Metabolic syndrome, clustering of cardiovascular risk factors and high carotid intima–media thickness in children and adolescents

Zhao, Min; Caserta, Carmelo Antonio; Medeiros, Carla Campos Muniz; López‐Bermejo, Abel; Κόλλιας, Αναστάσιος; Zhang, Qian; Pacifico, Lucia; Reinehr, Thomas; Litwin, Mieczysław; Bassols, Judit; Romeo, Elisabetta L.; Ramos, Talytta Menezes; Stergiou, George S.; Yang, Lili; Xargay-Torrent, Sílvia; Amante, Angela; Estrela, Tatianne M.; Grammatikos, Evangelos; Zhang, Yuanyuan; Prats‐Puig, Anna; Carvalho, Danielle Franklin de; Yang, Liu; Carreras‐Badosa, Gemma; Simões, Mônica de Oliveira; Hou, Yaping; Lizárraga-Mollinedo, Esther; Wang, Shui; Guo, Teng; Wang, Mingming; Zhang, Yanqing; Bovet, Pascal; Xi, Bo

doi:10.1097/hjh.0000000000002318

Cited by 21 publications

(9 citation statements)

References 39 publications

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“…These results are discordant with other observations including the study by Dalla Pozza, who found cIMT to be predicted by total cholesterol beyond age at onset of the disease, insulin dosage, and pSBP (33). In other studies, in children and adolescents without diabetes, lipid levels correlate with cIMT thickening (38,39). Thus, our findings could be related to the relatively good lipid profile of the children and adolescents followed by our center.…”

Section: Discussionsupporting

confidence: 68%

“…We chose to use the previously recommended ISPAD glycemic cut-off of 7.5% even if the most recent ISPAD guidelines ( 37 ) indicated a target of HbA1c of <7.0% in T1D. This is because the 7.5% cut-off ( 38 ) is still widely used in populations vulnerable to hypoglicaemia, such as children and adolescents. The reason for this lack of effect could be related to fact that there is little variability in the values of HbA1c in our cohort (in our sample 84% of the subjects with diabetes have HbA1c higher than 7%).…”

Section: Discussionmentioning

confidence: 99%

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Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Tagetti

Piona

Marcon

et al. 2021

Front. Cardiovasc. Med.

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Objective of the study: This study aimed to test the effect of multiple cardiovascular risk factors on subclinical indices of atherosclerosis in children and adolescents with type 1 diabetes (T1D).Methods: Carotid intima-media thickness (cIMT), carotid distensibility coefficient (cDC), and carotid–femoral pulse wave velocity (PWV) were measured in children and adolescents with T1D, in a follow-up at the outpatient clinics of Verona. Blood pressure (BP; both central and peripheral), metabolic and other cardiovascular risk factors were evaluated in multivariate linear regressions to assess the association with the measured indices of subclinical vascular damage.Results: One hundred and twenty-six children and adolescents were included. cIMT was above the 95th percentile for age and height in 60.8% of the population, whereas 26% of the sample had cDC impairment (less than the 5th percentile) and 4.8% had an elevated PWV. Independent determinants of cIMT according to the regression models were only gender type of glucose monitoring and central systolic BP (cSBP). PWV was associated with age, sex, heart rate, and cSBP; cDC with age and both cSBP and, alternatively, peripheral BP (pBP). Neither pBP nor any of the tested metabolic parameters, including glycated hemoglobin, was associated with PWV and cIMT.Conclusions: A high proportion of early vascular damage, especially an increased cIMT, is present in children and adolescents with T1D in whom cSBP seems to be a common determinant. In children and adolescents with T1DM, a special focus should be on hemodynamic risk factors beyond metabolic ones.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Tagetti

Piona

Marcon

et al. 2021

Front. Cardiovasc. Med.

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“…It led to the development of the concept of MHO and MUHO phenotypes. Recently, an operational definition of MHO in children was proposed; it defines MHO as a lack of metabolic and haemodynamic criteria of metabolic syndrome in obese children, even with increased WC [79]. The comparison of children and adolescents in relation to their anthropometric and metabolic phenotype showed that blood pressure was significantly higher in NWMU and MUHO compared with that in NWMH and MHO [80].…”

Section: Concept Of Metabolically Healthy and Metabolically Unhealthymentioning

confidence: 99%

Obesity, metabolic syndrome, and primary hypertension

2020

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Primary hypertension is the dominant form of arterial hypertension in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for metabolic syndrome, and increased adrenergic drive constitutes the intermediary phenotype of primary hypertension. Metabolic syndrome is observed in 15–20% of adolescents with primary hypertension. These features are also typical of obesity-related hypertension. Metabolic abnormalities and metabolic syndrome are closely associated with both the severity of hypertension and the risk of target organ damage. However, even though increased body mass index is the main determinant of blood pressure in the general population, not every hypertensive adolescent is obese and not every obese patient suffers from hypertension or metabolic abnormalities typical for metabolic syndrome. Thus, the concepts of metabolically healthy obesity, normal weight metabolically unhealthy, and metabolically unhealthy obese phenotypes have been developed. The risk of hypertension and hypertensive target organ damage increases with exposure to metabolic risk factors which are determined by disturbed body composition and visceral obesity. Due to the fact that both primary hypertension and obesity-related hypertension present similar pathogenesis, the principles of treatment are the same and are focused not only on lowering blood pressure, but also on normalizing body composition and metabolic abnormalities.

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“…The previous cross-sectional studies demonstrated that the individuals with MetS have increased CIMTs (7,19). In addition, an increasing trend in the CIMT values was observed with an increasing number of MetS components in both genders (20,21).…”

Section: Discussionmentioning

confidence: 84%

Association of Carotid Intima Media Thickness With Metabolic Syndrome Among Low-Income Middle-Aged and Elderly Chinese: A Population-Based Cross-Sectional Study

Yang

Lin

Guo

et al. 2021

Front. Cardiovasc. Med.

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Background: We aimed to evaluate the relationship between metabolic syndrome (MetS) including its components and carotid intima media thickness (CIMT) in a low-income Chinese population aged ≥45 years.Methods: The participants underwent a general health screening and B-mode carotid ultrasonography that measured CIMT. The diagnosis of MetS and its components was based on the modified International Diabetes Federation Criteria for the Asian Population. The univariate and multivariable linear regression analyses were used to evaluate the relationship between MetS and CIMT.Results: A total of 3,583 participants (mean age, 60 years) was included in the analyses (41.4% male and 58.6% female); more than 50% of the participants were diagnosed with MetS. In the multivariable linear regression analysis, the mean CIMT was 0.009 mm greater in the participants with MetS than in those without MetS (β = 0.009; 95% CI, 0.003–0.014; P < 0.05). Moreover, a high number of MetS components was associated with greater CIMT values; for example, CIMT increased by 0.007 and 0.015 mm for the individuals diagnosed with 3–4 and 5 MetS components, respectively. Among the MetS components, elevated blood pressure (β = 0.022; 95% CI, 0.015–0.029; P < 0.001) and abdominal obesity (β = 0.008; 95% CI, 0.001–0.015; P < 0.001) were positively correlated with CIMT. However, the increased triglyceride levels were negatively associated with CIMT (β = −0.008; 95% CI: −0.015 to −0.002; P = 0.012), especially among the elderly population.Conclusions: The risk of carotid atherosclerosis increased in the presence of multiple MetS components in a low-income, middle-aged, and elderly population. Accordingly, more detailed management strategies are essential for the early prevention and intervention of atherosclerosis in this low-income population with MetS, in China.

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Metabolic syndrome, clustering of cardiovascular risk factors and high carotid intima–media thickness in children and adolescents

Cited by 21 publications

References 39 publications

Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Obesity, metabolic syndrome, and primary hypertension

Association of Carotid Intima Media Thickness With Metabolic Syndrome Among Low-Income Middle-Aged and Elderly Chinese: A Population-Based Cross-Sectional Study

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