Effect of modest changes in BMI on cardiovascular disease risk markers in severely obese, minority adolescents

Background: African American and Hispanic adolescents have disproportionately higher rates of obesity compared to white adolescents. In adults, modest weight loss of five percent improves CVD risk marker levels. Less is known about the effects of modest changes in BMI on CVD risk markers in adolescents, particularly newer markers such as C reactive protein (CRP), lipoprotein (a) and homocysteine. Objective: To examine the effect of modest BMI change on CVD risk marker levels in a group of severely obese, African American and Hispanic adolescents. Study design: A six-month longitudinal analysis. Subjects: Eighty-three African American and Hispanic adolescents were recruited (mean age±sd: 15.1±2.0 years); 50 (60%) were reevaluated at 6±2 months. Results: At baseline, mean BMI was 42.3±7.8 kg/m ². BMI directly correlated with CRP (p = < 0.001); homocysteine (p = 0.02); insulin (p = 0.05); and systolic and diastolic blood pressures (both p = <0.001). BMI remained significantly associated with CRP and insulin after adjusting for age, sex and ethnicity (p = 0.001). At six-month follow up, there was a significant p for trend between the three groups of BMI change (those with a ≥5% BMI decrease, those who maintained BMI within 5% and those with ≥5% BMI increase) and CRP (p = 0.05) and insulin (p = 0.04). Conclusions: A modest decrease in BMI is associated with improvement in CRP and insulin levels. Obese adolescents should be encouraged to continue with modest weight loss goals as they result in improvement in cardiovascular disease risk markers.