Prevalence of Cardiometabolic Risk Factor Clustering and Body Mass Index in Adolescents

Objective To establish prevalence of cardiometabolic risk factor clustering within US adolescent body mass index (BMI) groups. Study design Data were obtained from National Health and Nutrition Examination Survey participants (12-18 years, n = 2457) recruited from 2001-2002, 2003-2004, 2005-2006, and 2007-2008 surveys. Prevalence of risk factor clustering (>= 2 risk factors: triglycerides; high-density lipoprotein cholesterol; systolic/diastolic blood pressure; fasting glucose) was determined within Centers for Disease Control-defined BMI groups (normal weight, <85(th) percentile; overweight, 85(th) to 94(th) percentile; obese, >= 95(th) percentile). Logistic regression examined associations of risk factor clustering within BMI groups for sex, race/ethnicity, income, household size, smoking, age, and BMI z-score. Results Approximately 9%, 21%, and 35% of normal weight, overweight, and obese adolescents had risk factor clustering. Adolescents with risk factor clustering were less likely to be female (OR 95% CI: overweight, 0.33, 0.16-0.68; obese, 0.38, 0.18-0.78) and non-Hispanic black (normal weight, 0.31, 0.17-0.55; overweight, 0.22, 0.07-0.69; obese, 0.24, 0.12-0.50), but more likely to be a smoker (overweight: 4.32, 1.44-12.96), and have a higher BMI z-score (obese, 3.15, 1.29-7.68). Lower income was associated with risk factor clustering in overweight adolescents (0.28, 0.12-0.63), but a higher income was related to risk factor clustering in obese adolescents (1.90, 1.04-3.48). Conclusions The prevalence of risk factor clustering increases across adolescent BMI categories; however, associations with sex, race/ethnicity, income, smoking, and BMI vary across groups. (J Pediatr 2011;159:303-7).