Cardiovascular Risk Factors in Severely Obese Teens | Journal Scan

Study Questions:

Are cardiovascular risk factors increased among adolescents who are severely obese?

Methods:

Data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS), which was an ancillary study of the Longitudinal Assessment of Bariatric Surgery (LABS) study, were used for the represent analysis. This was a prospective cohort study, which enrolled adolescents who were scheduled for weight-loss surgery at five US centers between February 2007 and December 2011. Patients aged 19 years or younger were eligible for this long-term outcomes study. All data were collected within 30 days of the planned bariatric procedure. Primary outcomes of interest were the prevalence of preoperative cardiovascular disease (CVD) risk factors including fasting hyperinsulinemia, elevated high-sensitivity C-reactive protein (hs-CRP), impaired fasting glucose levels, dyslipidemia, elevated blood pressure, and diabetes mellitus. Associations between risk factors and body mass index (BMI) were examined.

Results:

A total of 242 participants (mean age 17 years) were included in the study. The cohort was predominately female (76%) and white (72%). CVD risk factors were common in these teens including fasting hyperinsulinemia (74%), elevated hs-CRP (75%), dyslipidemia (50%), elevated blood pressure (49%), and diabetes (14%). For each 5 unit increase in BMI, increases in impaired fasting glucose (by 15%), elevated blood pressure (by 10%), and elevated hs-CRP (by 6%) were noted. Dyslipidemia and elevated blood pressure were more likely in adolescent boys compared to girls (relative risk [RR], 1.6; 95% confidence interval [CI], 1.26-2.03 and RR, 1.48; 95% CI, 1.16-1.89, respectively). White teens were more likely to have elevated triglycerides compared to other race/ethnic groups (RR, 1.76; 95% CI, 1.14-2.72).

Conclusions:

The investigators concluded that numerous CVD risk factors are observed among adolescents who are severely obese. Increased BMI and male sex were associated with specific risk factors.

Perspective:

These data suggest that even younger patients who are obese have cardiovascular risk factors. Furthermore, such risk factors were more prevalent with increasing BMI. Understanding change in risk factors after bariatric surgery in teens will add to current understanding of treatment of severe obesity among adolescents.

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

Keywords: Adolescent, Bariatric Surgery, Blood Pressure, Body Mass Index, C-Reactive Protein, Cardiovascular Diseases, Cohort Studies, Diabetes Mellitus, Dyslipidemias, Fasting, Glucose, Hyperinsulinism, Longitudinal Studies, Metabolic Syndrome X, Obesity, Morbid, Obesity, Prevalence, Prospective Studies, Risk, Risk Factors, Triglycerides


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