Overweight and obesity during adolescence are associated with an increased risk for cardiovascular disease (CVD) risk factors. The objective of this study was to examine the recent trends in the prevalence of selected biological CVD risk factors and the prevalence of these risk factors by overweight/obesity status among US adolescents.
The NHANES is a cross-sectional, stratified, multistage probability sample survey of the US civilian, noninstitutionalized population. The study sample included 3383 participants aged 12 to 19 years from the 1999 through 2008 NHANES.
Among the US adolescents aged 12 to 19 years, the overall prevalence was 14% for prehypertension/hypertension, 22% for borderline-high/high low-density lipoprotein cholesterol, 6% for low high-density lipoprotein cholesterol (<35 mg/dL), and 15% for prediabetes/diabetes during the survey period from 1999 to 2008. No significant change in the prevalence of prehypertension/hypertension (17% and 13%) and borderline-high/high low-density lipoprotein cholesterol (23% and 19%) was observed from 1999–2000 to 2007–2008, but the prevalence of prediabetes/diabetes increased from 9% to 23%. A consistent dose-response increase in the prevalence of each of these CVD risk factors was observed by weight categories: the estimated 37%, 49%, and 61% of the overweight, obese, and normal-weight adolescents, respectively, had at least 1 of these CVD risk factors during the 1999 through 2008 study period.
The results of this national study indicate that US adolescents carry a substantial burden of CVD risk factors, especially those youth who are overweight or obese.
Comments
Prevalence of Cardiovascular Disease Risk Factors among US Adolescents--1999-2008
Dear Editor:
In our recent publication, Prevalence of Cardiovascular Disease Risk Factors among US Adolescents--1999-2008, which appeared in the June 2012 issue of Pediatrics, we used the term pre-diabetes to define youth whose fasting plasma glucose levels were >99 mg/dl-<126 mg/dl instead of the American Diabetes Association (ADA) cutoff value of >=100 mg/dl used to describe the same condition. This occurred because in our statistical programming, we assumed that the plasma glucose levels in the NHANES were integers and therefore >99 mg/dl was the same as >= 100 mg/dl, however the NHANES uses decimals to report fasting plasma glucose. Thus, 85 adolescents had fasting plasma glucose levels between 99.1 mg/dl -99.9 mg/dl. As a result, in our analyses these 85 adolescents were reported as having pre-diabetes, but would not have been classified as such according to the ADA cut-off values for fasting plasma glucose.
While the results reported in our study are consistent with the described methodology in the paper, we would like to highlight that had we used the cut-off values recommended by the ADA, the prevalence of prediabetes/diabetes would have been lower than we reported. For example, the prevalence would have been as follows--7 vs. 9% in 1999-2000, 13 vs. 15% in 2001-2002, 10 vs. 13 % in 2003-2004, 14 vs. 16% in 2005-2006 and 18 vs. 23% in 2007-2008. Still, the paper's conclusion that many adolescents in the United States have cardiovascular disease risk factors remains the same.
We have published an erratum to clarify this in Pediatrics (Vol. 130 No. 4 October 1, 2012 pp. 764). We regret this error.
Conflict of Interest:
None declared
Re:Please post correction
Conflict of Interest:
None declared
Please post correction
Dear Editor,
I was delighted to read the great work by May et al. in this issue. However, I would like to point out a small grammatical "error" that may lead to wrong interpretation of the results.
In the abstract and in the results sections, the authors report the following:
"...increase in the prevalence of each of these CVD risk factors was observed by weight categories: the estimated 37%, 49%, and 61% of the overweight, obese, and normal-weight adolescents, respectively..."
However, when reading the discussion, one discovers the previous results are not correctly identified as the prevalence of CVD risk factors among normal-weight is 37% (not 61%) as "respectively" would suggest.
A small error that may lead to a wrong dissemination of the results. I thank you for your time.
Respectfully,
Dr. Yuri Feito
Conflict of Interest:
None declared