Disparities in the Cardiometabolic Impact of Adiposity among African American and Hispanic Adolescents

Nutrients. 2024 Sep 18;16(18):3143. doi: 10.3390/nu16183143.

Abstract

As adiposity increases in youth, so does the prevalence of cardiometabolic risk factors (CMRFs). The etiology of adiposity-based chronic disease and CMRFs includes ethnoracial disparities that are rarely considered in current treatment approaches. Precision interventions require further characterization of these disparities among high-risk youth. The objective of this study was to characterize differences in CMRF among African American (AA) and Hispanic (H) adolescents with varying levels of adiposity. A cross-sectional analysis of 2284 adolescents aged 12-17 was conducted using 3-year clinical data from Lifedoc Health. CMRF prevalence were compared using χ2, with logistic regression models (LRM) applied to explore the relationships between exposures (age, sex, ethnoracial group, adiposity) and CMRF outcomes. Prevalence of CMRF rose with increasing adiposity, which was the strongest determinant of risk overall. However, individual risk profiles differed between the two groups, with H having higher prevalence of metabolic syndrome (MetS), higher triglycerides and liver enzymes, and low high-density lipoprotein cholesterol (HDL-c). Meanwhile, AA had higher prevalence of elevated blood pressure (BP) in the overweight category, prediabetes in overweight to severe obesity, and type 2 diabetes in obesity. LRM showed 3.0-fold greater chance of impaired glucose metabolism in AA than H, who were 1.7, 5.9, and 8.3 times more likely to have low HDL-c, high liver enzymes, and high triglycerides, respectively. Overweight/obesity prevalence was very high among AA and H adolescents. Excess adiposity was associated with an increased prevalence of CMRF, with individual risk factors differing between groups as adiposity increased. Research within routine clinical settings is required to better characterize these discrepancies and ameliorate their adverse impact on health in the transition to adulthood.

Keywords: adiposity; cardiometabolic; chronic disease; obesity; pediatric; racial disparities; risk factors.

MeSH terms

  • Adiposity*
  • Adolescent
  • Black or African American*
  • Cardiometabolic Risk Factors*
  • Cardiovascular Diseases / epidemiology
  • Child
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Hispanic or Latino*
  • Humans
  • Male
  • Metabolic Syndrome* / epidemiology
  • Metabolic Syndrome* / ethnology
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / ethnology
  • Prevalence
  • Risk Factors

Grants and funding

This was a collaborative research study run with involvement across the Lifedoc Research team and Novo Nordisk Inc. The funder had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.