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 s...
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| Veröffentlicht in: | Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2017-04, Vol.36, p.1-7 |
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| creator | Rutigliano, Irene, MD Vinci, Roberta, MD De Filippo, Gianpaolo, MD Mancini, Monica, MD Stoppino, Luca, MD d’Apolito, Maria, PhD Giardino, Ida, MD Macarini, Luca, MD Pettoello Mantovani, Massimo, MD Campanozzi, Angelo, MD |
| description | 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 |
| doi_str_mv | 10.1016/j.nut.2016.10.017 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1881762637</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0899900716302507</els_id><sourcerecordid>1881762637</sourcerecordid><originalsourceid>FETCH-LOGICAL-c469t-c5018278e76f3cbd437bf82a76dad8b4e11a51494541c4373c1ab81982fb2cfe3</originalsourceid><addsrcrecordid>eNqNkk-LFDEQxYMo7rj6AbxIgxcP9phK0kkaQZDFPwsrHtRzSCfVbGZ7kjHpXphvb5pZFfYgnpJUfu9B1StCngPdAgX5ZreNy7xl9VrfWwrqAdmAVrwFJsRDsqG679ueUnVGnpSyo5RCL_vH5IxpzmW12JDLLzjbIU3BNeUYfU57fN1c48HOa2VGO6cSSmOjb5zNPqRbW9wy2dzkUG6aEBt3HSafMT4lj0Y7FXx2d56THx8_fL_43F59_XR58f6qdUL2c-s6CpopjUqO3A1ecDWMmlklvfV6EAhgOxC96AS4-skd2EFDr9k4MDciPyevTr6HnH4uWGazD8XhNNmIaSkGtAYlmazS_0GZ7IToK_ryHrpLS461kZUSjHcdQKXgRLmcSsk4mkMOe5uPBqhZIzE7UyMxayRrqUZSNS_unJdhj_6P4ncGFXh7ArBO7TZgNsUFjA59yOhm41P4p_27e2o3hRicnW7wiOVvF6YwQ823dSfWlQDJKeuo4r8AocmvoQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1884235511</pqid></control><display><type>article</type><title>Metabolic syndrome, hepatic steatosis and cardiovascular risk in children</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Rutigliano, Irene, MD ; Vinci, Roberta, MD ; De Filippo, Gianpaolo, MD ; Mancini, Monica, MD ; Stoppino, Luca, MD ; d’Apolito, Maria, PhD ; Giardino, Ida, MD ; Macarini, Luca, MD ; Pettoello Mantovani, Massimo, MD ; Campanozzi, Angelo, MD</creator><creatorcontrib>Rutigliano, Irene, MD ; Vinci, Roberta, MD ; De Filippo, Gianpaolo, MD ; Mancini, Monica, MD ; Stoppino, Luca, MD ; d’Apolito, Maria, PhD ; Giardino, Ida, MD ; Macarini, Luca, MD ; Pettoello Mantovani, Massimo, MD ; Campanozzi, Angelo, MD</creatorcontrib><description>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<0.001). No statistical difference was recorded in cIMT and cIMT z-scores between patients with or without MS, until inclusion of HS as additional criterion for the diagnosis of MS. In this case there was a significant difference in cIMT z-score between the two groups. In multiple linear regression analysis, the cIMT z-score value was better predicted with HS grade and MS cluster (adjusted R2 2.6%, p =0.002), than using the MS cluster only. Conclusions HS could be used as additional criterion in detecting pediatric MS phenotype at higher risk for long-term cardiovascular morbidity.</description><identifier>ISSN: 0899-9007</identifier><identifier>EISSN: 1873-1244</identifier><identifier>DOI: 10.1016/j.nut.2016.10.017</identifier><identifier>PMID: 28336101</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Alanine Transaminase - blood ; Aspartate Aminotransferases - blood ; Biomarkers - blood ; Blood Glucose - metabolism ; Blood pressure ; Body mass ; Body Mass Index ; Body weight ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular risk ; Carotid arteries ; Child ; Child, Preschool ; Children ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Chronic illnesses ; Cluster Analysis ; Clusters ; Confidence intervals ; Criteria ; Diagnosis ; Fatty liver ; Fatty Liver - epidemiology ; Fatty Liver - etiology ; Female ; Gastroenterology and Hepatology ; Girls ; Glucose ; Health risks ; Heart ; Hepatic steatosis ; Hepatology ; Histology ; Humans ; Linear Models ; Liver ; Liver diseases ; Male ; Metabolic disorders ; Metabolic syndrome ; Metabolic Syndrome - epidemiology ; Metabolic Syndrome - etiology ; Morbidity ; Obesity ; Overweight ; Overweight - complications ; Overweight - epidemiology ; Patients ; Pediatric obesity ; Pediatric Obesity - complications ; Pediatric Obesity - epidemiology ; Pediatrics ; Prevalence ; Quality ; Regression analysis ; Risk Factors ; Steatosis ; Teenagers ; Triglycerides - blood ; Ultrasound ; Vascular diseases</subject><ispartof>Nutrition (Burbank, Los Angeles County, Calif.), 2017-04, Vol.36, p.1-7</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-c5018278e76f3cbd437bf82a76dad8b4e11a51494541c4373c1ab81982fb2cfe3</citedby><cites>FETCH-LOGICAL-c469t-c5018278e76f3cbd437bf82a76dad8b4e11a51494541c4373c1ab81982fb2cfe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0899900716302507$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28336101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rutigliano, Irene, MD</creatorcontrib><creatorcontrib>Vinci, Roberta, MD</creatorcontrib><creatorcontrib>De Filippo, Gianpaolo, MD</creatorcontrib><creatorcontrib>Mancini, Monica, MD</creatorcontrib><creatorcontrib>Stoppino, Luca, MD</creatorcontrib><creatorcontrib>d’Apolito, Maria, PhD</creatorcontrib><creatorcontrib>Giardino, Ida, MD</creatorcontrib><creatorcontrib>Macarini, Luca, MD</creatorcontrib><creatorcontrib>Pettoello Mantovani, Massimo, MD</creatorcontrib><creatorcontrib>Campanozzi, Angelo, MD</creatorcontrib><title>Metabolic syndrome, hepatic steatosis and cardiovascular risk in children</title><title>Nutrition (Burbank, Los Angeles County, Calif.)</title><addtitle>Nutrition</addtitle><description>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<0.001). No statistical difference was recorded in cIMT and cIMT z-scores between patients with or without MS, until inclusion of HS as additional criterion for the diagnosis of MS. In this case there was a significant difference in cIMT z-score between the two groups. In multiple linear regression analysis, the cIMT z-score value was better predicted with HS grade and MS cluster (adjusted R2 2.6%, p =0.002), than using the MS cluster only. Conclusions HS could be used as additional criterion in detecting pediatric MS phenotype at higher risk for long-term cardiovascular morbidity.</description><subject>Adolescent</subject><subject>Alanine Transaminase - blood</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - metabolism</subject><subject>Blood pressure</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body weight</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular risk</subject><subject>Carotid arteries</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cholesterol, HDL - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Chronic illnesses</subject><subject>Cluster Analysis</subject><subject>Clusters</subject><subject>Confidence intervals</subject><subject>Criteria</subject><subject>Diagnosis</subject><subject>Fatty liver</subject><subject>Fatty Liver - epidemiology</subject><subject>Fatty Liver - etiology</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Girls</subject><subject>Glucose</subject><subject>Health risks</subject><subject>Heart</subject><subject>Hepatic steatosis</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Metabolic disorders</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic Syndrome - etiology</subject><subject>Morbidity</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Overweight - complications</subject><subject>Overweight - epidemiology</subject><subject>Patients</subject><subject>Pediatric obesity</subject><subject>Pediatric Obesity - complications</subject><subject>Pediatric Obesity - epidemiology</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Quality</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Steatosis</subject><subject>Teenagers</subject><subject>Triglycerides - blood</subject><subject>Ultrasound</subject><subject>Vascular diseases</subject><issn>0899-9007</issn><issn>1873-1244</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk-LFDEQxYMo7rj6AbxIgxcP9phK0kkaQZDFPwsrHtRzSCfVbGZ7kjHpXphvb5pZFfYgnpJUfu9B1StCngPdAgX5ZreNy7xl9VrfWwrqAdmAVrwFJsRDsqG679ueUnVGnpSyo5RCL_vH5IxpzmW12JDLLzjbIU3BNeUYfU57fN1c48HOa2VGO6cSSmOjb5zNPqRbW9wy2dzkUG6aEBt3HSafMT4lj0Y7FXx2d56THx8_fL_43F59_XR58f6qdUL2c-s6CpopjUqO3A1ecDWMmlklvfV6EAhgOxC96AS4-skd2EFDr9k4MDciPyevTr6HnH4uWGazD8XhNNmIaSkGtAYlmazS_0GZ7IToK_ryHrpLS461kZUSjHcdQKXgRLmcSsk4mkMOe5uPBqhZIzE7UyMxayRrqUZSNS_unJdhj_6P4ncGFXh7ArBO7TZgNsUFjA59yOhm41P4p_27e2o3hRicnW7wiOVvF6YwQ823dSfWlQDJKeuo4r8AocmvoQ</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Rutigliano, Irene, MD</creator><creator>Vinci, Roberta, MD</creator><creator>De Filippo, Gianpaolo, MD</creator><creator>Mancini, Monica, MD</creator><creator>Stoppino, Luca, MD</creator><creator>d’Apolito, Maria, PhD</creator><creator>Giardino, Ida, MD</creator><creator>Macarini, Luca, MD</creator><creator>Pettoello Mantovani, Massimo, MD</creator><creator>Campanozzi, Angelo, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Metabolic syndrome, hepatic steatosis and cardiovascular risk in children</title><author>Rutigliano, Irene, MD ; Vinci, Roberta, MD ; De Filippo, Gianpaolo, MD ; Mancini, Monica, MD ; Stoppino, Luca, MD ; d’Apolito, Maria, PhD ; Giardino, Ida, MD ; Macarini, Luca, MD ; Pettoello Mantovani, Massimo, MD ; Campanozzi, Angelo, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-c5018278e76f3cbd437bf82a76dad8b4e11a51494541c4373c1ab81982fb2cfe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Alanine Transaminase - blood</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - metabolism</topic><topic>Blood pressure</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body weight</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular risk</topic><topic>Carotid arteries</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cholesterol, HDL - blood</topic><topic>Cholesterol, LDL - blood</topic><topic>Chronic illnesses</topic><topic>Cluster Analysis</topic><topic>Clusters</topic><topic>Confidence intervals</topic><topic>Criteria</topic><topic>Diagnosis</topic><topic>Fatty liver</topic><topic>Fatty Liver - epidemiology</topic><topic>Fatty Liver - etiology</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Girls</topic><topic>Glucose</topic><topic>Health risks</topic><topic>Heart</topic><topic>Hepatic steatosis</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Male</topic><topic>Metabolic disorders</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Metabolic Syndrome - etiology</topic><topic>Morbidity</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Overweight - complications</topic><topic>Overweight - epidemiology</topic><topic>Patients</topic><topic>Pediatric obesity</topic><topic>Pediatric Obesity - complications</topic><topic>Pediatric Obesity - epidemiology</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Quality</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Steatosis</topic><topic>Teenagers</topic><topic>Triglycerides - blood</topic><topic>Ultrasound</topic><topic>Vascular diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rutigliano, Irene, MD</creatorcontrib><creatorcontrib>Vinci, Roberta, MD</creatorcontrib><creatorcontrib>De Filippo, Gianpaolo, MD</creatorcontrib><creatorcontrib>Mancini, Monica, MD</creatorcontrib><creatorcontrib>Stoppino, Luca, MD</creatorcontrib><creatorcontrib>d’Apolito, Maria, PhD</creatorcontrib><creatorcontrib>Giardino, Ida, MD</creatorcontrib><creatorcontrib>Macarini, Luca, MD</creatorcontrib><creatorcontrib>Pettoello Mantovani, Massimo, MD</creatorcontrib><creatorcontrib>Campanozzi, Angelo, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition (Burbank, Los Angeles County, Calif.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rutigliano, Irene, MD</au><au>Vinci, Roberta, MD</au><au>De Filippo, Gianpaolo, MD</au><au>Mancini, Monica, MD</au><au>Stoppino, Luca, MD</au><au>d’Apolito, Maria, PhD</au><au>Giardino, Ida, MD</au><au>Macarini, Luca, MD</au><au>Pettoello Mantovani, Massimo, MD</au><au>Campanozzi, Angelo, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic syndrome, hepatic steatosis and cardiovascular risk in children</atitle><jtitle>Nutrition (Burbank, Los Angeles County, Calif.)</jtitle><addtitle>Nutrition</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>36</volume><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>0899-9007</issn><eissn>1873-1244</eissn><abstract>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<0.001). No statistical difference was recorded in cIMT and cIMT z-scores between patients with or without MS, until inclusion of HS as additional criterion for the diagnosis of MS. In this case there was a significant difference in cIMT z-score between the two groups. In multiple linear regression analysis, the cIMT z-score value was better predicted with HS grade and MS cluster (adjusted R2 2.6%, p =0.002), than using the MS cluster only. Conclusions HS could be used as additional criterion in detecting pediatric MS phenotype at higher risk for long-term cardiovascular morbidity.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28336101</pmid><doi>10.1016/j.nut.2016.10.017</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Alanine Transaminase - blood Aspartate Aminotransferases - blood Biomarkers - blood Blood Glucose - metabolism Blood pressure Body mass Body Mass Index Body weight Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cardiovascular risk Carotid arteries Child Child, Preschool Children Cholesterol, HDL - blood Cholesterol, LDL - blood Chronic illnesses Cluster Analysis Clusters Confidence intervals Criteria Diagnosis Fatty liver Fatty Liver - epidemiology Fatty Liver - etiology Female Gastroenterology and Hepatology Girls Glucose Health risks Heart Hepatic steatosis Hepatology Histology Humans Linear Models Liver Liver diseases Male Metabolic disorders Metabolic syndrome Metabolic Syndrome - epidemiology Metabolic Syndrome - etiology Morbidity Obesity Overweight Overweight - complications Overweight - epidemiology Patients Pediatric obesity Pediatric Obesity - complications Pediatric Obesity - epidemiology Pediatrics Prevalence Quality Regression analysis Risk Factors Steatosis Teenagers Triglycerides - blood Ultrasound Vascular diseases |
| title | Metabolic syndrome, hepatic steatosis and cardiovascular risk in children |
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