Native American children), and onset of puberty. There is no clear explanation of how these factors increase risk, but they appear to act in an additive fashion. We hypothesize that the constellation of these risk factors may be especially problematic during the critical period of adolescent development, especially in individuals who may have compromised beta-cell function and an inability to compensate for severe insulin resistance. Therefore, the purpose of this paper is to review the pathophysiology of type 2 diabetes and cardiovascular risk in obese children and adolescents.

Quality of Life and Health Outcomes in Overweight and Non-Overweight Children With Asthma

“…Type 2 diabetes, which is characterized primarily by insulin resistance and a relative decrease in insulin secretion, has typically been considered a disease of adults (Fagot-Campagna et al, 2000). However, over the last two decades an alarming number of newly diagnosed diabetes cases in children and adolescents are now the type 2 form (Goran, Ball, & Cruz, 2003;Roy, 2005). Currently, type 2 diabetes accounts for up to 45% of all newly diagnosed diabetes in pediatric patients, and is especially common in certain minority populations, such as African Americans and Mexican Americans (Dietz & Robinson, 2005;Fagot-Campagna et al, 2000).…”

“…Obesity-related diseases, especially type 2 diabetes and cardiovascular risk, are emerging problems in the pediatric population (Goran et al, 2003). How these new pediatric health problems will ultimately impact future adult health is unknown.…”

Aerobic fitness, body mass index, and CVD risk factors among adolescents: the Québec family study

“…1 The secular trend in pediatric obesity 2 in the past few decades has raised concern for the future cardiovascular and metabolic health of recent generations, [3][4][5] given the associations between CVD risk factors in childhood and adolescence and childhood obesity and all-cause and CVD mortality in adulthood. 6,7 In many of these studies, the body mass index (BMI) is used to define the level of adiposity and is recommended as the index to identify and treat overweight and obesity in adolescents. 8,9 In adults, overweight and low levels of aerobic fitness are independently associated with an increased risk of CVD mortality.…”

Female gender and wealth are associated to overweight among adolescents in La Paz, Bolivia

“…Adolescent obesity forecasts adult obesity (Dietz and Gortmaker, 2001), a predictor of chronic diseases (Caroli and Lagravinese, 2002;Swinburn et al, 2004) such as cardiovascular disease, type II diabetes (Goran et al, 2003), the metabolic syndrome (Vanhala et al, 1998), oesophagus, colorectal, breast, endometrial and kidney cancers (Bianchini et al, 2002;Key et al, 2004). In the US, for example, 60% of overweight children present already one risk factor such as hyperlipidemia, hypertension or high blood pressure, and more than 20% have two or more risk factors (Dietz and Gortmaker, 2001;Dietz, 2004).…”