Prevalence of cardiometabolic risk factor clustering and body mass index in adolescents

J Pediatr. 2011 Aug;159(2):303-7. doi: 10.1016/j.jpeds.2011.01.059. Epub 2011 Mar 22.


Objective: To establish prevalence of cardiometabolic risk factor clustering within US adolescent body mass index (BMI) groups.

Study design: Data were obtained from National Health and Nutrition Examination Survey participants (12-18 years, n = 2457) recruited from 2001-2002, 2003-2004, 2005-2006, and 2007-2008 surveys. Prevalence of risk factor clustering (≥2 risk factors: triglycerides; high-density lipoprotein cholesterol; systolic/diastolic blood pressure; fasting glucose) was determined within Centers for Disease Control-defined BMI groups (normal weight, <85(th) percentile; overweight, 85th to 94th percentile; obese, ≥95th percentile). Logistic regression examined associations of risk factor clustering within BMI groups for sex, race/ethnicity, income, household size, smoking, age, and BMI z-score.

Results: Approximately 9%, 21%, and 35% of normal weight, overweight, and obese adolescents had risk factor clustering. Adolescents with risk factor clustering were less likely to be female (OR 95% CI: overweight, 0.33, 0.16-0.68; obese, 0.38, 0.18-0.78) and non-Hispanic black (normal weight, 0.31, 0.17-0.55; overweight, 0.22, 0.07-0.69; obese, 0.24, 0.12-0.50), but more likely to be a smoker (overweight: 4.32, 1.44-12.96), and have a higher BMI z-score (obese, 3.15, 1.29-7.68). Lower income was associated with risk factor clustering in overweight adolescents (0.28, 0.12-0.63), but a higher income was related to risk factor clustering in obese adolescents (1.90, 1.04-3.48).

Conclusions: The prevalence of risk factor clustering increases across adolescent BMI categories; however, associations with sex, race/ethnicity, income, smoking, and BMI vary across groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Blood Glucose / analysis
  • Blood Pressure / physiology
  • Body Mass Index*
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Cluster Analysis
  • Continental Population Groups
  • Female
  • Health Surveys
  • Humans
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / epidemiology*
  • Obesity / epidemiology*
  • Overweight / epidemiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • United States / epidemiology


  • Blood Glucose