Clustering of cardiovascular disease risk factors among obese schoolchildren: the Taipei Children Heart Study

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Abstract
Childhood obesity increases the risk of obesity in adulthood and is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus, and dyslipidemia. We evaluated the clustering of CVD risk factors among obese schoolchildren in Taiwan. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1366 children (681 boys and 685 girls) aged 13.3 y (range: 12-16 y). Anthropometric, blood pressure (BP), and biochemical CVD risk factors (including blood glucose, lipid, and lipoprotein concentrations) were measured. Boys had a higher body mass index, systolic BP, and glucose concentrations than girls and girls had higher lipid and lipoprotein concentrations than boys. After adjustment for age, obese boys had a significantly higher BP, ratio of total to HDL cholesterol, and glucose, cholesterol, triacylglycerol, HDL cholesterol, LDL cholesterol, apolipoprotein A-I, and apolipoprotein B concentrations than nonobese boys. BP, HDL cholesterol, LDL cholesterol, and ratio of total to HDL cholesterol were significantly different between nonobese and obese girls. Approximately 70% of obese boys had one and 25% had two or more CVD risk factors other than obesity. Obese girls had a significantly higher prevalence of high BP and a higher prevalence of CVD risk factor clustering than nonobese girls. Boys had higher glucose concentrations and BP and lower lipid concentrations than girls. We found an association between obesity and higher BP and between obesity and blood glucose and lipid concentrations for both sexes. Clustering of CVD risk factors was especially apparent among the obese children. A clustering of CVD risk factors may begin during early adolescence among the obese.