| Atherogenic lipid profile changes and their cardiovascular
consequences across degrees of obesity in children and
adolescents: a structured narrative review |
Ashraf Soliman 
, Fawzia Alyafei
, Nada Alaaraj
, Noor Hamed
, Shayma Ahmed
, Rasha Amin
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Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar |
Correspondence:
Ashraf Soliman, Email: atsoliman@yahoo.com
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Received: 20 June 2026 • Revised: 27 July 2026 • Accepted: 30 July 2026 |
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| Abstract |
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Childhood and adolescent obesity is strongly associated
with an atherogenic lipid profile and silent cardiovascular
injury that begins early and evolves over time. In this
structured review, we synthesized PubMed-indexed evidence
from the past 25 years on lipid profile changes in
children and adolescents with varying degrees of obesity—
overweight, obesity, and severe obesity—and their
cardiovascular consequences from childhood through
young adulthood, as well as interventions that improve
lipid profile and cardiovascular risk. Obesity-related dyslipidemia
consistently involves elevated triglyceride,
reduced high-density lipoprotein cholesterol (HDL-C),
and elevated non-HDL-C levels, as well as increased triglyceride/
HDL-C ratio, whereas low-density lipoprotein
cholesterol levels, although clinically important, are less
consistently abnormal; the burden rises with obesity
severity. In childhood, this pattern manifests with subclinical
endothelial dysfunction and early carotid intimal
thickening; during adolescence, arterial stiffness, elevated
blood pressure levels, and early left ventricular remodeling
with diastolic dysfunction become detectable, particularly
in severe obesity; by young adulthood, these changes
progress into accelerated atherosclerosis and clinical car
diovascular risk. Mechanistically, visceral adiposity increases
free fatty acid flux and promotes hepatic very-lowdensity
lipoprotein overproduction, while adipose tissue
inflammation, low adiponectin levels, oxidative stress, and
impaired nitric oxide bioavailability link the lipid profile
to vascular and cardiac injury through insulin resistance.
Lifestyle interventions and improving physical fitness and
dietary quality remain first-line treatments. Antiobesity
pharmacotherapy and metabolic-bariatric surgery can
improve weight and cardiometabolic risk in selected
adolescents with severe obesity, but long-term pediatric
cardiovascular outcome data remain limited. Routine
lipid profile screening combined with blood pressure, insulin
resistance, and obesity severity assessments should
be integrated with early, family-centered intervention
to reduce lifelong cardiovascular risk. |
| Key Words:
Dyslipidemias, Pediatric obesity, Cardiovascular
diseases, Insulin resistance, Adolescent |
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