Persistence of the metabolic syndrome and its influence on carotid artery intima media thickness in overweight Latino children.

Objective: The objective of this study was to examine the influence of persistence of the metabolic syndrome (Mets) and its individual components over a 3-year period on carotid intima media thickness (CIMT) in overweight Latino children.

Methods: Ninety-seven healthy male and female overweight Latino children (mean age at baseline: 11.0+/-1.8 years) were assessed for MetS on four annual evaluations and classified according to the persistence of MetS: NEVER (0 annual visits with the MetS, n=53), INTERMITTENT (1 or 2 visits with the MetS, n=28), and PERSISTENT (3 or 4 visits with the MetS, n=16). CIMT was measured with high-resolution B-mode ultrasound (7.9+/-0.7 months after the most recent MetS assessment; mean age: 14.6+/-1.8 years).

Results: PERSISTENT MetS was associated with significantly higher CIMT (0.647+/-0.018mm compared to 0.600+/-0.007mm in those who NEVER had MetS, p<0.01). This difference remained significant after controlling for gender, baseline age, total fat mass, total lean tissue mass and insulin sensitivity. PERSISTENT high waist circumference and PERSISTENT high blood pressure were also significantly associated with higher mean CIMT, but these differences were no longer significant after controlling for total fat and lean tissue mass. Baseline systolic blood pressure and 2-h glucose were significantly related to CIMT independent of all other MetS components (p<0.05).

Conclusions: Persistence of the MetS over a 3-year period was uniquely associated with increased CIMT during childhood. Children with hypertension, persistent abdominal adiposity or impaired glucose tolerance may also be at higher risk for elevated CIMT.