[Subclinical atheroesclerosis and metabolic syndrome in children]

Area of Science:

• Pediatrics
• Cardiovascular Health
• Metabolic Disorders

Background:

• Metabolic syndrome (MS) in children is associated with subclinical atherosclerosis, measured by carotid intima-media thickness (CIMT).
• Understanding risk factors for CIMT in pediatric populations is crucial for early cardiovascular disease prevention.

Purpose of the Study:

• To determine the influence of metabolic syndrome (MS), insulin resistance (IR), and nutritional status on CIMT in children.
• To identify risk percentiles associated with increased CIMT.

Main Methods:

• A cross-sectional study of 447 school children in Santiago, Chile (2009-2011) with components of MS or IR.
• Assessment included anthropometry, blood pressure (BP), blood samples for glucose, insulin, lipids, and high-resolution ultrasonography for CIMT.
• Statistical analyses included correlation, t-tests, Chi-squared, and logistic regression.

Main Results:

• The study included 447 children (mean age 11.5 years, 59% girls), with 72% overweight, 24% having MS, and 15% with IR.
• Children with CIMT in the top 25% (≥ percentile 75) were more likely to have elevated systolic or diastolic blood pressure (BP ≥ percentile 90) and low high-density lipoprotein cholesterol (CHDL ≤ 40 mg/dL).
• Logistic regression identified BP ≥ percentile 90 and CHDL ≤ 40 mg/dL as independent predictors for CIMT ≥ percentile 75.

Conclusions:

• Elevated blood pressure (BP ≥ percentile 90) and low HDL cholesterol (CHDL ≤ 40 mg/dL) are associated with increased carotid intima-media thickness (CIMT ≥ percentile 75) in this pediatric cohort.
• Insulin resistance and nutritional status were not found to be independent predictors of CIMT in this study.
• These findings highlight specific cardiovascular risk factors in children that may warrant targeted interventions.