Prevalence of metabolic syndrome and cardiovascular disease risk factors in adults with cerebral palsy

Abstract

Aim To investigate the prevalence of metabolic syndrome and cardiovascular disease (CVD) risk factors and the association between common metabolic markers and Gross Motor Function Classification System (GMFCS) levels in ambulatory adults with cerebral palsy (CP). Method Metabolic markers and GMFCS levels were evaluated in a cross‐sectional study of 70 ambulatory adults with CP (34 males, 36 females; mean age 24y 5mo [SD 5y 4mo], range 18y 6mo–48y 8mo) to determine the prevalence of metabolic syndrome and CVD risk factors, and were compared to age‐matched, population norms from the National Health and Nutrition Examination Survey (NHANES) registry. The Framingham Heart Study (FHS) CVD risk estimation was also used to evaluate an individual's risk for CVD. Results Metabolic syndrome was identified in 17.1% of the cohort, higher than the 10% in the NHANES registry. The FHS CVD 30‐year lipid and body mass index (BMI)‐based risk factor results showed that 20% to 40% of the cohort was at greater risk of developing CVD (BMI‐based: 39.7% ‘full’ CVD risk factor; lipid‐based: 26.5% ‘full’ CVD risk factor) as compared to the FHS normative population data. There was a positive correlation between GMFCS level, waist circumference (r=0.28, p=0.02), and waist‐to‐hip ratio (r=0.28, p=0.02). Interpretation Adults with CP are at higher risk of CVD and metabolic syndrome compared to the general population, which is probably because of impaired mobility. What this paper adds Gross Motor Function Classification System levels can predict cardiovascular disease (CVD) risk factors in adults with cerebral palsy (CP). Anthropometric measures are significant in predicting CVD risk factors in adults with CP. Early CVD screening and ongoing risk factor monitoring are important in adults with CP.

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

“…According to Pontén et al ( 2 ) and Sarcher et al ( 3 ), contractions in the upper limbs of individuals with CP start early and require adequate intervention and special attention to provide increases in (or maintenance of) range of movement, better performance and physical activity (especially for the ones with less global mobility), improving the performance of the functions of daily life, increasing independence, activities, and participation ( 4 ). Likewise, there is growing evidence of the higher prevalence of metabolic syndrome, cardiovascular disease risk factors, and autonomic nervous system (ANS) dysfunctions in adults with CP ( 5 ). According to Katz-Leurer and Amichai ( 6 ), because of the sedentary behaviour that results from their limited mobility (i.e., the more limited the mobility, the less activity), individuals with CP are more disposed to chronic disorders such as heart conditions and hypertension.…”

Cardiovascular disease in cerebral palsy: shifting our focus from attention to prevention

“…Two patients died; a third developed a central nervous system Epstein-Barr virus (EBV)-associated B-cell lymphoma. The authors suggest that while three cases fulfilled the suggested diagnostic criteria for CLIPPERS, 3 the specific vulnerability of the developing brain during disease onset cause a more severe phenotype of CLIPPERS in pediatric cases.…”

“…Until then, we must direct our attention to screening and preventing CVD in this population. Indeed, the authors of both studies comment on the importance of developing appropriate techniques to measure CVD risk and risk factor cut‐offs specific to this population. Findings from these studies and others could direct clinicians to screen for risk factors such as obesity and hypertension using waist circumference and blood pressure measures, respectively.…”

“…I commend the authors of both studies for underscoring cardiometabolic and CVD risk in adults with CP. Clearly, we cannot prevent someone with CP from aging, but we can promote healthy aging in a population that is at risk for CVD.…”

“…Individuals with cerebral palsy (CP) are at increased risk of CVD, in part due to musculoskeletal problems impeding physical activity participation that are secondary to the non‐progressive disturbance to the developing infant brain. Two observational studies examine the prevalence of CVD risk factors and age‐related trends in cardiometabolic disease among adults with CP . Peterson et al .…”