Metabolic syndrome, hepatic steatosis and cardiovascular risk in children

Abstract Background Pediatric metabolic syndrome (MS) is a well-recognized entity, but there is no unanimous consensus on its exact value in predicting long-term cardiovascular risk. Hepatic steatosis (HS) is another emerging condition associated with pediatric obesity, and data have been reported suggesting a possible role of HS in cardiovascular risk linked to MS. Methods We studied 803 overweight and obese children (395 girls and 408 boys, mean age 9.4±2.5 years, BMI z-score 2.2±0.53) with complete clinical and biological assessment. MS was defined using the modified criteria of the American Heart Association. The diagnosis and severity of the HS was based on ultrasound. To assess cardiovascular risk, all patients underwent ultrasonography to measure carotid intima-media thickness (cIMT)—a validated marker of subclinical vascular disease. Results The overall prevalence of MS was 13.07%; HS was significantly higher in patients with MS (40.9% vs 18.5%; p < 0.001, OR 3.059, 95% CI 1.98-4.7). Spearman’s correlation between HS grade and the number of MS criteria met by each patient was significant (rho=0.285 p