Evaluation of cardiovascular risk in obese children and adolescents attended at a Level III hospital in Posadas, Misiones, Argentina

Abstract

Argentina suffers from an epidemic of non-communicable chronic diseases and a population with cardiovascular risk factors, particularly obesity. In this work, the cardiovascular risk in obese children and adolescents who attended a level III hospital in the city of Posadas, between September 2018 and January 2020, was studied. Eighty-one patients were included, age 10 (2-15) years; 51% female. Body mass index was calculated, blood pressure was measured and serum HDLc, LDLc, triglycerides and glucose were determined. A questionnaire was completed on family history of cardiovascular disease, physical activity, tobacco and alcohol consumption. The presence of metabolic syndrome (SAP) according to Argentine Pediatric Society criteria and cardiovascular risk (Alustiza ́sscore) were identified and the relationship between them was established. Results: severe obesity: 43 (53%) patients; biochemical or clinical family history 27 individuals (33%); insufficient physical activity: 57 (70%) patients; tobacco and/or alcohol consumption: absent; blood pressure >p95: 11 individuals (14%). Fifty one patients (63%) had some dyslipidemia, 4 (5%) had hyperglycemia; metabolic syndrome was observed in 26 (32%) and 25 (31%) at medium/high cardiovascular (CV) risk. No association was found between CV risk by Alustiza score and metabolic syndrome. Since the pediatric population has cardiovascular risk factors and components of metabolic syndrome, it is important to search for and validate scores to measure this risk.

Argentina, padece una epidemia de enfermedades crónicas no transmisibles y una población con factores de riesgo cardiovascular, particularmente obesidad. En este trabajo se estudió el riesgo cardiovascular en niños y adolescentes obesos que concurrieron a un hospital de nivel III de la ciudad de Posadas, entre septiembre 2018 y enero 2020. Se incluyeron 81 pacientes, edad 10 (2-15) años; 51% mujeres. Se calculó el índice de masa corporal, se midió la presión arterial y se determinaron los niveles de HDLc, LDLc, triglicéridos y glucosa. Se realizó un cuestionario sobre antecedentes familiares de enfermedades cardiovasculares, actividad física, consumo de tabaco y alcohol. Se identificó la presencia de síndrome metabólico (SAP) y el riesgo cardiovascular (puntaje de Alustiza) y se estableció la relación entre ellos. Resultados: obesidad grave: 43 (53%) pacientes; antecedentes familiares bioquímicos o clínicos 27 individuos (33%); actividad física insuficiente: 57 (70%) pacientes; consumo de tabaco y/o alcohol: ausente; presión arterial >p95: 11 individuos (14%). Presentaron alguna dislipidemia 51 pacientes (63%), hiperglucemia 4 (5%), síndrome metabólico 26 (32%) y riesgo cardiovascular medio/alto 25 (31%). No se encontró asociación entre riesgo cardiovascular y síndrome metabólico. Debido a que la población pediátrica posee factores de riesgo cardiovascular y componentes del síndrome metabólico, es importante establecer y validar puntajes para medir dicho riesgo.