Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study

Seo, Young–Il; Choi, Min-Kyu; Kang, Jae-Heon; Lee, Hye-Ja; Jang, Han Byul; Park, Sang Ick; Ju, Young Su; Park, Kyung Hee

doi:10.1136/archdischild-2017-313226

Cited by 29 publications

(25 citation statements)

References 36 publications

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“…Covariates-A priori covariates were chosen based on prior literature suggesting independent associations between each covariate and MetS [10,[14][15][16]. All covariates were self-reported or reported by parent/caregiver.…”

Section: Individual Risk Factors For Metsmentioning

confidence: 99%

“…The prevalence of adolescent (ages [12][13][14][15][16][17][18][19] obesity (body mass index (BMI) >95 th percentile for age and sex) almost doubled from approximately 11% in 1988-1989 to 21% in 2013-2014 and has remained stable in recent years (2007-2008 to 20015-2016 [1,2]. Obesity is hypothesized to be one of the predominant underlying causes of metabolic syndrome (MetS) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is of extreme importance to promote early interventions prior to chronic disease development. Recent studies suggest there are several risk factors for MetS incidence including low socioeconomic status, parental history of CVD, health behaviors like short sleep duration and poor nutrition, and childhood obesity [10,[14][15][16]. Obesity is a discernible MetS risk factor that could assist with identification of adolescents that may require further assessment for other MetS risk factors and MetS.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011–2016

Gaston

Tulve

Ferguson

2019

Annals of Epidemiology

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Purpose: The objectives were to use National Health and Nutrition Examination Survey (NHANES) data to: 1) estimate the prevalence of metabolic syndrome (MetS) risk factors (elevated blood pressure, triglycerides, blood glucose, and low HDL cholesterol); 2) estimate the prevalence of MetS using three common definitions; and 3) compare the odds of MetS risk factors/ MetS when using different measures of abdominal obesity (sagittal abdominal diameter (SAD) versus waist circumference (WC)) among United States adolescents. Methods: Analyses were performed on data collected from adolescents aged 12-19 years (N = 1,214) participating in the 2011-2016 NHANES. Prevalence of MetS risk factors and MetS were estimated. Unadjusted and adjusted binomial/multinomial logistic regressions were performed to test associations between WC and SAD z-scores and MetS risk factors/MetS. Results: Males were more likely to have MetS risk factors. Depending on sex and the definition applied, the prevalence of MetS ranged from 2% to 11% and was lowest among females. Adjusted logistic regressions showed that one z-score increase in SAD and WC resulted in similar increased odds of MetS risk factors/MetS, but associations between abdominal obesity and MetS may vary by definition applied and race/ethnicity. Conclusions: Metabolic dysfunction and MetS are prevalent among U.S. adolescents, and it is important to consider how MetS components and MetS are measured in population inference.

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Section: Individual Risk Factors For Metsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011–2016

Gaston

Tulve

Ferguson

2019

Annals of Epidemiology

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“…2,3 Accumulation of these risk factors is not only seen in adults but already in young children and adolescents. 4,5 Recently, based on the large European…”

Section: Introductionmentioning

confidence: 99%

Metabolic status in children and its transitions during childhood and adolescence—the IDEFICS/I.Family study

Börnhorst

Russo

Veidebaum

et al. 2019

International Journal of Epidemiology

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Background This study aimed to investigate metabolic status in children and its transitions into adolescence. Methods The analysis was based on 6768 children who participated in the European IDEFICS/I.Family cohort (T0 2007/2008, T1 2009/2010 and/or T3 2013/2014; mean ages: 6.6, 8.4 and 12.0 years, respectively) and provided at least two measurements of waist circumference, blood pressure, blood glucose and lipids over time. Latent transition analysis was used to identify groups with similar metabolic status and to estimate transition probabilities. Results The best-fitting model identified five latent groups: (i) metabolically healthy (61.5%; probability for group membership at T0); (ii) abdominal obesity (15.9%); (iii) hypertension (7.0%); (iv) dyslipidaemia (9.0%); and (v) several metabolic syndrome (MetS) components (6.6%). The probability of metabolically healthy children at T0 remaining healthy at T1 was 86.6%; when transitioning from T1 to T3, it was 90.1%. Metabolically healthy children further had a 6.7% probability of developing abdominal obesity at T1. Children with abdominal obesity at T0 had an 18.5% probability of developing several metabolic syndrome (MetS) components at T1. The subgroup with dyslipidaemia at T0 had the highest chances of becoming metabolically healthy at T1 (32.4%) or at T3 (35.1%). Only a minor proportion of children showing several MetS components at T0 were classified as healthy at follow-up; 99.8% and 88.3% remained in the group with several disorders at T1 and T3, respectively. Conclusions Our study identified five distinct metabolic statuses in children and adolescents. Although lipid disturbances seem to be quite reversible, abdominal obesity is likely to be followed by further metabolic disturbances.

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“…Recent studies report lower scores than ideal in a range of cardiovascular health factors (blood pressure, cholesterol and glucose level below the American heart association’s cut-offs) in European adolescents with low maternal education 8. In Korea, high income was protective against cardiovascular disease risk factors and in Finland, low socioeconomic status (SES) measured by occupation of the father was associated with higher low-density lipoprotein (LDL) levels in boys and higher systolic blood pressure and higher percentage of smokers 9 10. However, longitudinal data on the relationships between childhood SES and adolescent’s cardiovascular health are still scarce.…”

Section: Introductionmentioning

confidence: 99%

Inequalities in cardiovascular risks among Swedish adolescents (ABIS): a prospective cohort study

et al. 2020

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ObjectivesTo investigate if socioeconomic status (SES) is predictive of cardiovascular risk factors among Swedish adolescents. Identify the most important SES variable for the development of each cardiovascular risk factor. Investigate at what age SES inequality in overweight and obesity occurs.DesignLongitudinal follow-up of a prospective birth cohort.SettingAll Babies in Southeast Sweden (ABIS) study includes data from children born between October 1997 and October 1999 in five counties of south east Sweden.ParticipantsA regional ABIS-study subsample from three major cities of the region n=298 adolescents aged 16–18 years, and prospective data from the whole ABIS cohort for overweight and obesity status at the ages 2, 5, 8 and 12 years (n=2998–7925).Outcome measuresBlood pressure above the hypertension limit, overweight/obesity according to the International Obesity Task Force definition, low high-density lipoproteins (HDL) or borderline-high low-density lipoproteins according to National Cholesterol Education Program expert panel on cholesterol levels in children.ResultsFor three out of four cardiovascular risk outcomes (elevated blood pressure, low HDL and overweight/obesity), there were increased risk in one or more of the low SES groups (p<0.05). The best predictor was parental occupational class (Swedish socioeconomic classification index) for elevated blood pressure (area under the receiver operating characteristic (ROC) curve 0.623), maternal educational level for overweight (area under the ROC curve 0.641) and blue-collar city of residence for low HDL (area under the ROC curve 0.641). SES-related differences in overweight/obesity were found at age 2, 5 and 12 and for obesity at age 2, 5, 8 and 12 years (all p<0.05).ConclusionsEven in a welfare state like Sweden, SES inequalities in cardiovascular risks are evident already in childhood and adolescence. Intervention programmes to reduce cardiovascular risk based on social inequality should start early in life.

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Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study

Cited by 29 publications

References 36 publications

Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011–2016

Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011–2016

Metabolic status in children and its transitions during childhood and adolescence—the IDEFICS/I.Family study

Inequalities in cardiovascular risks among Swedish adolescents (ABIS): a prospective cohort study

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