Correlation of metabolic syndrome severity with cardiovascular health markers in adolescents

Abstract

Background and Objectives The presence of metabolic syndrome (MetS) in childhood is a significant risk factor for later cardiovascular disease (CVD). Recent data showed temporal decreases in a sex- and race/ethnicity-specific MetS severity z-score among U.S. adolescents. Our goal was to characterize the relationship of this MetS z-score with other CVD risk indicators and assess their temporal trends and lifestyle influences. Methods We analyzed 4837 participants aged 12–20 years from the National Health and Nutrition Examination Survey by 2-year waves from 1999–2012. We used linear regression to compare MetS z-score and dietary factors with serum levels of low-density lipoprotein (LDL), apolipoprotein-B (ApoB), high-sensitivity C-reactive protein (hsCRP) and uric acid. Results MetS severity z-score was positively correlated with LDL, ApoB, hsCRP, and uric acid measurements (p<0.0001 for all). These correlations held true among individual racial/ethnic groups. LDL, ApoB, and hsCRP measurements decreased over time among U.S. adolescents (p=0.002, p<0.0001, p=0.024 respectively). Saturated fat consumption was positively correlated with LDL (p=0.005), ApoB (p=0.012), and inversely related to serum uric acid (p=0.001). Total calorie intake was inversely related to LDL (p=0.003) and serum uric acid (p=0.003). Unsaturated fat, carbohydrate, and protein consumption were not related to LDL, ApoB, hsCRP, or serum uric acid. Conclusions There is a positive correlation between MetS severity and all four CVD risk indicators studied. LDL, ApoB, and hsCRP showed favorable temporal trends, which could be related to similar trends in MetS z-score. These data support the importance of considering multiple inter-related factors in clinical CVD risk assessment.

<p>Asymptomatic Hyperuricemia Associates with Cardiometabolic Risk Indicators in Overweight/Obese but Not in Lean Adolescents</p>

“…2 – 4 , 10 , 26 Large studies on the general population of adolescents documented an increase in mean SUA levels across cardiovascular risk classes 4 and a worsening of continuous MetS z-score with rising SUA levels. 6 Our hyperuricemic overweight/obese adolescents also displayed higher continuous cardiometabolic scores compared with their normouricemic peers, suggesting that asymptomatic hyperuricemia is associated with worse cardiometabolic status only in overweight/obese adolescents. Even though, we neither revealed systematic worsening in variables characterizing cardiometabolic risk nor documented a significant deterioration in continuous cardiometabolic score in lean hyperuricemic vs normouricemic adolescents, these findings should be interpreted with caution.…”

“… 1 – 5 Serum uric acid (SUA) levels rise with increasing number of manifested MetS components, the prevalence of MetS rises across quartiles of SUA, and clustering of cardiometabolic risk factors with rising SUA levels imposes increased cardiometabolic risk. 3 , 4 , 6 High baseline SUA levels during adolescence are associated with higher risk of later development of hypertension, and in males also of MetS. 7 …”

Food Insecurity Is Associated with Prediabetes Risk Among U.S. Adolescents, NHANES 2003–2014

“…15 Childhood and adolescent obesity portends other adverse outcomes such as MetS, prediabetes, cardiovascular disease, fatty liver disease, and renal dysfunction. [16][17][18][19] Food insecurity is a potentially modifiable factor in the pathogenesis of the obesity epidemic. One potential means of mitigating food insecurity is through the Supplemental Nutrition Assistance Program (SNAP), though data assessing food insecurity and SNAP use among adolescents are scarce.…”

High-sensitivity c-reactive protein and total and saturated fat intake in adolescent students: a longitudinal study

“…Lee, Gurka and Deboer [42] investigated the relationship between metabolic syndrome and cardiovascular risks in a population aged from 12 to 20 years, associating hs-CRP with the intake of total fats, carbohydrates, proteins and physical activity. They observed that the metabolic syndrome is directly associated with cardiovascular risk, although a relationship between the hs-CRP concentrations and fat intake analyzed in this study was not found.…”