OBJECTIVE: To determine if elevated plasma gamma-fibrinogen, typically involved in the formation of fibrinolysis-resistant clots, confers an increased risk for cardiovascular disease (CVD) and thrombosis in children as it does in adults. Although obesity-related hyperfibrinogenemia is frequently reported in children, the role of fibrinogen and its response to physical activity-based lifestyle are less clear in this population. STUDY DESIGN: In a randomized controlled 3-month physical activity-based lifestyle intervention, gamma fibrinogen concentration was measured in 21 children (aged 14 to 18 years; Tanner stage > IV), including 15 in the obese group and 6 in the normal weight group, with body mass index percentiles for age and sex of > 95 and < 85, respectively. RESULTS: The relationships between gamma fibrinogen and other risk factors for CVD, such as markers of insulin resistance and subclinical inflammation, along with body composition (as measured by dual-energy x-ray absortiometry), were assessed before and after the intervention. Gamma fibrinogen concentration was higher in the obese group compared with the normal weight group (p < 0.05) and was correlated with other risk factors for CVD (adjusted R2 = 0.9; p < 0.05), and insulin emerged as the major predictor of fibrinogen. The intervention reduced gamma-fibrinogen concentration (p < 0.05). CONCLUSION: Our data reveal: (1) elevated gamma fibrinogen concentrations in obese insulin-resistant children compared with normal lean controls; (2) a relationship between gamma fibrinogen and other CVD risk factors; and (3) physical activity-induced reduction in gamma fibrinogen in obese children.

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