Abstract P153: Is a Continuous Metabolic Syndrome Score a Better Predictor of Vascular Damage in Youth?
Obesity-related co-morbidities are increasing in adults and in adolescents. Although metabolic syndrome-like clustering of CV risk factors is known to be associated with target organ damage (TOD), how to define metabolic syndrome in young subjects is controversial. Gurka, et al used factor analysis of NHANES data to develop a new sex- and race/ethnicity-specific continuous metabolic syndrome score for adolescents. We compared the utility of this score (G) to the adult ATP and WHO definition in predicting presence of TOD in adolescents and young adults evaluated in a study of the CV effects of T2DM (N=779 age 17.9 + 3.3 yrs, 35% male, 59% non-Caucasian, 1/3 Lean, 1/3 Obese, 1/3 T2DM). Anthropometry, BP, fasting glucose, insulin, lipids, CRP, Brachial Distensibility (BrachD, PulseMetric device), Pulse Wave Velocity & Augmentation Index (PWV, AIx, SphygmoCor device), and carotid intima-media thickness (IMT) were obtained. Subjects were classified as MS+ or - based on ATP and WHO definitions and on a cut point of 0.75 as suggested by Gurka. Prevalence of MS was highest for G (43%) with similar prevalence for ATP (28.2%) and WHO (26.2%) by McNemar test. Adiposity was the major contributor to classification of subjects as MS+, with insulin/glucose the second contributor, then BP and lipids regardless of MS definition used. G as a continuous variable explained more of the variance in all TOD measures than ATP or WHO. Receiver operator characteristic curve analysis determined that a G cutpoint of near 1 had the best sensitivity and specificity for predicting abnormal arterial stiffness and thickness. We conclude that the continuous G score maybe superior to ATP and WHO in predicting TOD as it allows for assessment of severity of risk factor clustering not possible with dichotomous definitions. A continuous metabolic syndrome score near 1 may be a useful screening tool to identify youth at risk for TOD.
Author Disclosures: E. Urbina: B. Research Grant; Modest; 8 UL1 TR000077-04. B. Research Grant; Significant; R01 HL105591. Z. Gao: None. P. Khoury: None. C. McCoy: None. L. Dolan: B. Research Grant; Modest; R01 HL105591. T. Kimball: B. Research Grant; Modest; R01 HL105591.
- © 2015 by American Heart Association, Inc.