Childhood obesity alone may increase risk of later cardiovascular disease

January 26, 2010

By as early as 7 years of age, being obese may raise a child's risk of future heart disease and stroke, even in the absence of other cardiovascular risk factors such as high blood pressure, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

"This new study demonstrates that the unhealthy consequences of excess body fat start very early," said Nelly Mauras, MD, of Nemours Children's Clinic in Jacksonville, Florida and senior author of the study. "Our study shows that obesity alone is linked to certain abnormalities in the blood that can predispose individuals to developing cardiovascular disease early in adulthood.

These findings suggest that we need more aggressive interventions for weight control in obese children, even those who do not have the co-morbidities of the metabolic syndrome."

The metabolic syndrome is a cluster of risk factors that raise the risk of developing heart disease, stroke and diabetes. It is being increasingly diagnosed in children as being overweight becomes a greater problem. Although debate exists as to its exact definition, to receive a diagnosis of metabolic syndrome, one must have at least three of the following characteristics: increased waist circumference (abdominal fat), low HDL ("good") cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood glucose (blood sugar).

Mauras and her colleagues wanted to know if obesity could raise cardiovascular disease risk prior to the onset of the metabolic syndrome. Researchers therefore screened more than 300 individuals ages 7 to 18 years and included only those without features of the metabolic syndrome. They included 202 participants in the study: 115 obese children and 87 lean children as controls. Half of the children were prepubertal and the other half were in late puberty. Obese children had a body mass index (a measure of body fat) above the 95th percentile for their sex, age and height.

To be eligible to participate in the study, the children and adolescents had to have normal fasting blood sugar levels, normal blood pressure and normal cholesterol and triglycerides. Lean controls also could not have a close relative with type 2 diabetes, high cholesterol, high blood pressure or obesity. The latter group proved very difficult to find.

All study participants underwent blood testing for known markers for predicting the development of cardiovascular disease. These included elevated levels of C-reactive protein (CRP), a marker of inflammation, and abnormally high fibrinogen, a clotting factor, among others. Obese children had a 10 fold higher CRP and significantly higher fibrinogen concentrations, compared with age- and sex-matched lean children, the authors reported. These abnormalities occurred in obese children as young as age 7, long before the onset of puberty.

The results were striking Mauras stated, as the children were entirely healthy otherwise. Although it is not yet known whether early therapeutic interventions can reverse high CRP and fibrinogen, she said it would be prudent for health care providers to advise more aggressive interventions to limit calories and increase activity in "healthy" overweight children, even before the onset of puberty.

"Doctors often do not treat obesity in children now unless they have other features of the metabolic syndrome," Mauras said. "This practice should be reconsidered. Further studies are needed to offer more insight into the effects of therapeutic interventions in these children.
-end-
Other researchers working on the study include: Charles DelGiorno, Keisha Bird, Melissa Morgan, Shawn Sweeten, Prabhakaran Balagopal and Ligeia Damaso of Nemours Children's Clinic in Jacksonville, Fla; and Craig Kollman of the Jaeb Center for Health Research in Tampa, Fla.

The article, "Obesity Without Established Co-morbidities of the Metabolic Syndrome is Associated With a Pro-inflammatory and Pro-thrombotic State Even Before the Onset of Puberty in Children," will appear in the March 2010 issue of JCEM.

Founded in 1916, The Endocrine Society is the world's oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endo-society.org.

The Endocrine Society

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.