title: Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents.
abstract: Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12-16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1-2 and ≥3 risk components for pediatric metabolic syndrome (MetS) were defined as potential MetS (pot-MetS) and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5-1.6 and 1.9-4.2-fold, respectively). Low physical activity (<952.4 MET·min/week), long screen time (≥3 h/day) and high sugar-sweetened beverage intake (>500 mL/day) were associated with a 3.3- (95% confidence intervals (CI) = 1.5-7.3), 2.2- (95% CI = 1.1-4.4), and 26.9-fold (95% CI = 3.2-229.0) odds ratio (OR) of MetS, respectively. Pediatric body mass index (BMI) accounted for 18.8%-95.6% and 16.9%-60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3-17.3); p for multiplicative interaction, 0.009). The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI explains a part of these associations. Pediatric adiposity might be multiplicatively associated with sugar-sweetened beverage consumption for enhancing the MetS prevalence ratio among adolescents.
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan. cying@ms19.hinet.net.|Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. cying@ms19.hinet.net.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Institute of Environmental and Occupational Health Sciences, National Yang Ming University, Taipei 112, Taiwan. wtlin0123@gmail.com.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lin
authors.affiliation: Department of Laboratory Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 807, Taiwan. 0870718@kmhk.org.tw.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tsai
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan. ych0610@gmail.com.
authors.forename: Yu-Chan
authors.initials: YC
authors.lastname: Hung
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan. catstar1211@gmail.com.
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Wu
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan. l19920929@gmail.com.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan. tefu.chan@msa.hinet.net.|Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan. tefu.chan@msa.hinet.net.
authors.forename: Te-Fu
authors.initials: TF
authors.lastname: Chan
authors.affiliation: Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan. hhuang@kmu.edu.tw.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Food and Nutrition, Providence University, Taichung 433, Taiwan. ylweng@pu.edu.tw.
authors.forename: Yao-Lin
authors.initials: YL
authors.lastname: Weng
authors.affiliation: Health Policy and Systems Management Program, Health Sciences Center, School of Public Health, Louisiana State University, New Orleans, LA 70803, USA. ychiu@lsuhsc.edu.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Chiu
authors.affiliation: Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. chtshu@cc.kmu.edu.tw.
authors.forename: Chia-Tsuan
authors.initials: CT
authors.lastname: Huang
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan. cnhung@kmu.edu.tw.|Research Center for Environmental Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. cnhung@kmu.edu.tw.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lee
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008019:Life Style; D008297:Male; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D010290:Parents; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: adiposity; adolescent; cardiometabolic risk factors; metabolic syndrome; parental disease; screen time; sugar-sweetened beverages