Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents

Andrades, Clara dos Santos de; Poletti, Victória Volkweis; Closs, Vera Elizabeth; Gustavo, Andreia da Silva; Oliveira, Margareth da Silva; Donadio, Márcio Vinícius Fagundes; Feoli, Ana Maria Pandolfo

doi:10.1590/1984-0462/2023/41/2021312

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Revista Paulista de Pediatria

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ORIGINAL ARTICLE • Rev. paul. pediatr. 41 • 2023 • https://doi.org/10.1590/1984-0462/2023/41/2021312 copy

Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents

Prevalência de dislipidemia, risco aterogênico e cardiovascular em adolescentes com sobrepeso e obesidade

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements.

Methods:

This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05.

Results:

A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls — who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL.

Conclusions:

The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

Keywords:
Adolescent; Obesity; Cardiovascular diseases; Atherosclerosis; Lipid metabolism disorders; Body mass index

Characteristics	Total sample	Sex		p-value
Characteristics	Total sample	Boys n=37	Girls n=109	p-value
Sociodemographic
Age (years)	16.4±1.1	16.1±1.2	16.5±1.1	0.085*
Anthropometric
Z score	2.9±0.9	3.4±0.9	2.8±0.8	<0.001*
Classification
Overweight	14.0 (9.6)	1.0 (2.7)	13.0 (11.9)	0.013^†
Obesity	77.0 (52.7)	15.0 (40.5)	62.0 (56.9)
Severe obesity	55.0 (37.7)	21.0 (56.8)	34.0 (31.2)
Clinical
Triglycerides (mg/dL)	95.3±45.0	86.2±30.9	98.4±48.6	0.079*
Classification
Adequate	76.0 (52.1)	21.0 (56.8)	55.0 (50.5)	0.508^‡
Altered	70.0 (47.9)	16.0 (43.2)	54.0 (49.5)	0.508^‡
HDL (mg/dL)	48.8±13.7	41.8±8.5	51.1±14.4	<0.001*
Classification
Adequate	78.0 (53.4)	11.0 (29.7)	67.0 (61.5)	0.001^‡
Altered	68.0 (46.6)	26.0 (70.3)	42.0 (38.5)	0.001^‡
LDL (mg/dL)	96.0±27.8	96.9±28.8	95.7±27.6	0.825*
Classification
Adequate	107.0 (73.3)	26.0 (70.3)	81.0 (74.3)	0.631^‡
Altered	39.0 (26.7)	11.0 (29.7)	28.0 (25.7)	0.631^‡
Total cholesterol (mg/dL)	163.9±33.3	155.9±32.4	166.6±33.3	0.093*
Classification
Adequate	91.0 (62.3)	26.0 (70.3)	65.0 (59.6)	0.249^‡
Altered	55.0 (37.7)	11.0 (29.7)	44.0 (40.4)	0.249^‡

Risk parameters	Total sample	Sex		p-value
Risk parameters	Total sample	Boys n=37	Girls n=109	p-value
Castelli Risk Index 1	3.5±1.0	3.8±1.0	3.4±1.0	0.048*
Classification
No cardiovascular risk	124.0 (84.9)	34.0 (91.9)	90.0 (82.6)	0.171^†
High cardiovascular risk	22.0 (15.1)	3.0 (8.1)	19.0 (17.4)	0.171^†
Castelli Risk Index 2	2.1±0.9	2.4±0.8	2.0±0.9	0.026*
Classification
No cardiovascular risk	126.0 (86.3)	32.0 (86.5)	94.0 (86.2)	0.970^†
High cardiovascular risk	20.0 (13.7)	5.0 (13.5)	15.0 (13.8)	0.970^†
Atherogenic Index of Plasma	0.2 (0.1-0.4)	0.3 (0.1-0.4)	0.2 (0.1-0.4)	0.162^‡
Classification
Low risk	36.0 (24.7)	6.0 (16.2)	30.0 (27.5)	0.216^†
Intermediate risk	29.0 (19.9)	6.0 (16.2)	23.0 (21.1)
Increased risk	81.0 (55.5)	25.0 (67.6)	56.0 (51.4)

Clinical variables of cardiovascular risk	Z score
	Total sample		Sex
	Total sample		Boys n=37		Girls n=109
	r	p-value	r	p-value	r	p-value
Triglycerides (mg/dL)	0.094	0.259	0.334	0.043	0.096	0.320
HDL (mg/dL)	−0.381	<0.001	−0.317	0.056	−0.331	<0.001
LDL (mg/dL)	−0.001	0.987	0.010	0.953	−0.014	0.887
Total cholesterol (mg/dL)	−0.133	0.109	−0.011	0.950	−0.126	0.191
Castelli Risk Index 1	0.281	0.001	0.257	0.125	0.244	0.011
Castelli Risk Index 2	0.250	0.002	0.203	0.227	0.209	0.029
	s	p	s	p	s	p
Atherogenic Index of Plasma	0.302	<0.001	0.451	0.005	0.211	0.028

Cardiovascular Risk Parameters (Classification)	Z score
	Total sample			Sex
	Total sample			Boys n=37			Girls n=109
	n	Mean±SD	p-value	n	Mean±SD	p-value	n	Mean±SD	p-value
Triglycerides
Adequate	76.0	2.9±0.8	0.287	21.0	3.2±0.9	0.095	55.0	2.8±0.8	0.599
Altered	70.0	3.0±0.9	0.287	16.0	3.7±0.8	0.095	54.0	2.8±0.8	0.599
HDL
Adequate	78.0	2.7±0.7	0.002	11.0	3.2±0.7	0.364	67.0	2.7±0.7	0.040
Altered	68.0	3.2±0.9	0.002	26.0	3.5±0.9	0.364	42.0	3.0±0.9	0.040
LDL
Adequate	107.0	3.0±0.9	0.347	26.0	3.4±0.9	0.610	81.0	2.8±0.8	0.310
Altered	39.0	2.8±0.9	0.347	11.0	3.3±0.8	0.610	28.0	2.7±0.8	0.310
Total cholesterol
Adequate	91.0	3.1±0.9	0.022	26.0	3.5±0.9	0.296	65.0	2.9±0.8	0.084
Altered	55.0	2.7±0.8	0.022	11.0	3.2±0.8	0.296	44.0	2.6±0.8	0.084
Castelli Risk Index 1
No risk	124.0	2.9±0.9	0.264	34.0	3.4±0.8	0.721	90.0	2.7±0.8	0.052
High risk	22.0	3.1±0.9	0.264	3.0	3.2±1.4	0.721	19.0	3.1±0.8	0.052
Castelli Risk Index 2
No risk	126.0	2.9±0.8	0.213	32.0	3.4±0.9	0.757	94.0	2.7±0.8	0.081
High risk	20.0	3.2±0.9	0.213	5.0	3.3±1.0	0.757	15.0	3.1±0.9	0.081
Atherogenic Index of Plasma
Low risk	36.0	2.7^a±0.7		6.0	2.6^a±0.4		30.0	2.7±0.7
Intermediate risk	29.0	2.7±0.9	0.011	6.0	3.2±1.1	0.033	23.0	2.6±0.8	0.236
Increased risk	81.0	3.1^b±0.9		25.0	3.6^b±0.8	56.0	2.9±0.9

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[1] *Corresponding author: E-mail: anafeoli@pucrs.br (A. M. P. Feoli)