Predicting Adult MetS, T2D, CV Risks in Childhood
Metabolic syndrome in adulthood can be predicted by the presence of metabolic syndrome or type 2 diabetes in childhood.
Early childhood data can be used to identify adult risk for metabolic syndrome (MetS), type 2 diabetes (T2D), and subclinical atherosclerosis, according to a study published in the Journal of the American Heart Association.
Researchers identified 5803 individuals currently participating in 1 of 4 cohort studies and followed them for a mean 22.3 years to identify the age during which childhood obesity or MetS is associated with MetS, T2D, or carotid artery intima-media thickness in adulthood. MetS was diagnosed if the individual had 3 or more of the following 5 criteria: waist circumference of ≥102 cm for men and ≥88 cm for women to define abdominal obesity; triglyceride level ≥150 mg/dL; high-density lipoprotein-cholesterol <40 mg/dL in men or <50 mg/dL in women; blood pressure ≥130/≥85 mmHg; or fasting glucose ≥100 mg/dL.
Study results showed that a diagnosis of MetS at the age of 5 in overweight children was a significant predictor of MetS in adulthood (risk ratio [RR], 2.43-3.39, 95% CI, 1.74-3.40 and 1.68-6.83, respectively). In addition, the risk for T2D was significantly increased beginning at 8 years (RR, 2.6-4.1; 95% CI, 1.35-6.76 and 1.12-7.24, respectively). Finally, the risk for carotid artery intima-media thickness increased for children between 11 and 18 years related to childhood obesity or MetS (RR, 2.44-4.22; 95% CI, 1.55-3.55 and 2.55-5.66, respectively).
Because of the ethnicity of the participants, results may not be generalizable to a wider population.
The investigators concluded that adult MetS can be predicted in children diagnosed with childhood MetS as early as the age of 5 years. However, adult T2D and subclinical atherosclerosis may only be predicted in children at or after the age of 8 to 14 years. Findings support the current pediatric recommendations for lipid screening in children between the ages of 9 and 11 and even earlier screening of fasting glucose for high risk children.
Koskinen J, Magnussen CG, Sinaiko A, et al. Childhood age and associations between childhood metabolic syndrome and adult risk for metabolic syndrome, type 2 diabetes mellitus and carotid intima media thickness: the international Childhood Cardiovascular Cohort Consortium [published online August 16, 2017]. J Am Heart Assoc. doi:10.1161/JAHA.117.005632