Rate of Weight Gain and Cardiometabolic Abnormalities in Children and Adolescents.
Journal of Pediatrics, 2012
[Epub ahead of print] Rate of Weight Gain and Cardiometabolic Abnormalities in Children and Adolescents.
Abstract OBJECTIVE: To investigate whether the rate of weight gain is associated with cardiometabolic risk, independent of weight measured concurrently.
STUDY DESIGN: Healthy 7- to 17-year-old risperidone-treated patients (N = 105, 88% were boys) had blood pressure, anthropometry, and laboratory tests performed.
The rate of change in age- and sex-adjusted weight and body mass index (BMI) z score after the initiation of risperidone was individually modeled.
Multivariable linear regression analyses explored the association of the rate of weight or BMI z score change with cardiometabolic outcomes, independent of last measured weight or BMI z score, respectively.
RESULTS: Following a mean of 1.9 years (SD = 1.0) of risperidone treatment, the absolute increase in weight and BMI z scores was 0.61 (SD = 0.61) and 0.62 (SD = 0.73), respectively.
After controlling for the final weight z score, the rate of change in weight z score was significantly associated with final glucose (P < .04), C-peptide (P < .004), the homeostasis model assessment insulin resistance index (P < .02), high-density lipoprotein (HDL) cholesterol (P < .0001), a metabolic syndrome score (P < .005), adiponectin (P < .04), and high-sensitivity C-reactive protein (P < .04).
After controlling for the final BMI z score, the rate of change in BMI z score was associated with final HDL cholesterol (PÂ <Â .04), leptin (P < .03), and adiponectin (P < .04), with a suggestion of an association with the final homeostasis model assessment insulin resistance index (P < .08).
CONCLUSIONS: Compared with weight measured concurrently, the rate of weight gain in risperidone-treated children accounts for an equal or larger share of the variance in certain cardiometabolic outcomes (eg, HDL cholesterol [ÎR(2) = 8% vs ÎR(2) = 11%] and high-sensitivity C-reactive protein [ÎR(2) = 5% vs ÎR(2) = 9%]) and may serve as a treatment target.
Weight gain and metabolic abnormalities during extended risperidone treatment in children and adolescents.
