The cardio-metabolic risk of moderate and severe obesity in children and adolescents

Objective: To compare the cardio-metabolic risk profile between moderately obese and severely obese children and adolescents. Study design: Cross-sectional study involving 463 obese 6- to 19-year-olds who were referred to an inpatient weight-loss program. Anthropometric data were assessed and fasting blood samples were analyzed for lipid and glucose metabolism, adipokines, and inflammatory markers. Moderately obese individuals (percentiles corresponding to body mass index ≥30 to 35 kg/m² at age 18 years) and severely obese individuals (percentiles corresponding to body mass index ≥35 kg/m ² at age 18 years) were defined by sex and age-specific cut-offs according to the International Obesity Task Force. Results: The prevalence of the metabolic syndrome was three times higher in severely obese individuals compared with those who are moderately obese. Mean values for proinsulin, insulin, homeostatic model assessment-insulin resistance, triglycerides, and interleukin-6 were 30%-50% higher in severe obesity compared with moderate obesity. Concentrations of leptin and high-sensitive C-reactive protein were about 1.5-fold higher, adiponectin levels were 12% lower, and resistin levels 10% higher in severely obese individuals compared with moderately obese (all P <.001). Conclusion: Severely obese individuals have a markedly more unfavorable cardio-metabolic risk profile than those who are moderately obese. The results of this study underscore the substantial effect of severe obesity on health and highlights that these children need to receive particular attention regarding obesity treatment.