Cardiometabolic Risk and Obesity in the Young

Study Questions:

Does the prevalence of cardiometabolic risk factors vary according to weight among overweight and obese children and young adults?


This was a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2012. Children and young adults, ages 3-19 years who were overweight or obese, defined as at the 85th percentile or higher of body mass index (BMI), according to the Centers for Disease Control and Prevention growth charts, were included. Standard definitions were used for abnormal levels of cardiovascular risk factors including total cholesterol (≥200 mg/dl), high-density lipoprotein (HDL) cholesterol (<35 mg/dl), low-density lipoprotein cholesterol (≥130 mg/dl), triglycerides, blood pressure (≥150 mg/dl), glycated hemoglobin (>5.7%), fasting glucose (≥100 mg/dl), systolic blood pressure ≥95th percentile, and diastolic ≥95th percentile). Prevalence of cardiometabolic risk factors was reported according to weight status.


A total of 8,579 children and young adults with a BMI at the 85th percentile or greater were included. In this cohort, 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. The prevalence of abnormal values for total cholesterol, HDL, triglycerides, glucose, glycosylated hemoglobin, and blood pressure increased with increasing severity of BMI. After adjustment for age, race, or ethnic group, and sex, greater the severity of obesity was associated with greater risk of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels.


The investigators concluded that severe obesity in children and young adults was associated with increased prevalence of cardiometabolic risk factors, particularly among the males.


These data demonstrate a concerning prevalence for cardiometabolic risk factors at an early age when children and young adults are overweight or obese. This study supports the need for early interventions that promote healthy weight.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, CHD & Pediatrics and Arrhythmias, CHD & Pediatrics and Prevention, CHD & Pediatrics and Quality Improvement, Lipid Metabolism, Nonstatins

Keywords: Blood Pressure, Body Mass Index, Cardiovascular Diseases, Child, Cholesterol, HDL, Cholesterol, LDL, Hemoglobin A, Glycosylated, Metabolic Syndrome X, Obesity, Obesity, Morbid, Primary Prevention, Risk Factors, Triglycerides, Young Adult

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