Cardiometabolic risk factors as apolipoprotein B, triglyceride/HDL-cholesterol ratio and C-reactive protein, in adolescents with and without obesity: cross-sectional study in middle class suburban children

Musso C, Graffigna M, Soutelo J, Honfi M, Ledesma L, Miksztowicz V, Pazos M, Migliano M, Schreier LE, Berg GA. Cardiometabolic risk factors as apolipoprotein B, triglyceride/HDL‐cholesterol ratio and C‐reactive protein, in adolescents with and without obesity: cross‐sectional study in middle class suburban children. Background: The prevalence of obesity (OB), overweight (OW), and metabolic syndrome (MS) has increased worldwide. That imposes a substantial risk for type 2 diabetes and premature cardiovascular disease. However, to date no unified criteria exist to asses risk or outcomes in children and adolescents. Objectives: To establish the presence of OB/OW and MS and risk factors for cardiovascular disease in adolescents. Design and subjects: Male (n = 514) and female (n = 429) adolescents from high school were studied (11–14 yr). Weight, height, body mass index (BMI), waist circumference (WC), and blood pressure were determined in all subjects. Glucose, lipoprotein profile, apolipoprotein B (apoB), and high‐sensitivity C‐reactive protein (hs‐CRP) levels were measured. Triglyceride/high‐density lipoprotein‐cholesterol (TG/HDL‐cholesterol) ratio was calculated. Results: The frequency of OB/OW and MS were 22.2 and 3.7%, respectively. In comparison to healthy adolescents, TG/HDL‐cholesterol ratio was increased in OB/OW (2.9 ± 2.5 vs. 1.6 ± 1.0) and MS groups (4.0 ± 2.5 vs. 1.6 ± 0.9), p < 0.001. OB/OW adolescents presented higher values of hs‐CRP in comparison to non‐obese, median (range): 1.9 (0.1–9.4) vs. 1.4 (0.1–9.9), mg/L, p < 0.001. ApoB (mean ± SD) was 71 ± 21 mg/dL in MS group and 59 ± 17 mg/dL in those without MS (p < 0.001). TG/HDL‐cholesterol ratio positively correlated with BMI (r = 0.18, p < 0.001), WC (r = 0.24, p < 0.001), and apoB (r = 0.24, p < 0.001); hs‐CRP correlated with WC (r = 0.14, p < 0.001) and BMI (r = 0.17, p < 0.001). Conclusions: Even when the frequency of OB, OW, and MS in adolescents was low, those subjects presented an atherogenic lipoprotein. These findings emphasize the importance to evaluate cardiovascular risk factors in adolescents to assess strategies to prevent future disease.