Determinants of haemostatic risk factors for coronary heart disease in obese children and adolescents

OBJECTIVE: To investigate the contribution of serum lipids, parameters of g lucose metabolism body composition and cardiovascular fitness to the varian ce of several haemostatic risk factors for coronary heart disease (CHD) in obese children and adolescents. SUBJECTS AND MEASUREMENTS: Forty-two healthy, obese children and adolescent s (20 male, 22 female, age 12.6 +/- 3.2 y; body mass index (BMI), 30.4 +/- 5.3 kg/m(2)), were screened for haemostatic and metabolic risk factors for CHD. Thirty-five of the participants (18 male, age 13.5 +/- 2.9 y; BMI, 29. 9 +/- 4.5 kg/m(2); 17 female, age 12.8 +/- 2.1 y, BMI, 31.1 +/- 5.3 kg/m(2) ) were assessed for cardiovascular fitness by means of incremental cycle er gometer exercise. RESULTS: After adjustment for age, fat mass correlated significantly with p lasminogen activator inhibitor-1 antigen (PAI-1-Ag) in boys and girls and f actor Vile only in girls. Children with lower power output (less than or eq ual to 2.77W/kg) showed significantly higher values for factor VIIc, fibrin ogen and tissue-type plasminogen activator antigen (tPA-Ag). Neither body c omposition nor cardiovascular fitness contributed independently to the vari ance of the determined haemostatic risk factors, except PAI-1-Ag, which has been shown to be determined by fat mass. In multiple linear regression ana lysis, triglycerides and PAI-1-Ag explained significant independent proport ions of the variance of tPA-Ag. Factor Vile was explained by C-peptide, ins ulin and fibrinogen. Von Willebrand factor antigen (VWF-Ag) was significant ly related to glucose and insulin. CONCLUSION: The results suggest that in obese children and adolescents the haemostatic risk factors factor Vile, vWF-Ag and tPA-Ag are mainly determin ated by plasma insulin and triglyceride concentrations, but are primarily i ndependent of body composition and cardiovascular fitness.