Associations of Overweight and Obesity Indicators with Cardiometabolic Risk Profile in Children and Adolescents with Congenital Heart Disease

This study aimed to compare the cardiometabolic risk profile between overweight or obese and normal weight and to investigate the influence of overweight and obesity indicators on cardiometabolic risk profile in children and adolescents with congenital heart disease (CHD). A cross-sectional study with 232 children and adolescents with CHD. Cardiometabolic risk profile were evaluated: high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), non-HDL-c, fasting glucose, triglycerides, high-sensitivity C-reactive protein (hs-CRP), and systolic and diastolic blood pressure (SBP and DBP). Overweight and obesity indicators included body fat percentage (%BF) by air displacement plethysmography and waist circumference percentile (WC-p) and were categorized in "overweight or obese children and adolescents" versus "normal weight children and adolescents". Data were examined using linear regressions. In linear regression analysis, WC-p was inversely associated with HDL-c (ß: - 0.19, 95% CI - 0.16; - 0.03) and directly associated with hs-CRP (ß: 0.02, 95% CI 0.02; 0.03). %BF was directly associated with LDL-c (ß: 0.38, 95% CI 0.00;0.75), non-HDL-c (ß: 0.42, 95% CI 0.02;0.81), hs-CRP (ß: 0.02, 95% CI 0.01; 0.02), SBP (ß: 0.26, 95% CI 0.13;0.39) and DBP (ß: 0.15, 95% CI 0.07;0.23). When stratified by overweight or obese children and adolescents versus normal weight children and adolescents, WC-p and %BF were directly associated hs-CRP (ß:0.14, 95%CI 0.03;0.26 and ß:0.02, 95%CI 0.01; 0.04, respectively) and %BF was also directly associated with TC (ß:1.68, 95%CI 0.30;3.07), LDL-c (ß:1.64, 95%CI 0.32;2.95), non-HDL-c (ß:1.56, 95%CI 0.12;3.01) in overweight or obese children and adolescents. The increase in WC-p and %BF seems to increase the risk of altered cardiometabolic risk profile, especially in the overweight or obese children and adolescents. Early identification of overweight or obesity indicators may allow timely intervention to prevent adverse cardiovascular outcomes in adulthood.