Metabolic syndrome, hepatic steatosis, and cardiovascular risk in children

Irene Rutigliano, Roberta Vinci, Gianpaolo De Filippo, Monica Mancini, Luca Stoppino, Maria d'Apolito, Ida Giardino, Luca Macarini, Massimo Pettoello Mantovani, Angelo Campanozzi

Research output: Contribution to journalArticle

Abstract

Objectives Pediatric metabolic syndrome (MetS) is a well-recognized entity; however, there is no consensus on its exact value in predicting long-term cardiovascular (CV) risk. Hepatic steatosis (HS) is another emerging condition associated with pediatric obesity, and data have been reported suggesting a possible role of HS in CV risk linked to MetS. The aim of the present study was to evaluate the usefulness of HS and MetS cluster in predicting CV risk linked to pediatric obesity. Methods We studied 803 overweight and obese children (395 girls and 408 boys, mean age 9.4 ± 2.5 y, body mass index z-score 2.2 ± 0.53) with complete clinical and biological assessment. MetS was defined using the modified criteria of the American Heart Association. The diagnosis and severity of the HS was based on ultrasound. To assess CV risk, all patients underwent ultrasonography to measure carotid intima-media thickness (cIMT)—a validated marker of subclinical vascular disease. Results The overall prevalence of MetS was 13.07%; HS was significantly higher in patients with MetS (40.9 versus 18.5%; P < 0.001; odds ratio, 3.059; 95% confidence interval, 1.98–4.7). Spearman's correlation between HS grade and the number of MetS criteria met by each patient was significant (r = 0.285; P < 0.001). No statistical difference was recorded in cIMT and cIMT z-scores between patients with or without MetS, until inclusion of HS as an additional criterion for the diagnosis of MetS. In this case, there was a significant difference in cIMT z-scores between the two groups. In multiple linear regression analysis, the cIMT z-score value was better predicted with HS grade and the MetS cluster (adjusted R2 = 2.6%; P = 0.002) than when using the MetS cluster only. Conclusions HS could be used as additional criterion in detecting pediatric MetS phenotype at higher risk for long-term CV morbidity.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalNutrition
Volume36
DOIs
Publication statusPublished - Apr 1 2017
Externally publishedYes

Keywords

  • Cardiovascular risk
  • Children
  • Hepatic steatosis
  • Metabolic syndrome
  • Pediatric obesity

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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    Rutigliano, I., Vinci, R., De Filippo, G., Mancini, M., Stoppino, L., d'Apolito, M., Giardino, I., Macarini, L., Pettoello Mantovani, M., & Campanozzi, A. (2017). Metabolic syndrome, hepatic steatosis, and cardiovascular risk in children. Nutrition, 36, 1-7. https://doi.org/10.1016/j.nut.2016.10.017