Prevalence of risk factors for obesity-related metabolic and cardiovascular disease among minority urban youth

With obesity on the rise across all age groups nationally, type 2 diabetes and cardiovascular disease, once adult diseases, are now spreading into adolescence. Young people developing metabolic disease will have their lives significantly shortened and the quality of their lives adversely affected. Even though professional medical organizations have recommended screening overweight and obese adolescents for these risk factors, most do not receive these assessments. The BODY Project is a program developed at the NYU School of Medicine to screen New York City high school students for risk factors for obesity-related disease. At two high schools of largely minority populations (76% Hispanic, 17% Black, 7% Other), using age and gender specific growth charts developed by the Center for Disease Control, we found that 20% of the students were obese and an additional 18% overweight. We had 468 overweight or obese students, whose parent gave informed written consent, participate in a medical screen that included a fasting blood sample and blood pressure measurement. From these measurements we determined the presence of three risk factors: hypertension, dyslipidemia and insulin resistance. Hypertension was defined using the more conservative adult standards of a systolic value of ≥130 or a diastolic value of ≥85, dyslipidemia was defined as having an abnormally low HDL or high LDL cholesterol value, and insulin resistance was defined as having a HOMA (derived from fasting glucose and insulin) value of ≥3.99. We found that 22.4% of all participants were hypertensive, 16.9% were dyslipidemic and 22.4% were insulin resistant. The rates for each of these risk factors were significantly more prevalent in the obese group compared to the overweight group (p=<.001 for all three risk factors). Specifically, we found that 11.1% of overweight students had hypertension compared to 31.5% of the obese group; 9.1% of the overweight group had dyslipidemia compared to 23.1% of the obese group; and 10.1% of the overweight group had insulin resistance compared to 32.3% of the obese group. In addition, we found that hypertension was significantly more prevalent among male participants in both the overweight group (18.3% males vs. 7.3% females, p=.007) and the obese group (43.1% males vs. 18.7% females, p<.001). The alarming rates of these serious risk factors in teenagers underscores the importance of making these screenings a part of routine medical care for overweight and obese adolescents in order to intervene and prevent the progression of these conditions to overt disease.