WebMD Medical News
Elizabeth Klodas, MD, FACC
March 1, 2010 -- Obese
children as young as age 3 show signs of inflammation similar to that
linked to heart
disease in adults, a new study shows.
Researchers found much higher than expected levels of the inflammation
indicator C-reactive protein, and two other inflammation markers, in obese children enrolled in a nationwide health
C-reactive protein (CRP) is considered by many to be an important early
warning sign of heart disease and levels tend to be elevated in adults
who are overweight or obese.
But the study is among the first to suggest that obesity in very young
children leads to elevated CRP and other markers of systemic inflammation.
"This was definitely a surprise to us," pediatrician and study co-author
Eliana M. Perrin, MD, MPH, of the University of North Carolina, Chapel Hill
tells WebMD. "The fact that we saw this in children as young as 3 could
certainly be cause for concern."
The study included more than 16,000 children between the ages of 1 and 17
who took part in the National Health and Nutrition Examination Survey (NHANES)
between 1999 and 2006.
Based on body
mass index (BMI) scores, the children were classified as healthy
weight, overweight, obese, and very obese.
Nearly 70% fell into the healthy weight range, 15% were
overweight, 11% were obese, and 3.5% were very obese.
Among children between the ages of 3 and 5, just over 42% of those who were
very obese had elevated CRP levels, compared to about 17% of children who were
classified as healthy weight.
The difference was even greater for older children. More than four out of
five (83%) very obese teens between the ages of 15 and 17 had elevated CRP
levels, compared to 18% of healthy-weight teens.
Findings were similar with two other markers of systemic inflammation in
adults: absolute neutrophil count (ANC) and ferritin/transferring saturation
(E/T). In obese children, but not healthy-weight children, elevated E/T levels
were seen beginning at age 6 and elevated ANC levels were found starting at age
The study was published today online, and will also appear in the April
issue of Pediatrics.
"We measured these two other markers of inflammation just in case something
quirky was going on with CRP," Perrin says. "What we saw was a remarkably
consistent association between early obesity and inflammation."
The implications of this association with regard to heart
attack and stroke
risk are less clear.
Although childhood obesity is a known risk factor for developing type 2 diabetes early in life, it is not yet known if the same
is true for heart disease.
"We really can't say what the extra years of inflammation portend for these
children," Perrin says. "It is alarming, because of what we know about the
relationship in adults. But I am cautious about over-interpreting the findings,
because we simply don't know the implications for young children."
Pediatrician Stephen Daniels, MD, of Children's Hospital Denver agrees that
there is cause for concern.
Daniels, who is a spokesman for the American Heart Association, did not take
part in the study.
"We really don't know the full impact of the obesity epidemic in children,"
he says. "But it is hard to imagine that [systemic] inflammation from a very
early age would be a good thing."
And there are indications that, just as with type 2
diabetes, the rise in obesity is leading to earlier heart disease.
Just last week, researchers from the University of Cincinnati reported that
more young- and middle-aged adults are having strokes, at the same time that
the stroke rate is dropping among the elderly.
In 2005, 7.3% of strokes occurred in people younger than age 45, compared to
4.5% in 1993. The average age of a stroke patient also dropped during this
time, from age 71 to 68.
The rise in obesity, high blood
pressure, and diabetes among younger adults is widely believed to be the
cause of this demographic shift.
SOURCES:Skinner, A.C. Pediatrics, April, 2010; vol 125: online edition.Eliana M. Perrin, MD, MPH, assistant professor for pediatrics, University of
North Carolina, Chapel Hill; practicing pediatrician, North Carolina Children's
Hospital, Chapel Hill.Stephen Daniels, MD, PhD, chairman, Department of Pediatrics, University of
Colorado School of Medicine; pediatrician-in-chief, Children's Hospital
Denver.News release,UNC Medical Center, March 1, 2010.WebMD Health News: "Strokes Are Increasing Among Young."
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