Metabolic Syndrome in Adults With Congenital Heart Disease
Jason F Deen1, Eric V Krieger2, April E Slee3
1Division of Cardiology, Seattle Children's Hospital, University of Washington, Seattle, WA Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle, WA jason.deen@seattlechildrens.org.
Insights
Metabolic syndrome is more prevalent in adults with congenital heart disease (ACHD) than in the general population. Early screening and risk factor mitigation are crucial for preventing heart disease in ACHD patients.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Metabolic syndrome is a known risk factor for atherosclerotic coronary artery disease.
- Adults with congenital heart disease (ACHD) are living longer and accumulating cardiovascular disease risk factors.
- The prevalence of metabolic syndrome in ACHD patients remains unknown.
Purpose of the Study:
- To determine the prevalence of metabolic syndrome in adults with congenital heart disease.
- To compare the prevalence of metabolic syndrome in ACHD patients versus a matched general population control group.
Main Methods:
- Retrospective cohort study design.
- Case-control matching of 448 ACHD patients with 448 controls from a population-based sample.
- International Diabetes Federation criteria used to define metabolic syndrome.
- Logistic regression analysis to compare metabolic syndrome risk.
Main Results:
- No significant difference in obesity prevalence between ACHD patients (16.1%) and controls (16.7%).
- Metabolic syndrome was significantly more common in ACHD patients (15.0%) compared to controls (7.4%).
- Odds ratio for metabolic syndrome in ACHD patients was 1.82 (95% CI 1.25-2.65).
Conclusions:
- Metabolic syndrome is more prevalent in adults with congenital heart disease than in the general population.
- Routine screening for metabolic syndrome in ACHD patients is recommended.
- Risk factor mitigation and preventive cardiology are essential for managing atherosclerotic coronary artery disease risk in ACHD.
Background:
Metabolic syndrome increases risk for atherosclerotic coronary artery disease, and its prevalence increases with increasing age and body mass index. Adults with congenital heart disease (ACHD) are now living longer and accruing coronary artery disease risk factors. However, the prevalence of metabolic syndrome in ACHD patients is unknown.
Methods And Results:
We conducted a retrospective cohort study of ACHD patients at our center to quantify the prevalence of metabolic syndrome in an ACHD population. Using case-control matching, we constructed a comparable control group from a population-based sample of 150 104 adults. International Diabetes Federation criteria were used to define metabolic syndrome. We used logistic regression to compare the risk of metabolic syndrome across the resulting cohorts, which were composed of 448 ACHD patients and 448 controls matched by age and sex. Mean age of both groups was 32.4±11.3 years, and 51.3% were female. Obesity was present in 16.1% of the ACHD patients and 16.7% of the controls. Metabolic syndrome was more common in ACHD patients than in controls (15.0% versus 7.4%; odds ratio 1.82, 95% CI 1.25-2.65).
Conclusions:
Our data suggest that metabolic syndrome is more common among adults with congenital heart disease than in the general population. Thus, patients with congenital heart disease should be screened for metabolic syndrome and risk factors mitigated where possible to prevent atherosclerotic coronary artery disease. Preventive cardiology should be included during routine ACHD care.
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