Evaluation of ethnic differences in cardiometabolic risk in children

Maria G Tinajero; Charles Dg Keown-Stoneman; Laura Anderson; Jonathon L Maguire; Anthony J Hanley; John L Sievenpiper; Kassia Johnson; Catherine Birken; Vasanti S Malik

doi:10.1016/j.annepidem.2023.05.014

Evaluation of ethnic differences in cardiometabolic risk in children

Ann Epidemiol. 2023 Sep:85:121-126.e7. doi: 10.1016/j.annepidem.2023.05.014. Epub 2023 Jun 8.

Authors

Maria G Tinajero¹, Charles Dg Keown-Stoneman², Laura Anderson³, Jonathon L Maguire⁴, Anthony J Hanley⁵, John L Sievenpiper⁶, Kassia Johnson⁷, Catherine Birken⁸, Vasanti S Malik⁹

Affiliations

¹ University Health Network Biospecimen Services, University Health Network, Toronto, ON, Canada.
² Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
³ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON,Canada.
⁶ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON,Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁷ Faculty of Health Sciences, McMaster University, Department of Pediatrics, Hamilton Health Sciences, Hamilton, ON, Canada.
⁸ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁹ Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. Electronic address: vasanti.malik@utoronto.ca.

PMID: 37295761
DOI: 10.1016/j.annepidem.2023.05.014

Abstract

Purpose: In adults, cardiometabolic conditions manifest differently by ethnicity with South Asians particularly predisposed. Whether these differences arise in childhood remains narrowly explored. To address this evidence gap, we examined whether children of different ethnicities display differences in cardiometabolic risk (CMR).

Methods: A cross-sectional analysis was conducted among 5557 children (3-11 years). Multivariable linear regression models adjusted for age, sex, z-body mass index, and demographic factors were used to estimate differences in CMR outcomes between children with parents that self-reported European ancestry (reference group) and one of 13 other ethnicities (African, Arab, East Asian, Latin American, South Asian, Southeast Asian, Mixed Ethnicities, and Other). The primary outcome was a CMR score, calculated as the sum of age- and sex-standardized waist circumference, systolic blood pressure (SBP), glucose, log-triglycerides, and inverse high-density lipoprotein cholesterol (HDL-C), divided by √5.

Results: Lower mean CMR scores were observed among children with African (β = -0.62, 95% CI: -0.92; -0.32) and East Asian (β = -0.41, 95% CI: -0.68, -0.15) ancestry compared to children with European ancestry. Children with South Asian ancestry had higher SBP (β = 2.25, 95% CI: 1.27, 3.22) and non-HDL-C (β = 0.17, 95% CI: 0.07, 0.26) than children with European ancestry.

Conclusions: Ethnic differences in CMR were observed in early and middle childhood.

Keywords: Blood pressure; Cardiometabolic risk; Children; Cholesterol; Ethnicity; Glucose; Triglycerides; Waist circumference.

MeSH terms

Adult
Blood Glucose
Body Mass Index
Cardiometabolic Risk Factors
Cardiovascular Diseases* / epidemiology
Child
Cholesterol
Cross-Sectional Studies
Ethnicity
Humans
Triglycerides
Waist Circumference / physiology

Substances

Blood Glucose
Triglycerides
Cholesterol