Novel Markers of Cardiovascular Risk in Childhood Obesity

Cardiovascular diseases (CVDs) represent the primary global cause of mortality annually. Numerous distinct risk factors contribute to the development of CVD, such as hypertension, age, smoking, insulin resistance, obesity, elevated concentrations of low density lipoprotein-cholesterol, as well as reduction of high density lipoprotein-cholesterol (HDL-C) levels. Traditional markers of CVD have been insufficient to accurately predict atherogenic risk, promoting the search of novel markers such as lipoprotein associated phospholipase A2 (Lp-PLA2), considered a marker of vascular specific inflammation and HDL functionality. Among the risk factors for CVD, obesity represents one of particular importance given that its prevalence has increased notably on a global scale. In addition to adults, obesity has become highly prevalent in pediatric populations. Importantly, childhood obesity and related complications can track into adulthood. Furthermore, the atherogenic process starts early in life and the status of these new markers of CVD risk has been insufficiently described in children and adolescents, particularly in the context of childhood obesity. In the different studies carried out by our group, we showed alterations in vascular inflammation, and different cardioprotective functions of HDL suggesting an increase in atherogenic risk in obese pediatric populations even at early age. These alterations would be present in both general and abdominal specific obesity and could extend beyond alterations in traditional markers such as lipid profile. The purpose of this chapter is to highlight the status of these markers in childhood obesity.