Šebeková Katarína, Gurecká Radana, Csongová Melinda, Koborová Ivana, Celec Peter
Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia.
Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, 81108 Bratislava, Slovakia.
Children (Basel). 2023 Jun 30;10(7):1144. doi: 10.3390/children10071144.
Cardiometabolic risk factors at a young age pose a significant risk for developing atherosclerotic cardiovascular disease in adulthood. Atherogenic dyslipidemia is highly associated with obesity and metabolic syndrome already in young age. It remains unclear whether cardiometabolic risk factors associate with the atherogenic index of plasma (AIP = log (TAG/HDL-C) in lean subjects with low atherogenic risk. As both the AIP and markers of cardiometabolic risk are continuous variables, we expected their association to be linear before the manifestation of obesity and atherogenic dyslipidemia. We analyzed the prevalence of increased atherogenic risk (AIP ≥ 0.11) in 2012 lean 14-to-20-year-old subjects (55% females) and the trends of cardiometabolic risk factors across the quartiles (Q) of AIP in a subgroup of 1947 (56% females) subjects with low atherogenic risk (AIP < 0.11). The prevalence of AIP ≥ 0.11 reached 3.6% in females and 8.5% in males. HDL-C, non-HDL-C, triglycerides, and the continuous metabolic syndrome score showed a stepwise worsening across the AIP quartiles in both sexes. Measures of obesity and insulin resistance were worse in Q4 vs. Q1 groups, and leukocyte counts were higher in Q4 and Q3 vs. Q1. Females in Q4 presented with a higher C-reactive protein and lower adiponectin, estradiol, and testosterone levels. The multivariate regression model selected non-HDL-C, QUICKI, and erythrocyte counts as significant predictors of AIP in males; and non-HDL-C and C-reactive protein in females. A question arises whether the lean individuals on the upper edge of low atherogenic risk are prone to earlier manifestation of metabolic syndrome and shift to the higher AIP risk group.
年轻时的心血管代谢危险因素会显著增加成年后患动脉粥样硬化性心血管疾病的风险。致动脉粥样硬化血脂异常在年轻时就与肥胖和代谢综合征高度相关。在动脉粥样硬化风险较低的瘦人中，心血管代谢危险因素是否与血浆动脉粥样硬化指数（AIP = log（甘油三酯/高密度脂蛋白胆固醇））相关尚不清楚。由于AIP和心血管代谢风险标志物均为连续变量，我们预期在肥胖和致动脉粥样硬化血脂异常出现之前，它们的关联呈线性。我们分析了2012名14至20岁瘦人（55%为女性）中动脉粥样硬化风险增加（AIP≥0.11）的患病率，以及1947名动脉粥样硬化风险较低（AIP<0.11）的受试者（56%为女性）亚组中AIP四分位数（Q）间心血管代谢危险因素的变化趋势。AIP≥0.11的患病率在女性中为3.6%，在男性中为8.5%。高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、甘油三酯和连续代谢综合征评分在两性中均随AIP四分位数呈逐步恶化。与Q1组相比，Q4组的肥胖和胰岛素抵抗指标更差，Q4和Q3组的白细胞计数高于Q1组。Q4组女性的C反应蛋白水平较高，脂联素、雌二醇和睾酮水平较低。多变量回归模型选择非高密度脂蛋白胆固醇、QUICKI和红细胞计数作为男性AIP的显著预测因子；女性为非高密度脂蛋白胆固醇和C反应蛋白。一个问题出现了，即处于低动脉粥样硬化风险上限的瘦人是否更容易较早出现代谢综合征并转向更高AIP风险组。
