title: Effect of BMI on cardiovascular and metabolic syndrome risk factors in an Appalachian pediatric population.
abstract: BACKGROUND
  The purpose of this study was to characterize cardiovascular risk factors in a rural pediatric population by body mass index (BMI) category and the presence of the metabolic syndrome.
  
  
  METHODS
  Data on 13,018 children and adolescents (aged younger than 20 years) from West Virginia and Ohio in 2005-2006 were obtained from the C8 Health Project to determine the prevalence of overweight/obesity and the metabolic syndrome, which was then compared with National Health and Nutrition Examination Survey 2005-2006 data. Cardiovascular risk factors were assessed by age-standardized and sex-standardized BMI category (<85th, 85th-95th, >95th percentiles) and the presence of metabolic syndrome, defined as the presence of three or more of the following criteria: BMI >97th percentile, triglycerides >110 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, and fasting blood glucose >110 mg/dL.
  
  
  RESULTS
  The population was 51% male and 95% white. The prevalence of overweight/obesity was 38% and metabolic syndrome was 4.6% in the C8 population, compared with a prevalence of 30% and 3.4%, respectively, within the National Health and Nutrition Examination Survey population. In our Appalachian population, a significant adverse trend across BMI categories was observed for lipids, insulin, inflammatory markers, white blood cell count, and C-reactive protein. Significant differences in these risk factors were seen among those with metabolic syndrome compared with those without metabolic syndrome.
  
  
  CONCLUSIONS
  The increased prevalence of overweight/obesity and the metabolic syndrome along with the increase in cardiovascular risk factors in Appalachian children and adolescents, suggests a cohort that may develop earlier onset and possibly increased severity of cardiovascular disease and other complications associated with metabolic syndrome and obesity.
authors.affiliation: Department of Epidemiology, Morgantown, WV, USAWest Virginia University, Morgantown, WV, USA.
authors.forename: Katelynn E
authors.initials: KE
authors.lastname: Weber
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Andrea Fr
authors.initials: AF
authors.lastname: Fischl
authors.affiliation: Department of Pediatrics, West Virginia University, Morgantown, WV, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Murray
authors.affiliation: Department of Epidemiology, Morgantown, WV, USAWest Virginia University, Morgantown, WV, USA.
authors.forename: Baqiyyah N
authors.initials: BN
authors.lastname: Conway
keywords: Appalachian; body mass index; cardiovascular; metabolic syndrome; pediatric population; risk factors