title: Elevated remnant lipoproteins may increase subclinical CVD risk in pre-pubertal children with obesity: a case-control study.
abstract: OBJECTIVE
  Current clinical guidelines to assess paediatric cardiovascular disease (CVD) risk heavily rely on cholesterol parameters that are generally normal for obese children. Remnant lipoproteins have emerged as a critical CVD risk factor particularly in adults with normolipidemia. We assessed remnant lipoprotein concentration (measured by apolipoprotein [apo] B48) and its relationship with other traditional CVD risk biomarkers in pre-pubertal children with obesity.
  
  
  METHODS
  Pre-pubertal children (n = 78) with obesity (n = 39, 9.9 ± 0.3 years old) as well as sex-matched normal-weight controls (n = 39, 9.8 ± 0.3 years) were assessed for anthropometry, blood pressure and fasting plasma biochemical parameters for remnant lipoprotein, lipid and glucose/insulin metabolism, and inflammatory status.
  
  
  RESULTS
  Children with obesity had striking 2-fold higher apoB48-containing remnant lipoproteins concentrations relative to normal-weight peers; the magnitude of elevation in the remnant lipoproteins is comparable to the levels previously reported for adults with established CVD and type-2 diabetes. Fasting apoB48 was positively correlated with fasting triglyceride concentration in children with obesity (r = 0.51, P < 0.001) and their normal-weight peers (r = 0.45, P < 0.01). Traditional CVD biomarkers including low-density lipoprotein cholesterol showed no difference between groups and remained within the normal range for a paediatric population.
  
  
  CONCLUSIONS
  Elevated apoB48-containing remnant lipoprotein is a stronger biomarker for paediatric CVD risk compared to traditional cholesterol parameters and may be associated with early adaptation of the intestine during obesity. Further investigation of abnormalities associated with the secretion and/or clearance of atherogenic remnant lipoproteins during the postprandial state may yield insight into our understanding of and therapeutic targets for managing risk for CVD in children with obesity.
authors.affiliation: Metabolic and Cardiovascular Disease Laboratory, Alberta Diabetes Institute, Alberta Mazankowski Heart Institute, University of Alberta, Edmonton, AB, Canada.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: C
authors.initials: C
authors.lastname: Pendlebury
authors.forename: M M U
authors.initials: MM
authors.lastname: Dodd
authors.forename: K
authors.initials: K
authors.lastname: Maximova
authors.forename: D F
authors.initials: DF
authors.lastname: Vine
authors.forename: M M
authors.initials: MM
authors.lastname: Jetha
authors.forename: G D C
authors.initials: GD
authors.lastname: Ball
authors.forename: S D
authors.initials: SD
authors.lastname: Proctor
mesh_terms: D053283:Apolipoprotein B-48 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D053283:Apolipoprotein B-48; D015415:Biomarkers; D014280:Triglycerides