Biological cardiovascular risk factors cluster in Danish children and adolescents: the European Youth Heart Study

Background The aim of this study was to determine whether the number of participants with multiple coronary heart disease (CHD) risk factors exceeded the number expected from a random distribution. Methods A cross-sectional study of 1020 randomly selected boys and girls, 9 and 15 years old, was conducted. Risk factors were total cholesterol, HDL-cholesterol, triglyceride, serum insulin, and blood pressure. Physical fitness was assessed from a maximal cycle test and body fat from the sum of four skinfolds. Risk factors selected in the analysis were those related to the metabolic syndrome. Results More participants than expected had four or five CHD risk factors. Four risk factors were found in 3.03 (95% confidence interval (CI): 2.24–4.10) times as many participants as expected from a random distribution and five risk factors were found in 8.70 (95% CI: 4.35–17.4) times as many participants as expected. Fifty (5.4%) had four or five risk factors and in these individuals physical fitness was 1.2 standard deviation (SD) lower and body mass index (BMI) 1.6 SD higher than mean values for the population. Conclusion Clustering of risk factors for the metabolic syndrome was found in children and adolescents. Low levels of physical fitness and raised BMI in these individuals indicate that lifestyle factors such as physical activity and diet may influence the development of these unhealthy risk profiles.