This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cook, S. Articles by Gidding, S. S. Search for Related Content PubMed PubMed Citation Articles by Cook, S. Articles by Gidding, S. S. Related Collections Lipids Obesity Risk Factors Epidemiology

(Circulation. 2007;115:2251-2253.)
© 2007 American Heart Association, Inc.

Editorial

Modifying Cardiovascular Risk in Adolescent Obesity

Stephen Cook, MD; Samuel S. Gidding, MD

From the Department of Pediatrics (S.C.), Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry, Rochester, NY; and Outreach Services (S.S.G.), Nemours Cardiac Center, A.I. DuPont Hospital for Children, Wilmington, Del, and Jefferson Medical College, Philadelphia, Pa.

Correspondence to Stephen Cook, MD, Golisano Children’s Hospital at Strong, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 777, Rochester, NY 14642. E-mail Stephen_cook@urmc.rochester.edu

Key Words: Editorials • epidemiology • lipids • obesity • pediatrics • risk factor • syndrome X

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Obesity affects at least 1 in 6 children and adolescents in this country and should be considered the most common chronic disease in childhood. The complications of obesity also represent a group of chronic conditions that pediatricians must face and should be identified by their persistence over time and not at a single visit. Guidelines for hypertension, another complication of obesity, recommend that a diagnosis should be made after multiple elevated measurements taken over at least 3 visits.¹ Diabetes mellitus guidelines also recommend repeat testing for confirmation of elevated fasting blood glucose in asymptomatic patients.

Article p 2316

Expert recommendations for identification and management of childhood obesity endorse regular tracking of body mass index (BMI) and medical assessment for complications of obesity.² They recommend the collection of information on history, symptoms, and physical findings, as well as a screening for abnormalities in lipids, glucose, insulin, and liver enzymes. The ubiquitous nature of childhood obesity (17%) contrasts with the rarity of severe complications such as type 2 diabetes mellitus (<0.5%), which suggests that a group of obese youth exists with additional abnormalities that elevate their risk for future cardiovascular disease (CVD) and/or type 2 diabetes mellitus. Obese youth who persistently have multiple, moderately abnormal cardiovascular risk factors should be identified for aggressive lifestyle counseling as an essential part of primordial prevention.³

Pediatric studies have modeled the adult metabolic syndrome (MetS) definition to describe the epidemiology and generate hypotheses for obese children, and the studies have found associations with other adult CVD . . . [Full Text of this Article]