Risk factors for cardiovascular disease in obese and normal school children: association of insulin with other cardiovascular risk factors.

OBJECTIVE

To investigate the level of insulin and other known cardiovascular risk factors in school children and their association with obesity.

DESIGN

Cross-sectional study.

SUBJECTS

123 normal and 116 obese school children categorized by weight-for-height, mean age: 10.2 and 10.5 years old respectively.

MEASUREMENTS

Family histories of diseases by questionnaires; blood pressure (BP) and waist and hip circumferences by measurements; fasting blood for glucose, insulin, total cholesterol, HDL-cholesterol and triglycerides.

RESULTS

The numbers of boys in the normal and obese group were 65 and 58, those of the girls, 53 and 63 respectively. The obese group was more likely to have family histories of obesity, high blood pressure and diabetes; had significantly greater waist-hip-ratio (WHR), higher systolic and diastolic BP, lower HDL-cholesterol, higher triglyceride and fasting insulin levels (with fasting blood sugar in the normal range) than the normal weight group. In a crude analysis, insulin levels were positively correlated with obesity, systolic BP, WHR, age and triglycerides and negatively associated with male gender and HDL-cholesterol. After adjustment using multiple regression, only obesity status, age, gender and triglycerides still remained significantly associated with insulin level. Limitation of utilizing family disease history report for identification of children at risk was discussed.

CONCLUSION

These findings suggest that risk to coronary heart disease and hypertension through insulin resistance already operates in school-aged children.