Circulation. 2003;107:1448-1453
doi: 10.1161/01.CIR.0000060923.07573.F2
doi: 10.1161/01.CIR.0000060923.07573.F2
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;107:1448.)
© 2003 American Heart Association, Inc.
AHA Scientific Statement |
Obesity, Insulin Resistance, Diabetes, and Cardiovascular Risk in Children
An American Heart Association Scientific Statement From the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism)
This statement was reviewed by the American Diabetes Association. The recommendations contained herein are consistent with the American Diabetes Association’s Clinical Practice Recommendations.
Key Words: AHA Scientific Statements • pediatrics • cardiovascular diseases • obesity • diabetes mellitus
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
 |
Introduction |
|---|
Atherosclerotic cardiovascular disease is the No. 1 killer in the adult population of Western societies,1 but the pathological processes and risk factors associated with its development have been shown to begin during childhood.2 Obesity plays a central role in the insulin resistance syndrome, which includes hyperinsulinemia, hypertension, hyperlipidemia, type 2 diabetes mellitus, and an increased risk of atherosclerotic cardiovascular disease. The incidence of type 2 diabetes reported in children has increased alarmingly.3,4
Resistance of the body to the actions of insulin results in increased production of this hormone by the pancreas and ensuing hyperinsulinemia. Obesity beginning in childhood often precedes the hyperinsulinemic state. Other components of the insulin resistance syndrome are also present in children and adolescents.5,6 An association between obesity and insulin resistance has been reported in the young, as has the link between insulin resistance, hypertension, and abnormal lipid profile. There is an increasing amount of data showing that being overweight during childhood and adolescence is significantly associated with insulin resistance, dyslipidemia, and elevated blood pressure in young adulthood. Weight loss by obese youngsters results in a decrease in insulin concentration and improvement in insulin sensitivity. Moreover, it has been determined that increased left ventricular mass, which is an independent risk factor for cardiovascular disease in adults, is present in childhood. Recent research has found that left ventricular hypertrophy is related to other risk factors, including obesity and insulin resistance in children and adolescents.7 The specifics of the transition from risk factors in childhood to diabetes and cardiovascular
This article has been cited by other articles:
 |
|
 |
|
  L. Pacifico, E. Poggiogalle, F. Costantino, C. Anania, F. Ferraro, F. Chiarelli, and C. Chiesa Acylated and nonacylated ghrelin levels and their associations with insulin resistance in obese and normal weight children with metabolic syndrome Eur. J. Endocrinol., December 1, 2009; 161(6): 861 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Giannini, T de Giorgis, A Scarinci, I Cataldo, M L Marcovecchio, F Chiarelli, and A Mohn Increased carotid intima-media thickness in pre-pubertal children with constitutional leanness and severe obesity: the speculative role of insulin sensitivity, oxidant status, and chronic inflammation Eur. J. Endocrinol., July 1, 2009; 161(1): 73 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Steinberger, S. R. Daniels, R. H. Eckel, L. Hayman, R. H. Lustig, B. McCrindle, and M. L. Mietus-Snyder Progress and Challenges in Metabolic Syndrome in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism Circulation, February 3, 2009; 119(4): 628 - 647. [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Morrison, C. J Glueck, P. S Horn, G. B Schreiber, and P. Wang Pre-teen insulin resistance predicts weight gain, impaired fasting glucose, and type 2 diabetes at age 18-19 y: a 10-y prospective study of black and white girls Am. J. Clinical Nutrition, September 1, 2008; 88(3): 778 - 788. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Miller, C. Manlhiot, N. Chahal, G. Cullen-Dean, L. Bannister, and B. W. McCrindle Impact of Increasing Adiposity in Hyperlipidemic Children Clinical Pediatrics, September 1, 2008; 47(7): 679 - 684. [Abstract] [PDF]
|
|
|
|
|
|
S. K. Kumanyika, E. Obarzanek, N. Stettler, R. Bell, A. E. Field, S. P. Fortmann, B. A. Franklin, M. W. Gillman, C. E. Lewis, W. C. Poston II, et al. Population-Based Prevention of Obesity: The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance: A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (Formerly the Expert Panel on Population and Prevention Science) Circulation, July 22, 2008; 118(4): 428 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Tjonna, S. J. Lee, O. Rognmo, T. O. Stolen, A. Bye, P. M. Haram, J. P. Loennechen, Q. Y. Al-Share, E. Skogvoll, S. A. Slordahl, et al. Aerobic Interval Training Versus Continuous Moderate Exercise as a Treatment for the Metabolic Syndrome: A Pilot Study Circulation, July 22, 2008; 118(4): 346 - 354. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Steele, S. Brage, K. Corder, N. J. Wareham, and U. Ekelund Physical activity, cardiorespiratory fitness, and the metabolic syndrome in youth J Appl Physiol, July 1, 2008; 105(1): 342 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Aggoun, N. J. Farpour-Lambert, L. M. Marchand, E. Golay, A. B.R. Maggio, and M. Beghetti Impaired endothelial and smooth muscle functions and arterial stiffness appear before puberty in obese children and are associated with elevated ambulatory blood pressure Eur. Heart J., March 2, 2008; 29(6): 792 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Meriwether, F. Lobelo, and R. R. Pate Themed Review: Clinical Interventions to Promote Physical Activity in Youth American Journal of Lifestyle Medicine, February 1, 2008; 2(1): 7 - 25. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Ramachandran, C. Snehalatha, A. Yamuna, N. Murugesan, and K.M. V. Narayan Insulin Resistance and Clustering of Cardiometabolic Risk Factors in Urban Teenagers in Southern India Diabetes Care, July 1, 2007; 30(7): 1828 - 1833. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Day Metabolic syndrome, or What you will: definitions and epidemiology Diabetes and Vascular Disease Research, March 1, 2007; 4(1): 32 - 38. [Abstract] [PDF]
|
|
|
|
|
|
C. E. Canter, R. E. Shaddy, D. Bernstein, D. T. Hsu, M. R.K. Chrisant, J. K. Kirklin, K. R. Kanter, R. S.D. Higgins, E. D. Blume, D. N. Rosenthal, et al. Indications for Heart Transplantation in Pediatric Heart Disease: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young; the Councils on Clinical Cardiology, Cardiovascular Nursing, and Cardiovascular Surgery and Anesthesia; and the Quality of Care and Outcomes Research Interdisciplinary Working Group Circulation, February 6, 2007; 115(5): 658 - 676. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Ventura, E. Loken, and L. L. Birch Risk Profiles for Metabolic Syndrome in a Nonclinical Sample of Adolescent Girls Pediatrics, December 1, 2006; 118(6): 2434 - 2442. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Ullman Kids' Cardiology DOC News, August 1, 2006; 3(8): 8 - 8. [Full Text]
|
|
|
|
 |
|
 S Sookoian, S I Garcia, P I Porto, G Dieuzeide, C D Gonzalez, and C J Pirola Peroxisome proliferator-activated receptor gamma and its coactivator-1 alpha may be associated with features of the metabolic syndrome in adolescents J. Mol. Endocrinol., October 1, 2005; 35(2): 373 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Cisneros-Tapia, F. A. Navarrete, A. C. Gallegos, A. E. Robles-Sardin, R. O. Mendez, and M. E. Valencia Insulin Sensitivity and Associated Risk Factors in Mexican Children and Adolescents Diabetes Care, October 1, 2005; 28(10): 2546 - 2547. [Full Text] [PDF]
|
|
|
|
|
|
G. S. Boyd, J. Koenigsberg, B. Falkner, S. Gidding, and S. Hassink Effect of Obesity and High Blood Pressure on Plasma Lipid Levels in Children and Adolescents Pediatrics, August 1, 2005; 116(2): 442 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Bunt, P. A. Tataranni, and A. D. Salbe Intrauterine Exposure to Diabetes Is a Determinant of Hemoglobin A1c and Systolic Blood Pressure in Pima Indian Children J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3225 - 3229. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kadohisa, E. T. Rolls, and J. V. Verhagen Neuronal Representations of Stimuli in the Mouth: The Primate Insular Taste Cortex, Orbitofrontal Cortex and Amygdala Chem Senses, June 1, 2005; 30(5): 401 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G D Kolovou, K K Anagnostopoulou, and D V Cokkinos Pathophysiology of dyslipidaemia in the metabolic syndrome Postgrad. Med. J., June 1, 2005; 81(956): 358 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. McQuaid, D. J. O'Gorman, O. Yousif, T. P. Yeow, Y. Rahman, D. Gasparro, G. Pacini, and J. J Nolan Early-Onset Insulin-Resistant Diabetes in Obese Caucasians Has Features of Typical Type 2 Diabetes, but 3 Decades Earlier Diabetes Care, May 1, 2005; 28(5): 1216 - 1218. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Ferreira, R. M. A. Henry, J. W. R. Twisk, W. van Mechelen, H. C. G. Kemper, and C. D. A. Stehouwer The Metabolic Syndrome, Cardiopulmonary Fitness, and Subcutaneous Trunk Fat as Independent Determinants of Arterial Stiffness: The Amsterdam Growth and Health Longitudinal Study Arch Intern Med, April 25, 2005; 165(8): 875 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Nemet, S. Barkan, Y. Epstein, O. Friedland, G. Kowen, and A. Eliakim Short- and Long-Term Beneficial Effects of a Combined Dietary-Behavioral-Physical Activity Intervention for the Treatment of Childhood Obesity Pediatrics, April 1, 2005; 115(4): e443 - e449. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Ferreira, J. W. R. Twisk, W. van Mechelen, H. C. G. Kemper, and C. D. A. Stehouwer Development of Fatness, Fitness, and Lifestyle From Adolescence to the Age of 36 Years: Determinants of the Metabolic Syndrome in Young Adults: The Amsterdam Growth and Health Longitudinal Study Arch Intern Med, January 10, 2005; 165(1): 42 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. V. Verhagen, M. Kadohisa, and E. T. Rolls Primate Insular/Opercular Taste Cortex: Neuronal Representations of the Viscosity, Fat Texture, Grittiness, Temperature, and Taste of Foods J Neurophysiol, September 1, 2004; 92(3): 1685 - 1699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Miller, A. Rosenbloom, and J. Silverstein Childhood Obesity J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4211 - 4218. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Eyre, R. Kahn, R. M. Robertson, and and the ACS/ADA/AHA Collaborative Writing Committe Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association Stroke, August 1, 2004; 35(8): 1999 - 2010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Eyre, R. Kahn, R. M. Robertson, and the ACS/ADA/AHA Collaborative Writing Committe, N. G. Clark, C. Doyle, T. Gansler, T. Glynn, Y. Hong, R. A. Smith, et al. Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association CA Cancer J Clin, July 1, 2004; 54(4): 190 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Eyre, R. Kahn, and R. M. Robertson Preventing Cancer, Cardiovascular Disease, and Diabetes: A common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association Diabetes Care, July 1, 2004; 27(7): 1812 - 1824. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Eyre, R. Kahn, R. M. Robertson, the ACS/ADA/AHA Collaborative Writing Committee, ACS/ADA/AHA Collaborative Writing Committee Member, N. G. Clark, C. Doyle, Y. Hong, T. Gansler, T. Glynn, et al. Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association Circulation, June 29, 2004; 109(25): 3244 - 3255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Weiss, J. Dziura, T. S. Burgert, W. V. Tamborlane, S. E. Taksali, C. W. Yeckel, K. Allen, M. Lopes, M. Savoye, J. Morrison, et al. Obesity and the Metabolic Syndrome in Children and Adolescents N. Engl. J. Med., June 3, 2004; 350(23): 2362 - 2374. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. A. Kobaissi, M. J. Weigensberg, G. D.C. Ball, M. L. Cruz, G. Q. Shaibi, and M. I. Goran Relation Between Acanthosis Nigricans and Insulin Sensitivity in Overweight Hispanic Children at Risk for Type 2 Diabetes Diabetes Care, June 1, 2004; 27(6): 1412 - 1416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Davidoff, M. M. Mason, M. B. Davidson, M. W. Carmody, K. K. Hintz, L. E. Wold, D. A. Podolin, and J. Ren Sucrose-induced cardiomyocyte dysfunction is both preventable and reversible with clinically relevant treatments Am J Physiol Endocrinol Metab, May 1, 2004; 286(5): E718 - E724. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. T. Bloomgarden Type 2 Diabetes in the Young: The evolving epidemic Diabetes Care, April 1, 2004; 27(4): 998 - 1010. [Full Text] [PDF]
|
|
|
|
 |
|
 I. L. Pina A better survival for women with heart failure? it's not so simple... J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2135 - 2138. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Khan, F. C Green, J S. Forsyth, S. A Greene, A. D Morris, and J. J F Belch Impaired microvascular function in normal children: effects of adiposity and poor glucose handling J. Physiol., September 1, 2003; 551(2): 705 - 711. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Cook, M. Weitzman, P. Auinger, M. Nguyen, and W. H. Dietz Prevalence of a Metabolic Syndrome Phenotype in Adolescents: Findings From the Third National Health and Nutrition Examination Survey, 1988-1994 Arch Pediatr Adolesc Med, August 1, 2003; 157(8): 821 - 827. [Abstract] [Full Text] [PDF]
|
|