High BMI in Children Linked to Elevated Cardiometabolic Risk: Study
A substantial proportion of U.S. children aged 6–17 with overweight or obesity exhibit borderline or abnormal cardiometabolic risk markers, including dyslipidemia, diabetes, and non-alcoholic fatty liver disease. Using the CDC’s 2022 extended BMI-for-age growth charts, the study found that higher BMI percentiles were strongly associated with an increased likelihood of abnormal cardiometabolic laboratory findings, highlighting early health risks related to childhood obesity. The study was published in the Obesity journal by Samantha L. P. and colleagues.
Overweight and obesity in childhood are established risk factors for future cardiometabolic disease; however, traditional BMI percentiles often fall short in delineating true cardiometabolic risk within higher categories of obesity. The objective of this analysis was to assess how the CDC's 2022 extended BMI percentiles relate to key cardiometabolic biomarkers among youth aged 6-17 years. DESIGN: This was a cross-sectional analysis using data from the electronic medical record. Inclusion criteria included children and adolescents aged 6-17 years with BMI ≥85th percentile who had at least one recorded cardiometabolic laboratory test.
Participants were categorized using extended BMI percentiles as follows:
85th–<95th percentile (overweight, reference group)
95th–<98th percentile
98th–<99th percentile
99th–<99.9th percentile
≥99.9th percentile
Key findings
Compared with youth with overweight (BMIp 85th–<95th), those in higher extended BMIp categories showed a markedly higher prevalence of cardiometabolic abnormalities:
HbA1c: aPR 1.46–2.79
ALT: aPR 1.58–2.59
Triglycerides: aPR 1.24–1.46
Total cholesterol: aPR 1.11–1.23
HDL: aPR 1.40–1.94
LDL: aPR 1.23–1.55
Clear dose–response relationships were observed, with risk increasing stepwise across higher BMIp categories. Similar trends were seen when analyses were limited to abnormal laboratory values only.
Among young people aged 6-17 years with excess weight/obesity, there was a positive association between increasing extended BMI percentiles and the risk for borderline or abnormal cardiometabolic profiles. The findings verify the extended BMIp cut points as useful metrics for risk adjustment and management of pediatric excess weight/obesity.
Reference:
Pierce, S. L., Porter, R. M., Kompaniyets, L., He, S., & Goodman, A. B. (2025). Examining biomarkers for dyslipidemia, diabetes, and NAFLD by CDC’s 2022 extended BMI percentiles in US youth aged 6-17 years. Obesity (Silver Spring, Md.), oby.70077. https://doi.org/10.1002/oby.70077
