Abstract
BackgroundThe clinical significance of metabolic syndrome (MetS) during adolescence and its association with adulthood adverse outcomes is a controversial issue. This study aimed to investigate the association of MetS and metabolic phenotypes with a high carotid intima-media thickness (CIMT) in early adulthood. MethodsMetS was defined as proposed by Cook, de Ferranti, the National Cholesterol Education Program (NCEP), and the pediatric International Diabetes Federation (IDF). Metabolic phenotypes were defined based on the binary clustering of cardiovascular risk factors. The participants were adolescent's individual selected from a large cohort study and followed for 18.2 years. Multivariate-adjusted odds ratios (ORs) were calculated for a high CIMT incidence (≥95th percentile). ResultsIn this study, 862 adolescents (52.3% males), with the mean age of 13.4 ± 2.2 years, were included. The presence of MetS, based on the definitions proposed by Cook (OR = 1.90, 95% CI: 1.01–3.57, P = 0.046) and de Ferranti (OR = 1.74; 95% CI: 1.04–2.90, P = 0.033), was associated with the increased risk of a high CIMT in early adulthood. Metabolic phenotypes, including high waist circumference (WC)/hypertension (HTN), high WC/low high-density lipoprotein-cholesterol (HDL-C), and high triglyceride (TG)/high WC, showed higher risks of a high CIMT. However, these positive associations become insignificant after adjusting for the adulthood BMI, except for the high WC/low HDL-C phenotype (OR = 2.04, 95% CI: 1.02–4.11, P = 0.044). ConclusionThe high WC/low HDL-C phenotype had a better predictive value and could be used as a simpler alternative for MetS to identify adolescents with a higher risk of high CIMT during early adulthood.
Highlights
Metabolic syndrome (MetS) is a complex disorder, defined by a cluster of interrelated criteria, including dyslipidemia, elevated blood pressure, and dysregulated glucose homeostasis, with abdominal obesity and/or insulin resistance as its main manifestations in both children and adolescents [1]
We aimed to investigate the role of metabolic syndrome (MetS) and its phenotypes among children in predicting the incidence of a high carotid intima-media thickness (CIMT)
There was an association between the presence of MetS and the incidence of a high CIMT based on Cook’s definition (OR = 1.90, 95% confidence intervals (CIs): 1.01–3.57, P = 0.046) and de Ferranti’s definition (OR = 1.74, 95% CI: 1.04–2.90, P = 0.033) after adjusting for age, sex, family history of cardiovascular disease (CVD), and smoking
Summary
Metabolic syndrome (MetS) is a complex disorder, defined by a cluster of interrelated criteria, including dyslipidemia, elevated blood pressure, and dysregulated glucose homeostasis, with abdominal obesity and/or insulin resistance as its main manifestations in both children and adolescents [1]. Various definitions of MetS in adolescents have been endorsed by national and international organizations, as well as the Balinese expert group [2]. MetS has an increasing prevalence among children and adolescents both globally and locally [3, 4]. The overall prevalence of MetS in adolescents ranges from 1.2–9.8% [5, 6] and from 4.5–8.4% [7, 8], based on the modified Adult Treatment Panel III (ATP-III) and IDF definitions. The prevalence of MetS was 9.8, 6.0, and 17.5% in Iranian adolescents, based on the ATP-III, IDF, and de Ferranti’s definitions, respectively [4]. The prevalence of metabolic syndrome (MetS) during adolescence has shown an increasing trend. This study aimed to investigate the association of MetS and metabolic phenotypes with a high carotid intima-media thickness (CIMT) in early adulthood in the framework of a large cohort study
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