Background In young adults the use of short-term cardiovascular (CV) risk prediction has well-established limitations as it classifies virtually all younger adults as low risk regardless of risk factor burden. The lifetime risk algorithm provides information regarding risk prediction that is not obtained through modifications of the 10-year risk window. Aim To evaluate the lifetime risk in a group of severely obese young adults candidates to bariatric surgery according to gender. Materials and methods One-hundred thirty-seven severely obese individuals referred to our Unit for bariatric surgery (43 M and 94 F; 30.8 ± 6.3 and 32.3 ± 7.6 years, respectively) were included in this study. Body composition was evaluated by bioimpedance analysis (Akern Bioresearch, Firenze). In obese subjects[35 years (22 M and 66 F), global CV risk at 10 years was evaluated using the Progetto Cuore program (http://www.cuore.iss.it/). In all subjects the lifetime risk compared with reference individuals at 50 years with optimal risk factor levels was calculated according to ACC/ AHA Guideline for the Assessment of Cardiovascular Risk (https://my.americanheart.org/professional/StatementsGuidelines/ PreventionGuidelines/Prevention-Guideline). Results Percentages of fat mass (FM %) in males and females were 48.2 ± 8.8 vs 49.9 ± 7.5, while % fat-free mass (FFM %) were 53.3 ± 9.9 vs 51.6 ± 8.9, respectively. Short-term CV risk score was  % in males and % in females. The lifetime risk compared with reference individuals was 55.2 ± 14.6 vs 5.0 ± 0.0 in males and 40.7 ± 10.4 vs 8.0 ± 0.0 in females. In women, the lifetime risk significantly correlated with waist circumference (WC) (r = 0.262, p = 0.011), FM % (r = 0.251, p = 0.015) and FFM % (r = -0.251, p = 0.041). No significant correlations were observed in men. At multiple regression analysis, WC was the major predictor of the lifetime risk (b = 0.154, p = 0.034). Conclusions Despite normal short-term CV risk scores, severely obese young adults presented with high lifetime predicted risk. The long-term CV risk assessment is particularly relevant for obese young adults, in whom the limitation to low short-term CV risk assessment might cause a possible delay in adopting more intensive lifestyle or pharmacologic preventive interventions.
LIFETIME RISK ALGORITHM IN SEVERELY OBESE YOUNG ADULTS
Barrea L;
2014-01-01
Abstract
Background In young adults the use of short-term cardiovascular (CV) risk prediction has well-established limitations as it classifies virtually all younger adults as low risk regardless of risk factor burden. The lifetime risk algorithm provides information regarding risk prediction that is not obtained through modifications of the 10-year risk window. Aim To evaluate the lifetime risk in a group of severely obese young adults candidates to bariatric surgery according to gender. Materials and methods One-hundred thirty-seven severely obese individuals referred to our Unit for bariatric surgery (43 M and 94 F; 30.8 ± 6.3 and 32.3 ± 7.6 years, respectively) were included in this study. Body composition was evaluated by bioimpedance analysis (Akern Bioresearch, Firenze). In obese subjects[35 years (22 M and 66 F), global CV risk at 10 years was evaluated using the Progetto Cuore program (http://www.cuore.iss.it/). In all subjects the lifetime risk compared with reference individuals at 50 years with optimal risk factor levels was calculated according to ACC/ AHA Guideline for the Assessment of Cardiovascular Risk (https://my.americanheart.org/professional/StatementsGuidelines/ PreventionGuidelines/Prevention-Guideline). Results Percentages of fat mass (FM %) in males and females were 48.2 ± 8.8 vs 49.9 ± 7.5, while % fat-free mass (FFM %) were 53.3 ± 9.9 vs 51.6 ± 8.9, respectively. Short-term CV risk score was % in males and % in females. The lifetime risk compared with reference individuals was 55.2 ± 14.6 vs 5.0 ± 0.0 in males and 40.7 ± 10.4 vs 8.0 ± 0.0 in females. In women, the lifetime risk significantly correlated with waist circumference (WC) (r = 0.262, p = 0.011), FM % (r = 0.251, p = 0.015) and FFM % (r = -0.251, p = 0.041). No significant correlations were observed in men. At multiple regression analysis, WC was the major predictor of the lifetime risk (b = 0.154, p = 0.034). Conclusions Despite normal short-term CV risk scores, severely obese young adults presented with high lifetime predicted risk. The long-term CV risk assessment is particularly relevant for obese young adults, in whom the limitation to low short-term CV risk assessment might cause a possible delay in adopting more intensive lifestyle or pharmacologic preventive interventions.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
