ASSOCIATION OF SUBCLINICAL ATHEROSCLEROSIS WITH DIFFERENT STANDARDS OF THE METABOLIC SYNDROME AND INSULIN RESISTANCE
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Date
2013
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Abstract
Background and objectives: we have previously selected two metabolic syndrome (MS) components blood pressure (BP) and high density lipoprotein cholesterol (HDLC) as associated with carotid intima media thickness (CIMT) a surrogate marker of subclinical atherosclerosis in children (Rev Med Chile 2012; 140: 1268-75). We aimed to ascertain with a higher sample size the influence of the above mentioned variables and three standards defining the MS plus three standards defining insulin resistance (IR). Methods: A cross-sectional study of 447 children 10-14 years old of low socio-economic strata from an urban area of Chile was performed during years 2009-2011. This sample was selected considering the presence of one or more MS component and IR. Anthropometry and BP were assessed. A blood sample for determination of glycaemia, insulinemia (quimioluminiscence) and blood lipids were taken; HOMA was calculated and three standards were applied to select HOMA-IR cases. Three standards to define MS were also used. Medium CIMT was assessed using ultrasonography with automated software. Chi-squared test and stepwise regression were used. Results: Mean age was 11.5 ±1.0 years old; 59% girls; 92.6% pubertal; 72% excess weight. Three standards for MS had prevalence of 24.4% (Cook, 2004), 14.1% (IDF, 2007), 42.9% (De Ferranti, 2004). Three standards for HOMA-IR had the following prevalence: 15.2% (Barja, 2011), 37.4% (Burrows, 2006), 23.0% (De Onis, 2012). Elevated blood pressure and reduced CHDL had significant associations with CIMT ≥ percentile 75. The logistic regression for CIMT ≥ percentile 75 only selected BP ≥ percentile 90 (OR = 2.963) and CHDL < 40 mg/dL (OR = 1.789) Conclusions: None of the various classifications for the MS and the HOMA-IR were selected in the multivariate analysis confirming the previously found influence of increased BP and reduced CHDL on medium CIMT.
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Metabolic syndrome, Insulin resistance, Carotid intima-media thickness, Child