ComorbidityDyslipidemia and Pediatric Obesity
Section snippets
Trends and prevalence in obesity among pediatric populations
Unfortunately, the pediatric obesity epidemic has resulted in a second and much larger population of children with abnormal lipids, those with secondary combined dyslipidemia. Childhood obesity rates have tripled in the past 30 years with as many as 17% of US adolescents and 16% of US children, 2 to 11 years of age, defined as obese.11 Alarmingly, prevalence rates among black and Hispanic children and adolescents in the United States are even higher.11 Severe obesity is formally defined by the
Pathophysiology of dyslipidemia and pediatric obesity
Childhood obesity appears with a powerful array of cardiovascular risk factors, including combined dyslipidemia, insulin resistance, and hypertension,17 and has been shown to be associated with pathologic evidence of accelerated atherosclerosis in autopsy studies in this age group.18 The dyslipidemia pattern associated with pediatric obesity consists of a combination of elevated TGs, decreased HDL-C, and top normal to mildly elevated LDL-C.8 Normal lipid values in childhood have been developed
Lifestyle management of combined dyslipidemia
Treatment of combined dyslipidemia of obesity is primarily lifestyle change and this is often highly effective. Combined dyslipidemia has been shown to be responsive to even small changes in weight status, diet composition, and activity. Most importantly, in obese children, adolescents, and adults, even small amounts of weight loss are associated with significant decreases in TG levels and increases in HDL-C levels.32, 33, 34, 35, 36 Even without weight loss, exercise training is associated
Drug therapy for combined dyslipidemia
In the rare child with combined dyslipidemia and severe hypertriglyceridemia for whom diet and exercise interventions are insufficient, there are nutriceutical and medication options that can be considered. The TG level and the timing for consideration of more advanced therapy are outlined in the algorithm (see Fig. 1). A recent systematic review demonstrated that omega-3 fish oil capsules are both safe and effective in adults, reducing TGs by 30% to 45%, with significant associated increases
Summary
The prevalence of obesity has continued to rise over the past 3 decades. The obesity epidemic is already having an impact on the cardiovascular health of today’s adults in their 30s and 40s. In children, obesity—especially abdominal obesity—is strongly associated with insulin resistance and with a high prevalence of the atherogenic combined dyslipidemia described in this article. Although these cardiometabolic abnormalities have not resulted in measurable increases in TC or LDL-C, adult and
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2023, Research in Social and Administrative PharmacyDiet Quality and Cardiometabolic Risk Factors in Adolescents with Down Syndrome
2023, Journal of the Academy of Nutrition and DieteticsCitation Excerpt :This finding is interesting in light of our previously published work. Typically, metabolic dyslipidemia in obese/overweight youth involves abnormalities in triglyceride levels, HDL-C levels, and small LDL-particles, but not particularly in LDL-C levels.43,44 However, in our prior publication comparing lipids levels between the two groups of this same cohort, youth who were overweight/obese with DS had a significantly higher prevalence of elevated LDL-C levels, compared with controls who were overweight/obese.12
Nutrition interventions for youth with dyslipidemia: a National Lipid Association clinical perspective
2022, Journal of Clinical Lipidology