Obesity as a cardiovascular risk factor in pediatric age group

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Obesity as a cardiovascular risk factor in
pediatric age group

• Dr Abla Saleh Mostafa
• MBBch, M.Sc ,MD Pediatrics
• Professor of Pediatrics
• Faculty of Medicine
• Cairo University

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Introduction

• Obesity has become a pandemic .
• Obesity or overweight is defined as a body mass
  index (BMI) above the 95th percentile for age and
  gender.
• Documented trends in the increasing prevalence of
  obesity in children and adolescents have posed
  great concern regarding their short- and
  long-term complications in this population.

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• The purpose of this study was to
• Determine the extent and severity of
  obesity-related cardiovascular risk factors.
• Determine the association between obesity and
  hypertension as a complication of the disease.

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Patients Methods

• The study population included included 900
  patients 540(63) males 360(37) females
  580(64) of our patients were obese and 320
  (36) non-obese individuals aged 6-14 years.
• BMI was calculated as weight (kg)/height (m2).
• All subjects had blood samples taken in the
  morning, after an overnight fast, for the
  estimation of, fasting blood glucose (FBG) serum
  lipid profile
• Resting blood pressure was measured systolic
  or diastolic . .

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• Cardiovascular risk abnormalities were considered
  present if
• Blood pressure exceeded the 95th percentile for
  age/gender/height or antihypertensive treatment
  was prescribed.
• Dyslypideamia
• LDL cholesterol was 130 mg/dL
• HDL cholesterol was lt40 mg/dL
• Triglycerides were 100mg/dL .

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Table 1 Demographic and clinical
characteristics of the study population
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Comparision between the metabolic characteristics
of the study population( non-obese and obese
subjects)
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FIG I Comparision of lipid Profile between
Obese Nonobese Patients.
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• Lipotoxic Theory Accumulation of abdominal
  fat is accompanied by
• resistance to insulin action
• heightened sensitivity to catecholamines

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• Rates of FFA flux in patients with upper body
  abdominal obesity exceed those in lower body
  obese and lean subjects.
• Portal flux of FFA increases in response to mass
  visceral fat

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• The majority of patients with high blood pressure
  are overweight.
• Factors to be considered in linking obesity to an
  increase in blood pressure include
• direct effects of obesity on hemodynamics
• increase in blood volume
• increase in peripheral vascular resistance

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FIG IIComparision of lipid profile between
Hypertensive Normotensive obese patients.
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Table III Partial correlation coefficients
for Body mass index with serum variables, blood
pressure in obese children
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Scatterplot of serum LDL, against BMI.
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Scatterplot of serum cholesterol against
BMI.
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Scatterplot of Systolic diastolic blood
pressure against BMI .
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CONCLUSIONS RECOMENDATIONS
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• Whole body and central fatness are correlated
  with several important CVD risk factors early in
  life.
• More detailed screening studies are essential to
  reveal the full extent of this problem.
• Heath care providers are increasingly challenged
  to provide evaluation and treatment for the
  serious comorbidities and complications of
  obesity in childhood.

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THANK YOU