The purpose of this study is to evaluate whether serum markers of inflammation and
thrombosis, which ultimately increase cardiovascular risk (CRP, fibrinogen and others) are
already abnormal in obese children that do not yet have other features of the metabolic
syndrome. The investigators will assess the status of these risk factors in pubertal and
prepubertal children ages 8-18 years, both lean and obese. The pubertal cohort that has
elevations in these markers will participate in a longitudinal interventional study with
lifestyle modification (diet and structured exercise) with or without Metformin for 6mo in a
cross over design. Intrahepatic fat contents will be measured as well.
The investigators hypothesize that obese children in these age groups will have increased
cardiovascular risk related to their obese state before reaching the currently defined
criteria of metabolic syndrome.
The investigators hypothesize that these cardiovascular risks can be reduced with lifestyle
and drug interventions.
- Ages 8-18 years.
- Obese children are greater than the 95th percentile body mass index for their age and
- Lean children are between the 10th and 50th percentile body mass index for their age
- Children are in Tanner Stage I or IV or V.
- Normal Blood Pressure.
- Normal fasting glucose.
- Normal lipids.
- Menstruating girls must have completed their most recent period at least 2 weeks
prior to blood draw.
- NO recent illness, no chronic illnesses, no routine medications, no smoking or
- Chronic active illnesses.
- Recent illnesses.
- Use of routine medications, vitamins, herbal remedies, oral contraceptive pills,
or other over the counter medications within 4 weeks of blood draw.
- History of recent or chronic smoking.
- Currently pregnant.
- For the lean control group, immediate family history of Type 2 Diabetes mellitus or
Hypertension or Hyperlipidemia.
- Impaired fasting glucose.
- Actively in puberty.
- Weight greater than 300 pounds.