Cardiovascular risk factors in prepubertal, pubertal and young adult patients with overweight or obesity: Effects of age, gender and degree of overweight evaluated in 14869 patients

The cardiovascular risk factors hypertension and dyslipidemia clearly predict morbidity and mortality.Data on the prevalence before, during and after puberty, and on the rela- tion to gender and degree of overweight, pro-vide a basis for early intervention. 65 cen- ters specialised in obesity care contributed standardized, anonymized data documented by the “APV“-software (see http://www.a-p-v.de). 6751 patients were prepubertal (age <12years), 7344 pubertal (12–14years) and 774 were young adults (16–40years). A total of 14869 patients were available for analysis. BMI was evaluated according to age- and sex-standardized reference values and classified as normal weight, overweight (>90. perc), obesity (>97.perc) or extreme obesity (>99.5. perc). 921 subjects were normalweight (6.2%), 2582 (17.4%) were overweight, 6837 (45.9%) were obese and 4529 (30.5%) were extremely obese based on German references (Kromeyer-Hauschild/Nationale Verzehrstudie). Blood pressure was evaluated based on 2nd Task Force recommendations. A cholesterol >200, HDL <35, LDL >130 and triglycerides >150mg/dl were considered abnormal according to Am. Heart Association guidelines. In multivariate logistic regression analysis, the presence of hypertension was significantly related to male gender (OR 1.2), overweight (OR 1.7), obesity (OR 2.8) or extreme obesity (OR 5.7), as well as to puberty (OR 1.3) or adulthood (OR 2.4).

Reduced HDL-cholesterol was independent of gender, but related to overweight (OR 2.9), obesity (OR 3.8) or extreme obesity (OR 4.1) and puberty/adulthood (OR 1.2/2.1). Hyper-triglyceridemia was less prevalent in males, increased progressively with obesity and more prevalent in adults. In contrast, ele-vated LDL was not related to gender, degree of overweight or age group.These data from a vast, multicenter database demonstrate, that established cardiovascular risk factors in-cluding hypertension, reduced HDL- or elevated LDL-cholesterol and delevated triglycerides have different relationships to gender age/pubertal status and the degree of overweight.