Abstract 17353: Predictors of Cardiovascular Risk in Overweight Black Adolescents
Increasingly cardiovascular risk (CVR) factors are being seen in overweight-obese youth. Current screening recommendations include measurement of BP, fasting insulin and glucose, and lipids. However, it is uncertain which tests best risk stratify overweight-obese black youth and which factors predict CVR in this population.
Purpose: Determine the contribution of adipose severity, insulin resistance, cardiorespiratory fitness, family history and diet in predicting a CVR profile in overweight-obese black adolescents.
Methods: Black youth (n=122, mean age=14.8 yrs, 57% female) had anthropometrics, oral glucose tolerance test, 3-day diet diary, treadmill exercise test, family history of early MI, resting BP, and adolescents tobacco use measured. Insulin resistance was calculated based on insulin and glucose levels. The CVR profile (0-12) was based on fasting blood samples of CVR markers of high-sensitivity C-reactive protein (hsCRP), fibrinogen, plasminogen-activator inhibitor-1 (PAI-1), homocysteine, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, LDL particle size, Lp(a) and high BP and tobacco use. Backward multiple regression, controlling for age, gender, and Tanner stage, was used to generate models for predict the CVR profile of black overweight youth.
Results: A greater number of CVR factors was associated with higher severity of obesity (r=0.33 to r=0.37), lower insulin sensitivity (r= -0.28), the presence of abnormal glucose metabolism (r=0.18), and family history of early MI (r=0.30). Risk factors that were highly prevalent included: high Lp(a) (78.3%), fibrinogen (59.2%), hsCRP (59.2%), BP (55%), PAI-a (50.4%), and low HDL-cholesterol (47.5%). The model which best predicted the CVR profile included age, tanner stage, family history of MI, relative body mass index, and insulin resistance (R2=0.33, p<0.0001).
Conclusion: Non-traditional CVR factors were prevalent in overweight black youth. Obese black youth with a positive family history of early MI should undergo screening for inflammatory and thrombotic markers, and Lp(a), in addition to current screening recommendations.
- © 2010 by American Heart Association, Inc.