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Persistent hypercholesterolemia is associated with the development of obesity among girls: the Bogalusa Heart Study^1,2,3

¹ From the Division of Gastroenterology and Nutrition (AMT) and Biostatistics (AFJ and NOS), The Children’s Hospital of Philadelphia, and the Tulane Center for Cardiovascular Health, New Orleans (AE, SRS, and GSB).

Background: Obesity is associated with cardiovascular disease (CVD) risk factors. Cross-sectional data suggest that hypercholesterolemia is associated with the development of childhood obesity.

Objective: The objective was to assess age-related changes in relative weight and the association between relative weight and CVD risk factors in hypercholesterolemic and nonhypercholesterolemic children who were nonobese at baseline.

Design: Data on relative weight and CVD risk factors were extracted from the Bogalusa Heart Study for nonobese 5–6-y-old black and white hypercholesterolemic (LDL cholesterol > 75th percentile; n = 58) and nonhypercholesterolemic (LDL cholesterol < 60th percentile; n = 215) children (41% black, 52% girls) who were also assessed 3 and 6 y later. Changes in body mass index (BMI) and CVD risk factors were assessed as a function of age, sex, race, and cholesterol concentration.

Results: BMI increased more in the hypercholesterolemic (n = 31) than in the nonhypercholesterolemic (n = 111) girls during the 6 y of follow-up but was not significantly different between hypercholesterolemic (n = 27) and nonhypercholesterolemic (n = 104) boys aged 5–12 y. Associations between BMI and the risk factors blood pressure, insulin, and blood lipids were observed to be stronger with increasing age and, in some cases, stronger in hypercholesterolemic children and girls.

Conclusions: Hypercholesterolemia is associated with increased relative weight in girls. The increased relative weight, even at an early age, is associated with a deleterious effect on blood lipids and other CVD risk factors in hypercholesterolemic children, although the strength of these associations is sex dependent.

Key Words: Hypercholesterolemia • obesity • children • Bogalusa Heart Study • girls

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