Background: Lipid assessment is emerging as a useful and easy detectable tool to define the overall cardiovascular risk in children and adolescents. Nevertheless, no all dyslipidemic patients suffer the same cardiometabolic consequences.
Objective and hypotheses: To compare anthropometric, biochemical and blood pressure variables among dyslipidemic children and adolescents according to the presence of metabolic syndrome (MetS).
Method: 700 dyslipidemic children and adolescents (median age 9.75, range 2.0017.50 years) referred to our endocrine outpatient clinic were screened for MetS according to Weiss definition. Anthropometric parameters (BMI-SDS and waist-to-height ratio (WHeR)), systolic blood pressure (SBP), lipid profile including LDL/HDL and TC/HDL ratios, fasting glycaemia (G), insulin (Ins), G/Ins ratio (GInsR) and HOMA index were collected for all the enrolled patients.
Results: Among dyslipidemic patients, the prevalence of MetS was 8.71% (61/700). Children and adolescents with MetS presented higher BMI-SDS and WHeR than no-MetS patients (BMI-SDS 2.34±0.32 vs 1.29±1.35, P<0.00; WHeR 0.62±0.05 vs 0.58±0.05, P<0.00). In MetS, level of TG (150.11±66.43 vs 90.25±55.42 mg/dl, P<0.00), TC/HDL (4.62±1.43 vs 3.69±1.18) and LDL/HDL (2.93±1.12 vs 2.34±0.98) ratios were higher and HDL-cholesterol levels were lower (39.80±13.92 vs 53.04±13.66, P<0.00) than no-MetS. Glucidic metabolism was more altered in MetS than no-MetS (GInsR 6.63±7.04 vs 9.84±8.70, P<0.00; HOMA index 4.94±4.23 vs 2.86±1.82, P<0.00). High SBP values defining hypertension were found in 74% MetS and in 22.5% no-MetS. Among all dyslipidemic children, TG levels together with GInsR and HOMA index were identified as independent predictive factors for MetS.
Conclusion: In our outpatient setting of dyslipidemic children, the finding of high TG and low HDL levels helps in discriminating patients with MetS, especially when associated with increased BMI-SDS, insulin resistance and high SBP. Our data highlight the presence of a cluster of conditions that concurrently increased the cardiovascular risk already in childhood and, therefore, that had to be globally investigated.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology