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Cardiovascular complications of obesity in adolescents

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Abstract

Obesity is an increasingly important worldwide health problem, representing the major risk factor for coronary heart disease. The increase in the prevalence of obesity, particularly among younger age groups, is likely to have long-term implications for cardiovascular disease (CVD) in the years to come, especially at a young age. Obesity plays a central role in the insulin resistance (IR) syndrome and increases the risk of atherosclerotic CVD. The present review will examine the relationships among cardiovascular risk (CVR) factors during the childhood-adolescence-adulthood transition. In fact, the relation between obesity, in particular visceral obesity and CVD, appears to develop at a relatively young age. The foremost physical consequence of obesity is atherosclerotic CVD, and an intriguing example of obesity-related cardiovascular complications affecting young women is the polycystic ovary syndrome (PCOS).

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References

  1. World Health Organization: Obesity: Preventing and managing the global epidemic. World Health Organ Tech Rep Ser 2000, 894.

  2. Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults: The Evidence Report. Bethesda, MD: National Institutes of Health, 1998. NIH publication 98-4083.

  3. Krebs NF, Jacobson MS. Prevention of pediatric overweight and obesity. Pediatrics 2003, 112: 424–30.

    PubMed  Google Scholar 

  4. Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. Arch Dis Child 1966, 41: 454–71.

    PubMed Central  PubMed  CAS  Google Scholar 

  5. Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. Inter-relationships among childhood BMI, childhood height, and adult obesity: the Bogalusa Heart Study. Int J Obes (Lond) 2004, 28: 10–6.

    CAS  Google Scholar 

  6. Fung TT, Willett WC, Stampfer MJ, Manson JE, Hu FB. Dietary patterns and the risk of coronary heart disease in women. Arch Intern Med 2001, 161: 1857–62.

    PubMed  CAS  Google Scholar 

  7. Esmailzadeh A, Mirmiran P, Azizi F. Clustering of metabolic abnormalities in adolescents with the hypertriglyceridemic waist phenotype. Am J Clin Nutr 2006, 83: 36–46.

    Google Scholar 

  8. Taylor RW, Jones IE, Williams SM, Goulding A. Evaluation of waist circumference, waist-to-hip ratio and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y. Am J Clin Nutr 2000, 72: 490–5.

    PubMed  CAS  Google Scholar 

  9. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006, 148: 188–94.

    PubMed  CAS  Google Scholar 

  10. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002, 288: 1723–7.

    PubMed  Google Scholar 

  11. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 2002, 288: 1728–32.

    PubMed  Google Scholar 

  12. Eckel RH, Krauss RM, for the AHA Nutrition Committee. American Heat Association call to action: obesity as a major risk factor for coronary heart disease. Circulation 1998, 97: 2099–100.

    PubMed  CAS  Google Scholar 

  13. McTingue KM, Garrett JM, Popkin BM. The natural history of the development of obesity in a cohort of young US adults between 1981 and 1998. Ann Intern Med 2002, 136: 857–64.

    Google Scholar 

  14. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harward Study of 1922 to 1935. N Engl J Med 1992, 327: 1350–5.

    PubMed  CAS  Google Scholar 

  15. McFarlane SI, Banerji M, Sowers JR. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab 2001, 86: 713–8.

    PubMed  CAS  Google Scholar 

  16. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001, 24: 683–9.

    PubMed  CAS  Google Scholar 

  17. Yudkin JS, Stehouwer CDA, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects:associations with obesity, insulin resistance, and endothelial dysfunction. A potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999, 19: 972–8.

    PubMed  CAS  Google Scholar 

  18. Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000, 102: 42–7.

    PubMed  CAS  Google Scholar 

  19. Matsuzawa Y, Funahashi T, Nakamura T. Molecular mechanism of metabolic syndrome X: contribution of adipokines adipocyte-derived bioactive substances. Ann NYAcad Sci 1999, 892: 146–54.

    CAS  Google Scholar 

  20. Lobstein T, Baur L, Uauy R for the IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health. Obes Rev 2004, 5: 4–85.

    PubMed  Google Scholar 

  21. Rosamond WD, Chambless LE, Folsom AR, et al. Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. N Engl J Med 1998, 339: 861–7.

    PubMed  CAS  Google Scholar 

  22. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med 1998, 338: 1650–6.

    PubMed  CAS  Google Scholar 

  23. Freedman DJ, Serdula MK, Khan LK. The adult health consequences of childhood obesity. In: Chen C, Dietz WH eds. Obesity in childhood and adolescence. Nestle Nutrition Workshop Series Pediatric Programme, V. 49. Philadelphia: Lippincott Williams and Wilkins. 2002, 63–82.

    Google Scholar 

  24. Srinivasan SR, Bao W, Wattigney WA, Berenson GS. Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996, 45: 235–40.

    PubMed  CAS  Google Scholar 

  25. Lauer RM, Lee J, Clarke WR. Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. Pediatrics 1988, 82: 309–18.

    PubMed  CAS  Google Scholar 

  26. Hulman S, Kushner H, Katz S, Falkner B. Can cardiovascular risk be predicted by newborn, childhood and adolescent body size? An examination of longitudinal data in urban African Americans. J Pediatr 1998, 132: 90–7.

    PubMed  CAS  Google Scholar 

  27. Vanhala M, Vanhala P, Kumpusalo E, Halonen P, Takala J. Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study. BMJ 1998, 317: 319.

    PubMed Central  PubMed  CAS  Google Scholar 

  28. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L. Waist circumference and cardiovascular risk factors in prepubertal children. Obese Res 2001, 9: 179–87.

    CAS  Google Scholar 

  29. Rocchini AP. Pediatric hypertension 2001. Curr Opin Cardiol 2002, 17: 385–9.

    PubMed  Google Scholar 

  30. National High Blood Pressure Education Program Working Group on Hypertension Control in children and adolescents: a working group report from the National High Blood Pressure Education Programme. Pediatrics 1996, 98: 649–58.

    Google Scholar 

  31. Lauer RM, Clarke WR, Beaglehole R. Level, trend, and variability of blood pressure during childhood: the Muscatine study. Circulation 1984, 69: 242–9.

    PubMed  CAS  Google Scholar 

  32. Coatmellec-Taglioni G, Ribiere C. Factors that influence the risk of hypertension in obese individuals. Curr Opin Nephrol Hypertens 2003; 12: 305–8.

    PubMed  CAS  Google Scholar 

  33. Kondo H, Shimomura I, Matsukawa Y, et al. Association of adiponectin mutation with type 2 diabetes: a candidate gene for the insulin resistance syndrome. Diabetes 2002, 51: 2325–8.

    PubMed  CAS  Google Scholar 

  34. Steinberger J, Daniels SR; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young); American Heart Association Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 2003, 107: 1448–53.

    PubMed  Google Scholar 

  35. Steinberg J, Moorehead C, Katch V, Rocchini AP. Relationship between insulin resistance and abnormal lipid profile in obese adolescents. J Pediatr 1995, 126: 690–5.

    Google Scholar 

  36. Urbina EM, Gidding SS, Bao W, Elkasabany A, Berenson GS. Association of fasting blood sugar level, insulin level, and obesity with left ventricular mass in healthy children and adolescents: The Bogalusa Heart Study. Am Heart J 1999, 138: 122–7.

    PubMed  CAS  Google Scholar 

  37. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983, 67: 968–77.

    PubMed  CAS  Google Scholar 

  38. Lee IM, Manson JE, Hennekens CH, Paffenbarger RS Jr. Body weight and mortality. A 27-year follow-up of middleaged men. JAMA 1993, 270: 2823–8.

    PubMed  CAS  Google Scholar 

  39. Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995, 122: 481–6.

    PubMed  CAS  Google Scholar 

  40. Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiol Rev 1994, 74: 761–811.

    PubMed  CAS  Google Scholar 

  41. Freedman DS, Burke GL, Harsha DW, et al. Relationship of changes in obesity to serum lipid and lipoprotein changes in childhood and adolescence. JAMA 1985, 254: 515–20.

    PubMed  CAS  Google Scholar 

  42. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005, 45: 1638–43.

    PubMed  Google Scholar 

  43. Grundy SM. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab 2004, 89: 2595–600.

    PubMed  CAS  Google Scholar 

  44. Grundy SM, Hansen B, Smith Jr, SC, Cleeman JI, Kahn RA. American Heart Association; National Heart, Lung, and Blood Institute; American Diabetes Association. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004, 109: 551–6.

    PubMed  Google Scholar 

  45. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002, 106: 3143–21.

    Google Scholar 

  46. Guerre-Millo M. Adipose tissue hormones. J Endocrinol Invest 2004, 25: 855–61.

    Google Scholar 

  47. Grundy SM, Brewer Jr HB, Cleeman JI, Smith Jr SC, Lenfant C. National Heart, Lung, and Blood Institute; American Heart Association. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/ American Heart Association conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol 2004, 24: e13–e18.

    PubMed  CAS  Google Scholar 

  48. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002, 287: 356–9.

    PubMed  Google Scholar 

  49. McGill HC Jr, McMahan CA, Herderick EE, et al. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 2002, 105: 2712–8.

    PubMed  Google Scholar 

  50. Hu FB, van Dam RM, Liu S. Diet and risk of type II diabetes: the role of types of fat and carbohydrate. Diabetologia 2001, 44: 805–17.

    PubMed  CAS  Google Scholar 

  51. Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation 2002, 105: 2696–8.

    PubMed  Google Scholar 

  52. Sowers JR. Obesity and cardiovascular disease. Clin Chem 1998, 44: 1821–5.

    PubMed  CAS  Google Scholar 

  53. Sowers JR. Obesity as a cardiovascular risk factor. Am J Med 2003, 115: 37S-41S.

    Google Scholar 

  54. Chobanian AV, Bakris GL, Black HR, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003, 42: 1206–52.

    PubMed  CAS  Google Scholar 

  55. De Pergola G, Pannacciulli N. Coagulation andfibrinolysis abnormalities in obesity. J Endocrinol Invest 2002, 25: 899–904.

    PubMed  Google Scholar 

  56. Franks S. Polycystic ovary syndrome. N Engl J Med 1995, 33: 853–61.

    Google Scholar 

  57. Scarpitta AM, Sinagra D. Polycystic ovary sindrome: an endocrine and metabolic disease. Gynecol Endocrinol 2000, 14: 392–5.

    PubMed  CAS  Google Scholar 

  58. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004, 81: 19–25.

    Google Scholar 

  59. Lobo RA, Carmina E. The importance of diagnosing the polycystic ovary syndrome. Ann Intern Med 2000, 132: 989–93.

    PubMed  CAS  Google Scholar 

  60. Franks S. Are women with polycystic ovary syndrome at increased risk of cardiovascular disease? Too early to be sure, but not too early to act! Am J Med 2001, 111: 665–6.

    PubMed  CAS  Google Scholar 

  61. Elting MW, Korsen TJM, Shoemaker J. Obesity rather than menstrual cycle pattern or follicle cohort size, determines hyperinsulinemia, dyslipidemia and hypertension in ageing women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2001, 55: 767–76.

    CAS  Google Scholar 

  62. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997, 18: 774–800.

    PubMed  CAS  Google Scholar 

  63. Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. Am J Med 2001, 111: 607–13.

    PubMed  CAS  Google Scholar 

  64. Yildiz BO, Haznedaroglu IC, Kirazli S, Bayraktar M. Global fibrinolytic capacity is decreased in polycystic ovary syndrome, suggesting a prothrombotic state. J Clin Endocrinol Metab 2002, 87: 3871–5.

    PubMed  CAS  Google Scholar 

  65. Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril 2002, 77: 1095–05.

    PubMed  Google Scholar 

  66. Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A. Polycystic ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study of women. Acta Obstet Gynecol Scand 1992, 71: 599–604.

    PubMed  CAS  Google Scholar 

  67. Talbott E, Guzick D, Clerici A, et al. Coronary heart disease risk factors in women with polycystic ovary syndrome. Arter Thromb Vascul Biol 1995, 15: 821–6.

    CAS  Google Scholar 

  68. Conway GS, Agrawal R, Better,Guzi DJ, Jacobs HS. Risk factors for coronary heart disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol (Oxf) 1992, 37: 119–25.

    CAS  Google Scholar 

  69. Talbott E, Guzick DS, Sutton-Tyrrell K, et al. Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middle-aged women. Arterioscler Thromb Vasc Biol 2000, 20: 2414–21.

    PubMed  CAS  Google Scholar 

  70. Tiras MB, Yalcin R, Noyan V, et al. Alterations in cardiac flow parameters in patients with polycystic ovarian syndrome. Hum Reprod 1999, 14: 1949–52.

    PubMed  CAS  Google Scholar 

  71. Legro RS. Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocr Rev 2003, 24: 302–12.

    PubMed  Google Scholar 

  72. Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000, 52: 595–600.

    CAS  Google Scholar 

  73. Paradisi G, Steinberg HO, Hempfling A, et al. Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 2001, 103: 1410–5.

    PubMed  CAS  Google Scholar 

  74. Yarali H, Yildirir A, Aybar F, et al. Diastolic dysfunction and increased serum homocysteine concentrations may contribute to increased cardiovascular risk in patients with polycystic ovary syndrome. Fertil Steril 2001, 76: 511–6.

    PubMed  CAS  Google Scholar 

  75. Kishore J, Harjai MBBS. Potential new cardiovascular risk factors: left ventricular hypertrophy, homocysteine, lipoprotein(a), triglycerides, oxidative stress, and fibrinogen. Ann Intern Med 1999, 131: 376–86.

    Google Scholar 

  76. Dubin D, Pratt RE, Cooke JP, Dzau VJ. Endothelin, a potent vasoconstrictor, is a vascular smooth mitogen. J Vasc Med Biol 1989, 1: 13–6.

    Google Scholar 

  77. Diamanti-Kandarakis E, Spina G, Kouli C, Migdalis I. Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endocrinol Metab 2001, 86: 4666–73.

    PubMed  CAS  Google Scholar 

  78. Takahashi K, Ghatei MA, Lam HC, O’Halloran DJ, Bloom SR. Elevated plasma endothelin in patients with diabetes mellitus. Diabetologia 1990, 33: 306–10.

    PubMed  CAS  Google Scholar 

  79. Arslanian SA, Lewy VD, Danadian K. Glucose intolerance in obese adolescents with polycystic ovary syndrome: roles of insulin resistance and beta-cell dysfunction and risk of cardiovascular disease. J Clin Endocrinol Metab 2001, 86: 66–71.

    PubMed  CAS  Google Scholar 

  80. Ferri C, Pittoni V, Piccoli A, et al. Insulin stimulates endothelin-1 secretion from human endothelial cells and modulates its circulating levels in vivo. J Clin Endocrinol Metab 1995, 80: 829–35.

    PubMed  CAS  Google Scholar 

  81. Pignoli P, Tyremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 1986, 74: 1399–406.

    PubMed  CAS  Google Scholar 

  82. Orio F Jr, Palomba S, Cascella T, et al. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89: 4588–93.

    PubMed  CAS  Google Scholar 

  83. Cleland SJ, Petrie JR, Ueda S, Elliott HL, Connell JM. Insulin as a vascular hormone: implications for the pathofisiology of cardiovascular disease. Clin Exp Pharmacol Physiol 1998, 25: 175–84.

    PubMed  CAS  Google Scholar 

  84. Hamsten A, Wiman B, de Faire U, Blomback M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985, 313: 1557–63.

    PubMed  CAS  Google Scholar 

  85. Kohler HP, Grant PJ. Plasminogen-activator inhibitor type 1 and coronary artery disease. N Engl J Med 2000, 342: 1792–801.

    PubMed  CAS  Google Scholar 

  86. Glueck CJ, Rorick MH, Schmerler M, et al. Hypofibrinolytic and atherogenic risk factors for stroke. J Lab Clin Med 1995, 125: 319–25.

    PubMed  CAS  Google Scholar 

  87. Meade TW, Cooper JA, Chakrabarti R, Miller GJ, Stirling Y, Howarth DJ. Fibrinolityc activity and clotting factors in ischaemic heart disease in women. Br Med J 1996, 312: 1581.

    CAS  Google Scholar 

  88. Dawson S, Henney A. The status of PAI-1 as a risk factor for arterial and thrombotic disease: a review. Atherosclerosis 1992, 95: 105–17.

    PubMed  CAS  Google Scholar 

  89. Festa A, D’Agostino Jr R, Tracy RP, Haffner SM. Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the Insulin Resistance Atherosclerosis Study. Diabetes 2002, 51: 1131–7.

    PubMed  CAS  Google Scholar 

  90. Meigs JB, Mittleman MA, Nathan DM, et al. Hyperinsulinemia, hyperglicemia, and impaired hemostasis: the Framingham Offspring Study. JAMA 2000, 283: 221–8.

    PubMed  CAS  Google Scholar 

  91. Reaven GM. Syndrome X: 6 years later. J Intern Med 1994, 236: 13–22.

    Google Scholar 

  92. Vague P, Juhan-Vague I, Chaberv V, Alessi MC, Atlan C. Fat distribution and plasminogen activator inhibitor activity in non diabetic women. Metabolism 1989, 38: 913–5.

    PubMed  CAS  Google Scholar 

  93. Shimomura I, Funahashi T, Takahashi K, et al. Enhanced expression of PAI-1 in visceral fat: possible contribution to vascular disease in obesity. Nat Med 1996, 2: 800–3.

    PubMed  CAS  Google Scholar 

  94. Loskutoff DJ, Samad F. The adipocyte and hemostatic balance in obesity:studies of PAI-1. Arterioscler Thromb Vasc Biol 1996, 18: 1–6.

    Google Scholar 

  95. Sampson M, Kong C, Patel A, Unwin R, Jacobs HS. Ambulatory blood pressure profiles and plasminogen activator inhibitor (PAI-1) activity in lean women with and withoutthe polycystic ovary syndrome. Clin Endocrinol (Oxf) 1996, 45: 623–9.

    CAS  Google Scholar 

  96. Kelly CJ, Lyall H, Petrie JR, et al. A specific elevation in tissue plasminogen antigen in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002, 87: 3287–90.

    PubMed  CAS  Google Scholar 

  97. Orio F, Palomba S, Cascella T, et al. Is plasminogen activator inhibitor-1 a cardiovascular risk factor in young women with polycystic ovary sindrome? Reproductive Biomedicine Online 2004, 9: 505–

    Google Scholar 

  98. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J. Paradoxical decrease of an adipose specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 1999, 257: 79–83.

    PubMed  CAS  Google Scholar 

  99. Orio F Jr, Palomba S, Cascella T, et al. Adiponectin levels in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003, 88: 2619–23.

    PubMed  CAS  Google Scholar 

  100. Panidis D, Kourtis A, Farmakiotis D, Mouslech T, Russo D, Koliakos G. Serum adiponectin levels in women with polycystic ovary syndrome. Hum Reprod 2003, 18: 1790–6.

    PubMed  CAS  Google Scholar 

  101. Pilz S, Horejsi R, Moller R, et al. Early atherosclerosis in obese juveniles is associated with low serum levels of adiponectin. J Clin Endocrinol Metab 2005, 90: 4792–6.

    PubMed  CAS  Google Scholar 

  102. Levy D, Garrison RH, Savage DD, Kannell WB, Castelli WP. Prognostic implication of echocardiographically determined left ventricular mass in the Framingham Heart Study. New Engl J Med 1991, 322: 1561–6.

    Google Scholar 

  103. Vetta F, Cicconetti P, Ronzoni S, et al. Hyperinsulinaemia, regional adipose tissue distribution and left ventricular mass in normotensive, elderly, obese subjects. Eur Heart J 1998, 19: 326–31.

    PubMed  CAS  Google Scholar 

  104. Pyorala K. Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 1979, 2: 131–41.

    PubMed  CAS  Google Scholar 

  105. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988, 37: 1595–607.

    PubMed  CAS  Google Scholar 

  106. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1985, 61: 946–51.

    PubMed  CAS  Google Scholar 

  107. Kaushal R, Parchure N, Bano G, Kaski JC, Nussey SS. Insulin resistance and endothelial dysfunction in the brothers of Indian subcontinent Asian women with polycystic ovaries. Clin Endocrinol (Oxf) 2004, 60: 322–8.

    CAS  Google Scholar 

  108. Orio F Jr, Palomba S, Spinelli L, et al. The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study. J Clin Endocrinol Metab 2004, 89: 3696–701.

    PubMed  CAS  Google Scholar 

  109. Zimmermann S, Phillips RA, Dunaif A, et al. Polycystic ovary syndrome: lack of hypertension despite profound insulin resistance J Clin Endocrinol Metab 1992, 75: 508–13.

    PubMed  CAS  Google Scholar 

  110. Ferri C, Desideri G, Baldoncini R, et al. Early activation of vascular endothelium in non-obese, non-diabetic essential hypertensive patients with multiple metabolic abnormalities. Diabetes 1998, 47: 660–7.

    PubMed  CAS  Google Scholar 

  111. Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Artherioscler Thromb Vasc Biol 2003, 23: 168–75.

    CAS  Google Scholar 

  112. Postiglione A, Rubba P, De Simone B, Patti L, Cicerano U, Mancini M. Carotid atherosclerosis in familial hypercholes-terolemia. Stroke 1985, 16: 658–61.

    PubMed  CAS  Google Scholar 

  113. Dubuisson JT, Wagenknecht LE, D’Agostino RB Jr, et al. Association of hormone replacement therapy and carotid wall thickness in women with and without diabetes. Diabetes Care 1998, 21: 1790–79.

    PubMed  CAS  Google Scholar 

  114. De Michele M, Panico S, Iannuzzi A, et al. Association of obesity and central fat distribution with carotid artery wall thickening in middle-aged women. Stroke 2002, 33: 2923–8.

    PubMed  Google Scholar 

  115. Rajala U, Laakso M, Paivansalo M, et al. Low insulin sensitivity measured by both quantitative insulin sensitivity check index and homeostasis model assessment method as a risk factor of increased intima-media thickness of the carotid artery. J Clin Endocrinol Metab 2002, 87: 5092–7.

    PubMed  CAS  Google Scholar 

  116. Golden SH, Maguire A, Ding J, et al. Endogenous postmenopausal hormones and carotid atherosclerosis: a case-control study of the atherosclerosis risk in communities cohort. Am J Epidemiol 2002, 155: 437–45.

    PubMed  Google Scholar 

  117. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Longterm morbidity and mortality of overweight adolescents: a follow-up of the Harward Growth Study of 1922 to 1935. N Engl J Med 1992, 327: 1350–5.

    PubMed  CAS  Google Scholar 

  118. Iannuzzi A, Licenziati MR, Acampora C, et al. Increased carotid Intima-media thickness and stiffness in obese children. Diabetes Care 2004, 27: 2506–8.

    PubMed  Google Scholar 

  119. Graf MJ, Richards CJ, Brown V, Meissner L, Dunaif A. The independent effects of hyperandrogenaemia, hyperinsulinaemia, and obesity on lipid and lipoprotein profiles in women. Clin Endocrinol (Oxf) 1990, 33: 119–31.

    CAS  Google Scholar 

  120. Vural B, Caliskan E, Turkoz E, Kilic T, Demirci A. Evaluation of metabolic syndrome frequency and premature carotid atherosclerosis in young women with polycystic ovary syndrome. Hum Reprod 2005, 20: 2409–13.

    PubMed  Google Scholar 

  121. Lakhani K, Seifalian AM, Hardiman P. Impaired carotid viscoelastic properties in women with polycystic ovaries. Circulation 2002, 106: 81–5.

    PubMed  Google Scholar 

  122. Mather KJ, Verma S, Corenblum B, Anderson T. Normal endothelial function despite insulin resistance in healthy women with the polycystic ovary syndrome. J Clin Endocrinol Metab 2000, 85: 1851–6.

    PubMed  CAS  Google Scholar 

  123. Kelly CJG, Speirs A, Gould GW, Petrie JR, Lyall H, Connell JMC. Altered vascular function in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002, 87: 742–6.

    PubMed  CAS  Google Scholar 

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Correspondence to F. Orio Jr MD, PhD.

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Orio, F., Palomba, S., Cascella, T. et al. Cardiovascular complications of obesity in adolescents. J Endocrinol Invest 30, 70–80 (2007). https://doi.org/10.1007/BF03347399

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