Body mass index, cardiovascular risk factors, and carotid intima-media thickness in a pediatric population in southern Italy.
OBJECTIVE
Obesity and exposure to cardiovascular risk factors during adolescence may be associated with the development of atherosclerosis and cardiovascular diseases later in life. The objective of the study was to investigate whether any excess body weight, including moderate overweight, is associated with a more severe cardiovascular risk profile and signs of early atherosclerosis in a pediatric population.


METHODS
A cross-sectional study was conducted among 646 adolescents ages 11 to 13 years from several primary schools of Reggio Calabria, Italy. Body mass index, waist circumference, blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and C-reactive protein (CRP) were determined. All of the subjects underwent carotid ultrasonography for the measurement of intima-media thickness. Complete clinical data were available from 575 subjects.


RESULTS
Overweight was similarly frequent in boys and girls (31.2% vs 31.0%), whereas prevalence of obesity was higher in boys (18.4% vs 10.1%). Subjects with lower levels of HDL and higher levels of triglycerides, insulin, and CRP plasma were observed more frequently among overweight and obese subjects than nonoverweight. At multivariate analysis, HDL cholesterol, insulin, and CRP were associated (P < 0.05) with overweight and obesity in girls, whereas in boys, insulin and CRP were associated (P < 0.05) with overweight and obesity, and LDL cholesterol with obesity. The association between overweight or obesity and increased intima-media thickness, a sign of early atherosclerosis, was present in girls (P < 0.05) and was close to statistical significance in obese boys (P = 0.07).


CONCLUSIONS
Overweight and obese adolescents have a higher prevalence of cardiovascular risk factors and show signs of early atherosclerosis. In girls, in particular, overweight is sufficient to determine a more severe cardiovascular risk profile.
Caserta
Carmelo Antonio
CA
Policlinico Madonna della Consolazione, Reggio di Calabria, Italy. lino.caserta@gmail.com
Pendino
Gaspare Maria
GM
Alicante
Saverio
S
Amante
Angela
A
Amato
Fulvia
F
Fiorillo
Mariateresa
M
Messineo
Arianna
A
Polito
Irene
I
Surace
Monica
M
Surace
Pasquale
P
Vacalebre
Carmelo
C
Zuin
Massimo
M
Cotichini
Rodolfo
R
Marcucci
Fabrizio
F
Rosmini
Francesco
F
Mele
Alfonso
A
D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D050177:Overweight / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
D007328:Insulin; D008055:Lipids; D002097:C-Reactive Protein