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Erschienen in: Pediatric Cardiology 4/2019

13.02.2019 | Original Article

Modifiable Clinical Correlates of Vascular Health in Children and Adolescents with Dyslipidemia

verfasst von: David A. White, Gautam M. Anand, Omar Qayum, Chizitam F. Ibezim, Ashley K. Sherman, Geetha Raghuveer

Erschienen in: Pediatric Cardiology | Ausgabe 4/2019

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Abstract

Atherosclerosis promoting cardiovascular disease risk factors (CVDrf) are highly prevalent among youth in the U.S. Determining which standard modifiable clinical measures (SMCMs) has the greatest impact on vascular structure and function is valuable for the health care provider to help identify children at highest risk. The aim of this study was to determine modifiable outpatient clinical predictors of vascular health in youth with CVDrf. Children and adolescents with CVDrf (n = 120, 13.1 ± 1.9 years, 49% female) were recruited from a pediatric preventive cardiology clinic. The SMCMs included BMI z-score, waist-to-height ratio (WTHR), lipid panel, hemoglobin A1c, blood pressure (BP), presence of tobacco smoke exposure, and presence of hypertriglyceridemic waist (HTW) phenotype (triglycerides ≥ 110 mg/dL and waist circumference ≥ 90 percentile). Vascular function and structure were measured with pulse wave velocity (PWV), central systolic BP (CSP), augmentation index (AIx), and carotid artery intima-media thickness (cIMT). Sex and height specific z-scores for PWV, CSP, and cIMT were used. Multiple linear regression with backwards selection identified SMCMs which strongly predicted vascular function and structure. Among SMCMs, WTHR and HTW were the most frequent predictors of vascular function (PWV: R2 = 0.32; CSP: R2 = 0.35; AIx R2 = 0.13). Other predictors of vascular function included hemoglobin A1C, BP, and BMI z-score. Systolic BP and LDL cholesterol were predictors of vascular structure (cIMT: R2 = 0.14). The strongest predictors of vascular health in youth with CVDrf were related to measures of central obesity. Targeting these SMCM in lieu of vascular testing in outpatient clinic setting may be practical to identify children and adolescents at greatest risk for CVD.
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Metadaten
Titel
Modifiable Clinical Correlates of Vascular Health in Children and Adolescents with Dyslipidemia
verfasst von
David A. White
Gautam M. Anand
Omar Qayum
Chizitam F. Ibezim
Ashley K. Sherman
Geetha Raghuveer
Publikationsdatum
13.02.2019
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 4/2019
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-019-02071-w

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