The Journal of Pediatrics
Volume 148, Issue 2 , Pages 176-182, February 2006

Nontraditional cardiovascular risk factors in pediatric metabolic syndrome

From the Division of Endocrinology, the Department of Medicine, and the Department of Laboratory Medicine and Pathobiology, University of Toronto, the Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, the J. Alick Little Lipid Research Laboratory, St. Michael’s Hospital, Toronto, and the Centre for Studies in Family Medicine, University of Western Ontario, London, Ontario, Canada

Received 19 May 2005; received in revised form 19 July 2005; accepted 1 August 2005.

Objective

To study the relationships between nontraditional cardiovascular (CV) risk factors and components of the metabolic syndrome in Native Canadian children, a population at risk of future CV disease.

Study design

CV risk factors were evaluated in a population-based study of a Canadian Oji-Cree community, involving 236 children aged 10 to 19 years.

Results

Using an age- and sex-specific case definition, 18.6% of the children met criteria for pediatric metabolic syndrome. As the number of metabolic syndrome component criteria increased, C-reactive protein, leptin, and ratio of apolipoprotein B to apolipoprotein A1 levels rose (all P < .0001) and adiponectin concentration decreased (P = .0006). Principal factor analysis using both traditional and nontraditional CV risk factors revealed 5 underlying core traits, defined as follows: adiposity, lipids/adiponectin, inflammation, blood pressure, and glucose.

Conclusions

Nontraditional CV risk factors accompany the accrual of traditional risk factors early in the progression to pediatric metabolic syndrome. Furthermore, inclusion of these factors in factor analysis suggests that 5 core traits underlie the early development of an enhanced CV risk factor profile in Native children.

ANOVA, Analysis of variance , apoB:A1, Ratio of apolipoprotein B to apolipoprotein A1 , BMI, Body mass index , CRP, C-reactive protein , CV, Cardiovascular , CVD, Cardiovascular disease , DM, Diabetes mellitus , HDL, High-density lipoprotein , HOMA-IR, Homeostasis model assessment index , IL-6, Interleukin-6 , LDL, Low-density lipoprotein , NHANES-III, Third National Health and Nutritional Survey , SAA, Serum amyloid A

 

 Supported by grants from the National Institutes of Health (91-DK-01 and 1-R21-DK-44597-01), the Ontario Ministry of Health (no. 04307) and the Canadian Institutes of Health Research (CIHR).

PII: S0022-3476(05)00770-5

doi:10.1016/j.jpeds.2005.08.025

Refers to article:

  • Pediatric metabolic syndrome: Smoke and mirrors or true magic?

    Elizabeth Goodman
    The Journal of Pediatrics February 2006 (Vol. 148, Issue 2, Pages 149-151)

The Journal of Pediatrics
Volume 148, Issue 2 , Pages 176-182, February 2006