Resumen

GAMBETTA, Juan Carlos et al. Obesidad y factores de riesgo cardiovascular en la edad pediátrica. Arch. Pediatr. Urug. [online]. 2008, vol.79, n.1, pp.7-14. ISSN 1688-1249.

Summary Introduction: atherosclerosis starts at an early age and its connection with cardiovascular risk factors has been proven. Obesity is a world epidemic disease and knowing its causes and specially its connection with non healthy habits is very important, not only for preventing it, but also for treating it. Aim: the assessment of clinical and epidemiologic characteristics of the patients and the exposure to risk factors in children who were referred to the Vital Health Service in Medica Uruguaya. Describe their evolution after the application of a multidisciplinary treatment plan. Material and method: all the patients who were referred to the Preventive Cardiology program of our service from December 2006 to June 2007 were included in the survey. The criteria for being included were all children over 2 years old with known cardiovascular risk factors or with a family history of such risk factors. A data sheet was completed for each patient. Family history of obesity, hypertension, lipid blood level alterations and diabetes and ischemic cardiovascular disease in young relatives were assessed, as well as active and passive smoking, birth weight, breast feeding, nutritional diagnosis, blood pressure, lipid blood level, physical activity, sedentarism and eating behavior and habits. Results: 97 patients were included, 50,5% were male, with an average age of 10. Obesity was the main reason for reference which occurred in 90% of the cases. Obesity was confirmed in 78,4% and it was severe in more than 50% of the children. In 27% (26 children) blood pressure was higher than percentile 90 (20 patients with hypertension and 6 with pre-hypertension). In 47,4% lipid blood levels alterations were found, especially LDL-cholesterol, and in 3 patients heterozygote family hypercholesterolemia was diagnosed. Strong family history related to risk factors was found in first-degree relatives. 88 patients with overweight and obesity were an only child in 38,6% and had obese parents in 60,2%. The inadequate quantity and quality of food which was usually large portions in 61,4%, eating between meals in 85%, the low consumption of fruit and vegetables, the high consumption of sweets and cola-drinks were all associated factors. Physical activity and sedentarism were assessed. What stands out in the survey of 76 patients with obesity is the high frecuency of hypertension, lipid blood level alterations and hyperinsulinism. Some variables were related to obesity grades. The evolution of patients who completed a 3 month treatment (25 patients) was assessed, and in those patients the body mass index fell down 1 point, losing 2,3 points of relative weight and 1,5 cm of abdominal circumference. Conclusions: obesity is the most frequent risk factor in the assessed population. The relationship between its severity and hypertension, alterations in blood levels of lipids and hyperinsulinism are highlighted. The association of several risk factors is evident. The improvement in our patients in a short term period where the treatment was based on the multidisciplinary management of behavior and habits was proved. The precise knowledge of our patient's clinical characteristics and a multidisciplinary team-work were the base for giving the best attention for the patient.

Palabras clave : OBESITY; ARTERIOSCLEROSIS; RISK FACTORS; CARDIOVASCULAR DISEASES; prevention & control.

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