title: Correlation of metabolic syndrome severity with cardiovascular health markers in adolescents.
abstract: The presence of metabolic syndrome (MetS) in childhood is a significant risk factor for later cardiovascular disease (CVD). Recent data showed temporal decreases in a sex- and race/ethnicity-specific MetS severity z-score among U.S. adolescents. Our goal was to characterize the relationship of this MetS z-score with other CVD risk indicators and assess their temporal trends and lifestyle influences.
  
  
  
  We analyzed 4837 participants aged 12-20years from the National Health and Nutrition Examination Survey by 2-year waves from 1999 to 2012. We used linear regression to compare MetS z-score and dietary factors with serum levels of low-density lipoprotein (LDL), apolipoprotein-B (ApoB), high-sensitivity C-reactive protein (hsCRP) and uric acid.
  
  
  
  MetS severity z-score was positively correlated with LDL, ApoB, hsCRP, and uric acid measurements (p<0.0001 for all). These correlations held true among individual racial/ethnic groups. LDL, ApoB, and hsCRP measurements decreased over time among U.S. adolescents (p=0.002, p<0.0001, and p=0.024, respectively). Saturated fat consumption was positively correlated with LDL (p=0.005) and ApoB (p=0.012) and inversely related to serum uric acid (p=0.001). Total caloric intake was inversely related to LDL (p=0.003) and serum uric acid (p=0.003). Unsaturated fat, carbohydrate, and protein consumption were not related to LDL, ApoB, hsCRP, or serum uric acid.
  
  
  
  There is a positive correlation between MetS severity and all four CVD risk indicators studied. LDL, ApoB, and hsCRP showed favorable temporal trends, which could be related to similar trends in MetS z-score. These data support the importance of considering multiple inter-related factors in clinical CVD risk assessment.
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Lee
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL 32608, United States.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gurka
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, United States. Electronic address: deboer@virginia.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
mesh_terms: D000293:Adolescent; D001055:Apolipoproteins B / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D012306:Risk; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D008077:Lipoproteins, LDL; D014527:Uric Acid; D002097:C-Reactive Protein
keywords: Apo A; Cardiovascular disease; LDL; Metabolic syndrome; Uric acid