Metabolic syndrome and subclinical atherosclerosis in children
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Date
2011
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Abstract
Atherosclerosis begins in childhood in response to the clustering of metabolic syndrome (MS) risk components since early life. Carotid intima-media thickness (CIMT), a surrogate marker of subclinical atherosclerosis, has been strongly related with cardiovascular disease and Diabetes 2 in adulthood. We aimed to study the possible association of CIMT with the MS components in a population of Chilean children.
A cross-sectional study of 304 children of low socio-economic strata from an urban area of Santiago was performed during 2009-2010. This sample was selected mainly considering the presence of one or more MS components and insulin resistance (IR). Anthropometry and systolic and diastolic blood pressure were assessed by trained personnel. While fasting, a blood sample was taken to determine lipids (enzymatic colorimetric tests), glycemia (hexoquinase), insulin (quimioluminiscence) and HOMA. CIMT was assessed using ultrasonography with automated software. Pearson correlation, chi-squared test and stepwise regression were used. Mean age was 11.5 ± 0.9 years old; 57% girls and 42% pre-pubertal; 64% overweight; and 25% had MS. MS components distribution was: 20% had 0, 29% had one, 26% had two and 25% had three or more. Pearson coefficients for CIMT medium and maximum with systolic blood pressure were: 0.206 (p 0.0003) and r: 0.213 (p 0.0002). Some MS components and IR had higher proportions of children over the 75th percentile of CIMT medium and maximum in the contingency tables: 1) the proportion of children with high CIMT medium was significantly higher for IR (0.035) and CHDL ≤ 40 mg/dL (p 0.039); 2) A tendency for significant differences was found for the proportions of children with high (>75th percentile) CIMT medium with waist circumference (p 0.052) and children with high (>75th percentile) CIMT maximum with CHDL ≤ 40 mg/dL (p 0.062). Multiple linear regression models for CIMT medium and maximum selected just
systolic blood pressure in both; p values were 0.0003 and 0.0002. Univariate analyses showed that CIMT medium and maximum were directly associated with systolic blood pressure. Bivariate analyses showed that CIMT medium was significantly associated with IR and CHDL ≤ 40 mg/dL. However, multiple regression models for both CIMTs just selected systolic blood pressure, a fact that would make it a proxy for CIMTs. These results are the first reported in our country.