Abstract MP16: Metabolic Predictors Of Target Organ Damage In Adolescents: The SHIP AHOY Study

Abstract

The development of cardiovascular disease in adults has been directly linked to a metabolic phenotype that includes hypertension, obesity and dyslipidemia. While there is evidence that the development of these risk factors in childhood is linked with persistence into adulthood and eventual development of cardiovascular disease, less is known about whether these risk factors contribute to target organ damage during childhood. We collected data from 379 otherwise healthy adolescents (mean age 15.5 +/- 1.8, 60% male, 37% Non-White) across the blood pressure spectrum to determine if there is a metabolic phenotype that predicts target organ damage in adolescents. A cardiovascular risk score was calculated (1 point each for: LDL >155 or HDL <40 or TG >150; BMI > 95%; fasting glucose >100; HOMA-IR > 2.5). Generalized linear models were constructed to determine if the cardiovascular risk score was independently associated with measures of target organ damage. Cardiovascular risk score was significantly associated increased left ventricular mass index (β = 1.64, R 2 0.19) , increased pulse wave velocity (β = 0.05, R 2 0.21) and several echocardiographic parameters of diastolic dysfunction (e’/a’: β = -0.07 R 2 0.27; E/A: β = -0.04, R 2 0.11; E/e’: β =0.03, R 2 0.13) after correction for age, sex, race, HR, creatinine, uric acid and log CRP (all models P<0.0009). We found no association with peak longitudinal strain or microalbuminuria. Our study suggests that presence of cardiovascular risk factors in adolescence predicts target organ damage at a young age and could potentially be modified to prevent progression of disease.