Prevalence of cardiometabolic risk factors by weight status in a population-based sample of Quebec children and adolescents

BACKGROUND: There are few data on the prevalence of cardiometabolic risk factors in population-based samples of overweight and obese youth. OBJECTIVES: To compare the prevalence of individual and multiple cardiometabolic risk factors across body mass index (BMI) categories in a population-based sample of youth. METHODS: In 1999, a school,based survey of a provincially representative sample of youth nine, 13 and 16 years of age was conducted in Quebec (1778 boys, 1835 girls). Overweight was defined as BMI in the 85th percentile or higher and lower than the 95th percentile of the Centers for Disease Control and Prevention 2000 growth charts, and obesity was defined as BMI in the 95th percentile or higher. Levels of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein 13, high-density lipoprotein cholesterol, triglycerides, insulin, glucose, C-reactive protein and systolic blood pressure were categorized as desirable, borderline or unfavourable. RESULTS: The proportions of overweight and obese participants were 14% and 10% in boys, and 14% and 7% in girls, respectively. With the exception of total cholesterol and low-density lipoprotein cholesterol in girls, and glucose in both sexes, the prevalence of all investigated risk factors (borderline or unfavourable) was significantly higher among overweight and obese participants. Almost one-third of obese participants had unfavourable levels of at least two of seven risk factors (apolipoprotein B, high-density lipoprotein cholesterol, triglycerides, insulin, glucose, C-reactive protein and systolic blood pressure) compared with 3% of normal weight participants (adjusted OR 15 and 18 in boys and girls, respectively). Thirty-four per cent of obese youth did not have unfavourable levels of any risk factor. CONCLUSION: There is marked heterogeneity in the association between excess weight and cardiometabolic risk factors. Nonetheless, the present study highlights a high prevalence of multiple risk factors in a population-based sample of overweight and obese youth.