title: Cardiovascular risk and metabolic syndrome in obese youth enrolled in a multidisciplinary medical weight management program: implications of musculoskeletal pain, cardiorespiratory fitness, and health-related quality of life.
abstract: BACKGROUND
  Obese youth demonstrate the same obesity-associated morbidities observed in obese adults, including poor cardiorespiratory fitness, poor quality of life, and reports of musculoskeletal pain. The purposes of this study were to compare the prevalence of cardiovascular risk factors and evaluate the odds of metabolic syndrome in obese youth based on measures of cardiorespiratory fitness, quality of life, and pain.
  
  
  METHODS
  A medical chart review of 183 obese youth in a medical weight management program was conducted. Measures of cardiovascular risk and metabolic syndrome were recorded. Groups were categorized based on Progressive Aerobic Cardiovascular Endurance Run (PACER) score, Pediatric Quality of Life (PedsQL)-Physical Function score, PedsQL-Psychosocial Health score, and reports of musculoskeletal pain. Statistical analysis included independent t-tests, Mann-Whitney U-test, chi-squared test, and logistic regression.
  
  
  RESULTS
  Thirty-three percent of the entire sample had C-reactive protein (CRP) levels >3.0 mg/dL and 30% were categorized as having metabolic syndrome. Patients with lower PACER scores demonstrated a greater prevalence of CRP levels >3.0 mg/dL versus those with higher PACER scores (45% vs. 12%; P=0.01). There were no other differences in the prevalence of cardiovascular risk factors or metabolic syndrome when categorized by PACER, PedsQL, or pain. Those with CRP levels >3.0 mg/dL demonstrated increased odds of metabolic syndrome-[odds (95% confidence interval, CI): 4.93 (1.24-19.61); P=0.02].
  
  
  CONCLUSIONS
  Overall, results do not show differences in cardiovascular risk in obese youth when categorized by PACER, PedsQL, or reports of MSK pain. Elevated CRP may be a useful predictor of metabolic syndrome in obese youth and warrants further investigation.
authors.affiliation: 1 Health and Rehabilitation Sciences PhD Program, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University , Columbus, Ohio.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Briggs
authors.forename: Colleen
authors.initials: C
authors.lastname: Spees
authors.forename: Sharon
authors.initials: S
authors.lastname: Bout-Tabaku
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Taylor
authors.forename: Ihuoma
authors.initials: I
authors.lastname: Eneli
authors.forename: Laura C
authors.initials: LC
authors.lastname: Schmitt
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000235:genetics* / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D059352:Musculoskeletal Pain; D009765:Obesity / Q000150:complications*; D010809:Physical Fitness; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D015431:Weight Loss; D061217:Weight Reduction Programs; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein