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Metabolic Syndrome Variables at Low Levels in Childhood Are Beneficially Associated With Adulthood Cardiovascular Risk

The Bogalusa Heart Study

Tulane Center for Cardiovascular Health, Department of Epidemiology, Tulane University Health Sciences Center, New Orleans, Louisiana

Address correspondence and reprint requests to Gerald S. Berenson, MD, Tulane Center for Cardiovascular Health, 1440 Canal St., Suite 1829, New Orleans, LA 70112. E-mail: berenson{at}tulane.edu

OBJECTIVE—Most epidemiologic studies have focused on the adverse impact of the metabolic syndrome on cardiovascular (CV) disease. However, information on the relationship between the clustering of metabolic syndrome variables at favorable levels in childhood and the measures of CV risk in adulthood is not known.

RESEARCH DESIGN AND METHODS—The study cohort included 1,474 individuals (552 blacks and 922 whites) who were examined for CV risk factors in childhood (aged 4–17 years) and again in adulthood (aged 19–41 years) in Bogalusa, Louisiana, during 1982–2003, with an average follow-up period of 15.8 years.

RESULTS—In childhood, 9.0% of the cohort displayed clustering of three- or four-criterion risk variables at the bottom quartiles of BMI, homeostasis model assessment of insulin resistance, systolic blood pressure, and total–to–HDL cholesterol ratio. The clustering was significantly higher than expected by chance alone (P < 0.01). These children, compared with those having clustering of less than three risk variables at the bottom quartiles, had a lower prevalence of metabolic syndrome in adulthood (clustering at top quartiles) (3.8 vs. 14.6%, P < 0.001). A higher prevalence of clustering of risk variables at low levels in childhood was associated with negative parental histories of coronary heart disease (9.4 vs. 5.0%, P = 0.024) and hypertension (10.5 vs. 6.6%, P = 0.012). Mean values of carotid intima-media thickness in adulthood decreased with an increasing number of risk variables clustering at the bottom quartiles in childhood (P for trend = 0.013).

CONCLUSIONS—The constellation of metabolic syndrome variables at low levels in childhood is associated with lower measures of CV risk in adulthood.

Abbreviations: CV, cardiovascular • HOMA-IR, homeostasis model assessment of insulin resistance • IMT, intima-media thickness • O/E, observed to expected prevalence • SBP, systolic blood pressure

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