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Age-related changes in cardiovascular disease risk factors of hypercholesterolemic children
A M Tershakovec1, A F Jawad, V A Stallings
1Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA.
Insights
Children with hypercholesterolemia (HC) show increased body fat and altered insulin and blood pressure levels, with these changes becoming more pronounced with age. These cardiovascular disease risk factors emerge before significant increases in body fat are observed.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Risk Factors
- Childhood Obesity
Background:
- Cardiovascular disease risk factors can manifest in childhood.
- Hypercholesterolemia (HC) in children is a concern for future cardiovascular health.
- Understanding the interplay of body fat, insulin, and blood pressure in young HC children is crucial.
Purpose of the Study:
- To investigate age-related changes in cardiovascular disease risk factors among young children with hypercholesterolemia (HC).
- To compare body composition and metabolic markers between hypercholesterolemic (HC) and nonhypercholesterolemic (NHC) children.
- To explore associations between adiposity, insulin levels, and blood pressure in this pediatric cohort.
Main Methods:
- Cross-sectional study comparing HC (n=227) and NHC (n=80) children aged 4-10 years.
- Measurements included height, weight, skin-fold thickness, blood pressure, and total cholesterol.
- Insulin levels were assessed in the HC group; statistical analyses included ANOVA and Spearman correlations.
Main Results:
- HC children exhibited significantly larger skin-fold measurements compared to NHC children, indicating greater body fat.
- The association between increased body fat and hypercholesterolemia was more evident in older children (8.0-9.9 years) than younger ones (4.0-5.9 years).
- Systolic blood pressure and insulin levels in the HC group were significantly associated with measures of adiposity.
Conclusions:
- Children with HC possess higher body fat percentages.
- Hypercholesterolemia appears to precede the significant increase in body fat.
- Increased adiposity with age is linked to altered insulin and blood pressure in children with HC, warranting further longitudinal investigation.
Objective:
To describe the age-related changes in cardiovascular disease risk factors in young, hypercholesterolemic (HC) children.
Methods:
Hypercholesterolemic (n = 227) and nonhypercholesterolemic (NHC) (n = 80) children between the ages of 4 and 10 years were identified. Height, weight, skin-fold and blood pressure measurements, and total cholesterol levels were measured. The HC group also had insulin levels evaluated. The groups were compared by analysis of variance. Simple Spearman correlations evaluated the associations between factors within each group.
Results:
The HC and NHC groups had similar mean ages, heights, and weights, both contained 51% girls, and all were white subjects. Percent weight-for-height median, and biceps, triceps, suprailiac and subscapular skin-fold measurements were all larger for the HC group. A significant age interaction demonstrated that the HC group's larger suprailiac and sum of skin-fold measures were expressed in the 8.0- to 9.9-year-old children, but not the 4.0- to 5.9-year-olds. For both groups, systolic blood pressure was associated with the measures of adiposity. For the HC group, insulin levels were also associated with adiposity.
Conclusions:
These results suggest that: (1) children with HC have greater body fat, (2) the expression of the hypercholesterolemia precedes the expression of increased body fat, (3) body fat increases with age, and (4) altered insulin and blood pressure levels are expressed in association with the increased body fat in children with HC. Confirmation with longitudinal data is necessary.