Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

Abstract

Objective: To evaluate the continuous metabolic syndrome score (cMetS) in Indian children and to investigate its relationship with the risk of carotid arterial stiffness. Methods: Data on weight, height, mean arterial pressure, serum lipids, insulin, glucose, carotid intima-media thickness and stiffness parameters, that is, pulse wave velocity (PWV), elasticity modulus (Ep), stiffness index (b) and arterial compliance (AC), were assessed in 236 children (6-17 years) from Pune city, India. cMetS was computed using standardized Z-scores for metabolic syndrome (MS) components. cMetS cutoff was obtained by receiver operating characteristic curve analysis across MS components. Results: cMetS was lowest (À3.6 ± 2.0) in normal children and highest (3.3 ± 2.4) in MS children. cMetS increased progressively with number of risk components. The cutoff of cMetS yielding maximal sensitivity (80%) and specificity (94%) for predicting the presence of MS was À0.8 (area under the curve ¼ 0.921 (95% CI: 0.877-0.964)). In children with cMetS above À0.8, average PWV (4.3±0.6 m s À1 ), b (3.8±1.2) and Ep (50.4±14.5 kPa) were significantly higher than the respective values (3.7 ± 0.5 m s À1 ; 3.4 ± 0.8; 37.0 ± 10.0 kPa) in children with cMetS below À0.8, whereas AC was lower (1.2 ± 0.5 mm 2 kPa À1 ) in children with cMetS above À0.8 as against AC (1.4±0.3 mm 2 kPa À1 ) in children with cMetS below À0.8 (Po0.05), demonstrating the risk of stiffness with increasing score. Pearson's correlation coefficients of cMetS with PWV (r ¼ 0.575), b (r ¼ 0.347), AC (r ¼ À0.267) and Ep (r ¼ 0.530) were statistically significant (Po0.01). Conclusion: Results demonstrate the usefulness of cMetS over individual MS components as a better tool for assessment of atherosclerotic risk in children.

Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation—Penn State Children Cohort

“…A study in Indian children investigating the association between cMetS and risk of carotid arterial stiffness, found a graded relationship between cMetS and risk factors of MetS, and that children with higher cMetS had higher risk of carotid arterial stiffness than those with lower cMetS [54]. Due to the limited data available on the cMetS in adolescence, to the best of our knowledge, this is the first study to demonstrate that cMetS and its components are associated with impairment of CAM, even in apparently healthy adolescents without symptomatic metabolic abnormalities or clinically abnormal cMetS components.…”

Central aortic pressure, arterial stiffness and echocardiographic parameters of children with overweight/obesity and arterial hypertension

“…8,9,20 One previous study demonstrated a correlation between PWV and continuous metabolic syndrome score in Indian children. 21 This evidence suggests that obesity may be an independent factor affecting the status of the vascular wall. However, this association is likely diseasestage specific, as it was shown to be particularly strong in adult patients with angiographic evidence of changes in coronary arteries.…”

Penentuan titik potong skor sindroma metabolik remaja dan penilaian validitas diagnostik parameter antropometri: analisis Riskesdas 2013

“…Nilai titik potong didefi niskan sebagai nilai antara normal dan abnormal atau nilai batas hasil uji positif dan negatif (10). Di beberapa negara sudah memiliki titik potong skor sindroma metabolik seperti di India, Iran, dan Brazil (11)(12)(13). Indonesia belum memiliki nilai titik potong skor sindroma metabolik khususnya pada remaja sehingga diperlukan penelitian terkait penentuan nilai titik potong skor sindroma metabolik di Indonesia.…”