title: Cardiometabolic Risk Factors among Severely Obese Children and Adolescents in the United States, 1999-2012.
abstract: BACKGROUND
  Severely obese children and adolescents are at high risk of suffering obesity-related comorbidities. This article is to examine the dose-response relationship between weight status and cardiometabolic risk factors among US adolescents.
  
  
  METHODS
  Youths aged 6-19 years participating in the National Health and Nutrition Examination Surveys (NHANES) 1999-2012 were included (N = 20,905). Severe obesity was defined as BMI ≥120% of 95th percentile of gender-specific BMI-for-age or BMI ≥35 kg/m(2). Obesity-related cardiometabolic risk factors included blood pressure (BP), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total cholesterol (TC), triglycerides, and fasting glucose (FG). Weighted multiple logistic regression was used to assess whether severe obesity significantly changed the odds of having cardiometabolic risk factors.
  
  
  RESULTS
  The prevalence of high BP, high TC, low HDL, high triglycerides, high LDL, and high FG among severely obese adolescents was 9.9%, 16.5%, 40.0%, 30.0%, 13.0%, and 26.8%, respectively. Severely obese adolescents had at least twice the odds compared to normal weight adolescents of presenting high BP (OR = 5.3, 95% CI: 3.8-7.3); high TC (OR = 2.3, 95% CI: 1.8-3.0); low HDL (OR = 7.3, 95% CI: 6.1-8.8); high triglycerides (OR = 4.5, 95% CI: 3.4-5.9); high LDL (OR = 2.3, 95% CI: 1.5-3.5); and high FG (OR = 2.7, 95% CI: 1.8-4.0). Significant differences were also found between severely obese status and moderately obese status in the odds of having high BP (OR = 1.8, 95% CI: 1.7-2.2) and low HDL (OR = 1.9, 95% CI: 1.6-2.3).
  
  
  CONCLUSIONS
  Adolescents classified as severe status exhibit higher odds of having cardiometabolic risk factors compared to those with normal weight and moderately obese weight status.
authors.affiliation: 1 Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center , Durham, NC.
authors.forename: Linlin
authors.initials: L
authors.lastname: Li
authors.affiliation: 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX.
authors.forename: Adriana
authors.initials: A
authors.lastname: Pérez
authors.affiliation: 1 Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center , Durham, NC.
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.affiliation: 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX.
authors.forename: Nalini
authors.initials: N
authors.lastname: Ranjit
authors.affiliation: 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX.
authors.forename: Henry S
authors.initials: HS
authors.lastname: Brown
authors.affiliation: 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kelder
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D058445:Bullying; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D050171:Dyslipidemias / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D007246:Infertility / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D009749:Nutrition Surveys; D063766:Pediatric Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology