Risk factors for cardiovascular diseases in children and adolescents with overweight and obesity
DOI:
https://doi.org/10.15448/1983-652X.2018.4.26468Keywords:
children, adolescents, dyslipidemias, obesity, risk factors, cardiovascular diseases.Abstract
Objective: To describe the prevalence of risk factors for cardiovascular diseases according to gender and percentage body fat (%BF) in overweight and obese children and adolescents.
Materials and Methods: Fifty-three children and adolescents (27 boys and 26 girls aged 6 to 16 years) who were overweight and obese underwent body mass (BM), height and waist circumference (WC) measurements, bioimpedance (%BF) and blood collection for determination of glucose, and lipid profile (TG, CT, HDL-C, LDL-C). The body mass index was calculated (BMI=BM kg/height m2) and BMI z-score was used to classify the nutritional status and the HOMA-IR index (> 2.5) for insulin resistance (IR).
Results: The girls showed, for the same age, higher BM and WC than boys. When classified according to the %BF, it was observed that the group with values determined as high (above 25% boys and 30% girls) presented higher levels of CT and LDL-C than participants with moderately high values (between 20- 25% boys and 25-30% girls). Most participants demonstrate altered cardiovascular risk %BF (77.5%), WC (64.2%), HDL-C (67.9%), CT (45.3%), LDL-C (24.5%), TG (41.5%) and IR (49.5%).
Conclusion: The prevalence of risk factors for cardiovascular diseases is high in this group of overweight and obese children and adolescents and primary prevention measures should be implemented.
References
Duncan BB, Chor D, Aquino EML, Bensenor IM, Mill JG, Schmidt MI, Lotufo PA, Vigo A, Barreto SM. Doenças crônicas não transmissíveis no Brasil: prioridade para enfrentamento e investigação. Rev Saúde Públ. 2012;46(1Suppl):126-34.
https://doi.org/10.1590/S0034-89102012000700017
Silva VS, Petroski EL, Souza GI, Silva DAS. Prevalência e fatores associados ao excesso de peso em adultos do Brasil: um estudo de base populacional em todo território nacional. Rev Bras Ciênc Esporte. 2012;34(3):713-26.
https://doi.org/10.1590/S0101-32892012000300013
Ministério da Saúde (Brasil), Secretaria de Vigilância em Saúde, Departamento de Análise de Situação de Saúde. Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, Vigitel 2009. Brasília: Ministério da Saúde; 2010.
Instituto Brasileiro de Geografia e Estatística (IBGE). POF 2008 2009 - Antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. IBGE; 2010.
Fraporti MI, Adami FS, Rosolen MD. Fatores de risco cardiovascular em crianças. Rev Port Cardiol. 2016;36(10):699-705.
https://doi.org/10.1016/j.repc.2016.12.013
Araújo J, Ramos E. Paediatric obesity and cardiovascular risk factors – A life course approach. Porto Biomed J. 2017;2(4):102–10.
https://doi.org/10.1016/j.pbj.2017.02.004
Silva LR, Stefanello JMF, Pizzi J, Timossi LS, Leite N. Aterosclerose subclínica e marcadores inflamatórios em crianças e adolescentes obesos e não obesos. Rev Bras Epidemiol. 2012;15(4):804-16.
https://doi.org/10.1590/S1415-790X2012000400012
Barbalho SM, Oshiiwa M, Fontana LCS, Finalli EFR, Paiva Filho ME, Spada APM. Metabolic syndrome and atherogenic indices in school children: A worrying panorama in Brazil. Diabetes Metab Syndr. 2017;11 Suppl 1:S397-S401.
https://doi.org/10.1016/j.dsx.2017.03.024
Lohman TG, Roche AF, Martorel R. Anthropometric standardization reference manual. Champaign (IL): Human Kinetics Books; 1988.
Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7.
https://doi.org/10.2471/BLT.07.043497
Freedman DS, Serdula MK, Srinivasan SR, Berenson GS. Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr. 1999;69:308-17.
https://doi.org/10.1093/ajcn/69.2.308
Lohman TG. Assesing fat distribuition. In: Lohman TG, editor. Advances in body composition assessment: current issues in exercise science. Champaign, IL: HumanKinetics; 1992. p. 57-63.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration no flow density lipoproteins cholesterol in plasma without use of the ultracentrifuge. Clin Chem. 1972;18(6):499-502.
Sociedade Brasileira de Cardiologia. I Diretriz de Prevenção da Aterosclerose na Infância e na Adolescência. Arq Bras Cardiol. 2005;85(6):3-36.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment, insulin resistance and β-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28(7):412-9.
https://doi.org/10.1007/BF00280883
d’Annunzio G, Vanelli M, Meschi F, Pistorio A, Caso M, Pongigline C, et al. The SIDEP Study Group. Valori normali di HOMA-IR in bambini e adolescenti: studio multicentrico italaiano. Quad Pediatr. 2004;3:44.
Garcés C, Oya M. Factores de riesgo cardiovascular en la edad infantil. Resultados globales del estudio Cuatro Provincias. Rev Esp Cardiol. 2007;60(4):517-24.
https://doi.org/10.1016/S0300-8932(07)75069-8
Gerber ZRS, Zielinsky P. Fatores de Risco de Aterosclerose na Infância. Um Estudo Epidemiológico. Arq Bras Cardiol. 1997:69(4):231-36.
https://doi.org/10.1590/S0066-782X1997001000002
Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen AS. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet. 2006:368(9532):299-304.
https://doi.org/10.1016/S0140-6736(06)69075-2
Rueda-Clausen C, Ambler KA, Ball GDC, Sharma AM, Padwal RS. Lipid profile abnormalities among children and adolescents with severe obesity. Can J Diabetes. 2013;37:S239.
https://doi.org/10.1016/j.jcjd.2013.03.140
Buff CG, Ramos E, Souza FIS, Sarni ROS. Frequência de síndrome metabólica em crianças e adolescentes com sobrepeso e obesidade. Rev Paul Pediatr. 2007;25(3):221-6.
https://doi.org/10.1590/S0103-05822007000300005
Fujii C, Sakakibara H. Association between insulin resistance, cardiovascular risk factors and overweight in Japanese schoolchildren. Obes Res Clin Pract. 2012;6(1):e1-e90.
https://doi.org/10.1016/j.orcp.2011.04.002
Bezerra AC, Sampaio HAC, Melo MLP, Maia SCS, Almeida PC. Associação entre dislipidemia e excesso de peso de crianças e adolescentes atendidos em uma unidade de saúde. Rev. Baiana Saúde Pública. 2011;35(2):348-62.
Sena ALS, Cardoso AD, Carvalho DFC, Medeiros JL, Coutinho GF, Albuquerque FCL, Medeiros, CCM. Excessive daytime sleepnessand cardiometabolic risk factors in children and teenagers with overweight. JHGD. 2013;23(1):24-30.
https://doi.org/10.7322/jhgd.50387
Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS. Protection from obesity-induced insulin resistance in mice lacking TNG-alpha function. Nature. 1997;395(6651):610-4.
Bergmann GG, Gaya A, Halpern R, Bergmann MLA, Rech RR, Constanzi CB, Alli LR. Waist circumference as screening instrument for cardiovascular disease risk factors in schoolchildren. J Pediatr. 2010;86(5):411-6.
https://doi.org/10.2223/JPED.2026
Yamborisut U, Sakamoto N, Wimonpeerapattana W, Tontisirin K. Waist circumference and body fat distribution indexes as screening tools for the overweight and obesity in Thai preschool children. Obes Res Clin Pract. 2010;4(4):307-14.
https://doi.org/10.1016/j.orcp.2010.08.001
Reinehr T, Wunsch R. Relationships between cardiovascular risk profile, ultrasonographic measurement of intra-abdominal adipose tissue, and waist circumference in obese children. Clin Nutr. 2010;29(1):24-30.
https://doi.org/10.1016/j.clnu.2009.06.004
Ramírez-Vélez R, García-Hermoso A, Agostinis-Sobrinho C, Mota J, Santos R, Correa-Bautista JE, Amaya-Tambo DC, Villa-González E. Cycling to school and body composition, physical fitness, and metabolic syndrome in children and adolescents. J Pediatr. 2017;188:57-63.
https://doi.org/10.1016/j.jpeds.2017.05.065
Spolidoro JV, Filho MLP, Vargas LT, Santana JC, Pitrez E, Hauschild JA, Bruscato NM, Moriguchi EH, Medeiros AK, Piva JP. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clin Nutr. 2013;32(1):93-7.
https://doi.org/10.1016/j.clnu.2012.05.020
Peper JS, Brouwer RM, Schnack HG, van Baal GC, van Leeuwen M, van den Berg SM, Delemarre-Van de Waal HA, Boomsma DI, Kahn RS, Hulshoff Pol HE. Sex steroids and brain structure in pubertal boys and girls. Psychoneuroendocrinology. 2009;34(3):332-42.
https://doi.org/10.1016/j.psyneuen.2008.09.012
Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L. Waist circumference and cardiovascular risk factors in prepubertal children. Obes Res. 2001;9(3):179-87.
https://doi.org/10.1038/oby.2001.19
Hirscheler V, Maccallini G, Karam C, Gonzalez C, Aranda C. Are girls more insulin-resistant than boys? Clin Biochem. 2009;42(10-11):1051-6.
https://doi.org/10.1016/j.clinbiochem.2009.03.002
Bonaccorsi G, Baggiani L, Bassetti A, Colombo C, C, Mantero S, Olimpi N, Santomauro F, Comodo S. Body composition assessment in a sample of eight-year-old children. Nutrition. 2009;25(10):1020-8.
https://doi.org/10.1016/j.nut.2009.01.016
Doak CM, Hoffman DJ, Norris SA, Ponce MC, Polman K, Griffiths PL. Is body mass index an appropriate proxy for body fat in children? Glob Food Sec. 2013;2(2):65-71.
https://doi.org/10.1016/j.gfs.2013.02.003
Freedman DS, Ogden CL, Berenson GS, Horlick M. Body mass index and body fatness in childhood. Curr Opin Clin Nutr Metab Care. 2005;8(6):618-23.
https://doi.org/10.1097/01.mco.0000171128.21655.93
Ma J, Feng N, Zhang S, Pan Y, Huang Y. Comparison of Changes in Body Composition during Puberty Development of Obese and Normal-weight Children in China. Biomed Environ Sci. 2009; 22(5):413-8.
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