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BMI, Waist Circumference and Chronic Disease Risk Factors in Australian Adolescents

The prevalence of overweight and obesity in adolescents is increasing worldwide.  Studies have shown that obese children and adolescents have an increased prevalence of metabolic risk factors for cardiovascular disease, type 2 diabetes, and, more recently, fatty liver disease.

In parallel with increasing prevalence of obesity in adolescents, it is expected that long-term morbidity in this population will increase.  A recent Australian research investigated the association between measures of adiposity (body mass index and waist circumference) and risk factors for heart disease, type 2 diabetes, fatty liver disease, and the clustering of risk factors in middle adolescence.

496 year 10 students (mean age – 15.4 years) in the Sydney metropolitan area were included in this study.  Blood samples were collected for biomarker studies including lipids (HDL and LDL cholesterol, triglycerides), insulin and glucose, liver health (ALT and GGT), high-sensitivity CRP (a marker for inflammation and risk predictor for cardiovascular disease), and blood pressure.

The study found that:

  • The prevalence of overweight and obesity in adolescent boys was 27.6%, based on BMI (body mass index calculated as weight in kilograms divided by height in meters squared), and 20.0% based on waist circumference cut points. The prevalence of overweight and obesity in adolescent girls was 19.4% based on BMI and 18.0% based on waist circumference.
  • Adolescent boys are more likely to have multiple risk factors than adolescent girls, particularly if they are overweight or obese.
  • 95% of obese and 80% of overweight adolescent boys had at least 1 risk factor.
  • Obese adolescent boys and girls were significantly more likely to have 2 or more risk factors than non-overweight adolescents.
  • The cardiovascular risk factors were relatively common, with high blood pressure being the most prevalent risk factor in adolescent boys (22.1%) and girls (10.8%).
  • Low HDL cholesterol levels and elevated high sensitivity-CRP levels were also relatively common, with 10.7% of adolescent boys and 3.9% of adolescent girls having low HDL cholesterol levels and 7.5% of adolescent boys and 8.6% of adolescent girls having high hs-CRP levels.
  • 4.5% of adolescent boys and 6.3% of adolescent girls have abnormal LDL cholesterol level.

Analysis on the clustering of risk factors indicates that Insulin, ALT, GGT, HDL cholesterol, high-sensitivity CRP, and blood pressure were significantly associated with overweight and obesity in adolescent boys. In adolescent girls, insulin, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly associated with overweight and obesity.

Previous studies suggested that the presence of more than 1 risk factor in childhood presents an increased risk of cardiovascular disease in adulthood.  Identifying adolescents at risk for long-term morbidity and offering early intervention may improve long-term outcomes.

Source:
Elizabeth Denney-Wilson et al (2008); Arch Pediatr Adolesc Med. 162(6):566-573

One Response




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