Childhood metabolic syndrome, inflammation and carotid intima-media thickness. The Aboriginal Birth Cohort Study

Markus Juonala; Gurmeet R Singh; Belinda Davison; Katherine van Schilfgaarde; Michael R Skilton; Matthew A Sabin; Michael Cheung; Susan Sayers; David P Burgner

doi:10.1016/j.ijcard.2015.10.073

Childhood metabolic syndrome, inflammation and carotid intima-media thickness. The Aboriginal Birth Cohort Study

Int J Cardiol. 2016 Jan 15:203:32-6. doi: 10.1016/j.ijcard.2015.10.073. Epub 2015 Oct 20.

Authors

Markus Juonala¹, Gurmeet R Singh², Belinda Davison³, Katherine van Schilfgaarde⁴, Michael R Skilton⁵, Matthew A Sabin⁶, Michael Cheung⁶, Susan Sayers³, David P Burgner⁷

Affiliations

¹ Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: markus.juonala@utu.fi.
² Northern Territory Medical Program, Flinders University, Darwin, Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
³ Northern Territory Medical Program, Flinders University, Darwin, Australia.
⁴ The Royal Children's Hospital, Melbourne, Australia.
⁵ Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia.
⁶ Murdoch Childrens Research Institute, Melbourne, Australia; The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
⁷ Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.

PMID: 26492305
DOI: 10.1016/j.ijcard.2015.10.073

Abstract

Background/objectives: We evaluated whether atherosclerotic changes associated with MetS in Australian Aboriginals are reversible in childhood. In addition, we investigated whether heightened inflammation is mediating the adverse effects of MetS.

Methods: The study cohort comprised of 351 children from the Aboriginal Birth Cohort Study (a longitudinal study based in the Northern Territory of Australia) aged 9-13 years at baseline examination who were followed up 6 years later. MetS was defined by at least three of the following parameters within the extreme sex- and age-specific quartile: highest quartile for waist circumference, blood pressure, triglycerides, and glucose, and lowest quartile for HDL-cholesterol. Carotid intima-media thickness (IMT) and C-reactive protein (CRP) were assessed at follow-up.

Results: Individuals with MetS at baseline or follow-up had increased carotid IMT at follow-up (mean ± SEM 539 ± 3 vs. 561 ± 8 μm, P=0.007; and 537 ± 3 vs. 567 ± 8 μm, P<0.0001 respectively). In combined analyses from baseline and follow-up studies, those individuals with MetS only at baseline had partially improved vascular status; their IMT was not significantly increased compared to those without MetS at both time-points (534 ± 3 vs. 550 ± 10 μm, P=0.09). At the follow-up examination, MetS status was associated with increased IMT levels only among individuals with CRP levels above the median (≥ 2.1mg/l) (536 ± 5 vs. 573 ± 9 μm, P<0.0001, P for interaction 0.01).

Conclusions: MetS in childhood is associated with subclinical atherosclerosis in an Australian Aboriginal population and the effects appear to be mediated by increased inflammation. The extent of atherosclerosis was partially reduced if metabolic status improved during the follow-up.

Keywords: Childhood; Indigenous; Inflammation; Intima-media thickness; Metabolic syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Carotid Intima-Media Thickness*
Child
Cohort Studies
Cross-Sectional Studies
Female
Humans
Inflammation / complications*
Longitudinal Studies
Male
Metabolic Syndrome / complications*
Native Hawaiian or Other Pacific Islander*