Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk.

ABSTRACT

OBJECTIVE: To evaluate the continuous metabolic syndrome score (cMetS) in Indian children and to investigate its relationship with the risk of carotid arterial stiffness. METHODS: Data on weight, height, mean arterial pressure, serum lipids, insulin, glucose, carotid intima-media thickness and stiffness parameters, that is, pulse wave velocity (PWV), elasticity modulus (Ep), stiffness index (ß) and arterial compliance (AC), were assessed in 236 children (6-17 years) from Pune city, India. cMetS was computed using standardized Z-scores for metabolic syndrome (MS) components. cMetS cutoff was obtained by receiver operating characteristic curve analysis across MS components. RESULTS: cMetS was lowest (-3.6±2.0) in normal children and highest (3.3±2.4) in MS children. cMetS increased progressively with number of risk components. The cutoff of cMetS yielding maximal sensitivity (80%) and specificity (94%) for predicting the presence of MS was -0.8 (area under the curve=0.921 (95% CI 0.877-0.964)). In children with cMetS above -0.8, average PWV (4.3±0.6 m s(-1)), ß (3.8±1.2) and Ep (50.4±14.5 kPa) were significantly higher than the respective values (3.7±0.5 m s(-1); 3.4±0.8; 37.0±10.0 kPa) in children with cMetS below -0.8, whereas AC was lower (1.2±0.5 mm(2) kPa(-1)) in children with cMetS above -0.8 as against AC (1.4±0.3 mm(2) kPa(-1)) in children with cMetS below -0.8 (P<0.05), demonstrating the risk of stiffness with increasing score. Pearson's correlation coefficients of cMetS with PWV (r=0.575), ß (r=0.347), AC (r=-0.267) and Ep (r=0.530) were statistically significant (P<0.01). CONCLUSION: Results demonstrate the usefulness of cMetS over individual MS components as a better tool for assessment of atherosclerotic risk in children.