Overweight Children at Higher Heart Risk

Study finds higher levels of telltale marker

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HealthDay Reporter

(HealthDay is the new name for HealthScoutNews.)

MONDAY, Aug. 18, 2003 (HealthDayNews) -- Overweight and obese children tend to have higher concentrations of a protein that may indicate the presence of extremely early heart disease.

"It's one more wake-up call that all of the wonderful things we are developing to treat and prevent heart disease are not going to prevent an increase in the epidemic if we don't learn how to be a population of people that eats fewer calories and exercises more," says Dr. Richard Stein, a spokesman for the American Heart Association.

Others urge caution about the finding, which appears in the Aug. 19 issue of Circulation.

"Whether that chronic response [of the protein] is going to result over time in significant increases in atherosclerotic disease is not yet clear," says Dr. Mubadda Salim, chief of pediatric cardiology at the University of Maryland Hospital for Children in Baltimore. "When we find something that correlates with something else, we don't know how long it's going to be before the relationship becomes more significant. That's one of the dilemmas we have with a study like this."

The protein in question is C-reactive protein (CRP), which has recently emerged as a possible new way to evaluate an adult's risk for cardiovascular disease. Levels of CRP increase in response to inflammation, such as the buildup of fat or plaque in artery walls. This type of buildup is the telltale sign of atherosclerosis or hardening of the arteries.

In children, CRP has been used for about a decade to measure the presence of a variety of different infections, Salim says. It has not been used in relation to cardiac events, however, because these events are so rare in children.

The authors of this study analyzed data on 1,479 boys and 1,367 girls, ages 3 to 17, that had been collected as part of the National Health and Nutrition Examination Survey (NHANES) in 1999 and 2000.

A highly sensitive test was used to measure CRP concentrations. These were then correlated with age, body mass index, systolic blood pressure, and triglyceride concentrations.

Body mass index turned out to be the best predictor of CRP concentration. The association was a linear one, meaning that the higher the BMI, the higher the CRP levels.

Increasing age was also associated with higher CRP concentrations among the boys in the group. For girls aged 12 to 17, increasing CRP levels were associated with increased systolic blood pressure (the top number in the reading).

There were also some racial and ethnic differences among boys aged 8 to 17 and among girls aged 8 to 11.

On the other hand, CRP levels did not correlate with other known risk factors for heart disease, such as smoking and blood pressure.

All in all, the findings are provocative but are not a reason to go get your child's CRP levels tested, experts say.

If a child is overweight or obese, however, that's reason enough to make lifestyle changes.

"You can tell obese people to lose weight. It's not only bad for your well-being, but it means your body is reacting adversely to the obesity," Salim says.

More information

The American Heart Association has information on atherosclerosis and on C-reactive protein. The CDC has a BMI calculator for kids.

SOURCES: Richard Stein, M.D., professor of clinical medicine, Weill Cornell Medical Center, associate chair of medicine, Beth Israel Hospital, both New York City, and spokesman, American Heart Association; Mubadda Salim, M.D., chief of pediatric cardiology, University of Maryland Hospital for Children, Baltimore; Aug. 19, 2003, Circulation

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