Early Intervention for Obese Children

Fat is associated with type 2 diabetes and cardiovascular disease

Nature is cruel to obese children. Fat affects the function of key organ systems. It is associated with type 2 diabetes and cardiovascular disease. It may also lead to non-alcoholic fatty liver disease (NAFLD) – the most common chronic liver disease in both children and adults.

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Cleveland Clinic has formed the Pediatric Preventive Cardiology and Metabolic Clinic to address this condition. A multidisciplinary team of physicians, nurse practitioners, dietitians, exercise physiologists and other healthcare professionals, they take a comprehensive approach to preventing the onset and progression of cardiovascular and metabolic conditions in high-risk pediatric patients. They work with families to create individualized programs to meet the needs of each patient.

On the research front, a new study led by Naim Alkhouri, MD, clinical director of the Pediatric Preventive Cardiology and Metabolic Clinic, may improve the treatment of cardiovascular disease in obese children.  Obesity and fatty liver (also known as non-alcoholic fatty liver disease, or NAFLD) are known to be risk factors for cardiovascular disease.  Dr. Alkhouri’s study showed that two serum markers of cardiovascular risk in adults– myeloperoxidase (MPO)* and high-sensitivity C-reactive protein (hsCRP) – are associated with obesity and fatty liver in children.  These biomarkers may become useful tools to identify obese children who are at increased risk of CVD, allowing for early intervention.

* MPO has already been identified as a marker for cardiovascular risk in adults.  In 2007, Stanley Hazen, MD, PhD, head of Preventive Cardiology, and S. Matthijs Boekholdt, MD, PhD, of Amsterdam, The Netherlands, published a large community based screening study of over 25,000 subjects. They showed that elevated levels of the enzyme MPO in the blood can help identify people at risk of developing coronary artery disease or heart attacks over the ensuing 8 years. The study added to previous findings by Dr. Hazen and his team, that MPO not only inhibits the beneficial activity of HDL cholesterol (see above), but that elevated levels of MPO in the blood can signal increased risk for development of atherosclerosis and experiencing a heart attack, stroke or death. Their findings appeared in the Journal of American College of Cardiology

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