Association of childhood metabolic syndrome and metabolic phenotypes with the carotid intima-media thickness (CIMT) in early adulthood: Tehran lipid and glucose study

• Published in: International journal of cardiology 2022-02, Vol.348, p.128-133
• Main Authors: Valizadeh, Majid, Tasdighi, Erfan, Barzin, Maryam, Hariri, Ramyar, Mahdavi, Maryam, Dehghan, Pooneh, Momeni Moghaddam, Amin, Azizi, Fereidoun, Hosseinpanah, Farhad
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Adult; Atherosclerosis; Carotid Intima-Media Thickness; Child; Cohort Studies; Female; Glucose; Humans; Iran - epidemiology; Lipids; Male; Metabolic syndrome; Metabolic Syndrome - diagnostic imaging; Metabolic Syndrome - epidemiology; Obesity; Phenotype; Risk Factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2021.12.010

The clinical significance of metabolic syndrome (MetS) during adolescence and its association with adulthood adverse outcomes is a controversial issue. This study aimed to investigate the association of MetS and metabolic phenotypes with a high carotid intima-media thickness (CIMT) in early adulthood. MetS was defined as proposed by Cook, de Ferranti, the National Cholesterol Education Program (NCEP), and the pediatric International Diabetes Federation (IDF). Metabolic phenotypes were defined based on the binary clustering of cardiovascular risk factors. The participants were adolescent's individual selected from a large cohort study and followed for 18.2 years. Multivariate-adjusted odds ratios (ORs) were calculated for a high CIMT incidence (≥95th percentile). In this study, 862 adolescents (52.3% males), with the mean age of 13.4 ± 2.2 years, were included. The presence of MetS, based on the definitions proposed by Cook (OR = 1.90, 95% CI: 1.01–3.57, P = 0.046) and de Ferranti (OR = 1.74; 95% CI: 1.04–2.90, P = 0.033), was associated with the increased risk of a high CIMT in early adulthood. Metabolic phenotypes, including high waist circumference (WC)/hypertension (HTN), high WC/low high-density lipoprotein-cholesterol (HDL-C), and high triglyceride (TG)/high WC, showed higher risks of a high CIMT. However, these positive associations become insignificant after adjusting for the adulthood BMI, except for the high WC/low HDL-C phenotype (OR = 2.04, 95% CI: 1.02–4.11, P = 0.044). The high WC/low HDL-C phenotype had a better predictive value and could be used as a simpler alternative for MetS to identify adolescents with a higher risk of high CIMT during early adulthood. •Identification of individuals with metabolic syndrome (MetS) is relatively more difficult in adolescents than adults. Previous studies have suggested a marked instability in the diagnosis of MetS among adolescents.•Puberty stage has a significant effect on insulin resistance and the prevalence of MetS components.•Adulthood body mass index (BMI) has a confounding effect on the association of pediatric MetS with cardiovascular outcomes in early adulthood.•It has been reported that specific combinations of metabolic phenotypes confer greater risks, especially among adolescents, and undermine the equal value of MetS components based on traditional definitions.•The carotid intima-media thickness (CIMT) is a non-invasive, sensitive, and repeatable technique for the diagnosis and evaluation of