Association of childhood metabolic syndrome and metabolic phenotypes with the carotid intima-media thickness (CIMT) in early adulthood: Tehran lipid and glucose study

Abstract

Background: 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.Methods: MetS was de ned as proposed by Cook, de Ferranti, the National Cholesterol Education Program (NCEP), and the pediatric International Diabetes Federation (IDF). Metabolic phenotypes were de ned based on the binary clustering of cardiovascular risk factors. The participants were followed up for 18.2 years. Multivariate-adjusted odds ratios (ORs) were calculated for a high CIMT incidence (≥95 th percentile).Results: In 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 de nitions 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 insigni cant 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). Conclusion:The 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.

Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity

“…The results of this study demonstrated that normal weight children, even with an unhealthy metabolic profile, did not show a higher risk of high CIMT. Likewise, obese children with healthy metabolic status are not at higher risk [ 20 ]. In another comparative evaluation between children and adolescents with MHO and MUO, subjects with MUO not only had a significantly higher CIMT but also had significantly greater left ventricular dimensions, epicardial adipose tissue, ascending aorta diameter, carotid, and ascending aorta stiffness as well as a significantly more impaired global longitudinal strain compared to MHO patients [ 21 ].…”

Diagnostic performance of different anthropometric indices among Iranian adolescents for intima media thickness in early adulthood: A prospective study and literature review

“…Several studies have shown a link between childhood cardiometabolic risk factors, including elevated blood pressure, glucose intolerance, abnormal blood lipids, and obesity, with the development of subclinical and clinical CVD in adulthood (4)(5)(6)(7). Carotid intima-media thickness (cIMT), as measured by ultrasonography, is a validated, sensitive, and reproducible technique for detecting and quantifying subclinical atherosclerosis in asymptomatic individuals that corresponds with the development of coronary artery disease and has been identified as a predictor of future cardiovascular events as well as all-cause mortality (8).…”