Identifying Biomarkers and Cardiovascular Risk Factors in Childhood Metabolic Syndrome
Condition: Metabolic Syndrome; Cardiovascular Disease
MeSH terms: Cardiovascular Diseases; Metabolic Syndrome; Syndrome
Study type: Observational

Summary: 
      Metabolic syndrome (MetS) is highly prevalent all over the world. MetS is largely
      under-diagnosed in children and adolescents. Obesity and hypertension are two important
      requirements for criteria of MetS. With early detection and early intervention of MetS in
      children and adolescents will enable better care to reduce the heavy burden of health care
      all over the world.

      Investigators intend to recruit 150 children and adolescents age 6 to 18 yr with
      overweight/obesity or prehypertension/hypertension and 50 normal age-matched controls to
      reach the following research goals:

      1) To identify biomarkers as risk factors; 2) To characterize that impact of vascular
      assessment in preMetS children; and 3) To examine the relationship among biomarkers, vascular
      assessment parameters, and metabolic phenotypes.
    

Detailed description: 
      Metabolic syndrome (MetS) is highly prevalent all over the world, including Taiwan. So far,
      there is still no standard definition of MetS for use in pediatric population. Thus MetS is
      largely under-diagnosed in children and adolescents. Obesity and hypertension are two
      important requirements for criteria of MetS. With early detection and early intervention of
      MetS in children and adolescents will enable better care to reduce the heavy burden of health
      care all over the world.

      MetS might originate from early life, namely developmental programming. Cardiovascular
      disease (CVD) is the most common comorbidity of MetS. Therefore identification of biomarkers
      for detecting children with high-risk to develop CVD and MetS progression is our priority.
      Investigators' previous studies identified some biomarkers from a variety of programming
      models, including asymmetric dimethylarginine (ADMA, a nitric oxide synthase inhibitor),
      β-trace protein (BTP, also known as lipocalin-type prostaglandin D synthase), and
      adiponectin. Thus, in the current study, ADMA profile, BTP, and adiponectin will be studied
      in children and adolescents with pre-MetS to explore their role as biomarkers to predict MetS
      and CVD progression.

      In childhood, assessment of CVD relies on endothelial function and arterial stiffness, as CV
      events are extremely rare. Thus, in this study investigators intend to perform a global
      vascular assessment (to determine endothelial function and arterial stiffness) in children
      with pre-MetS including 24hr ABPM, measure of pulse wave velocity (PWV) and ambulatory
      arterial stiffness index (AASI) to detect arterial stiffness, detection of flow mediated
      dilatation (FMD), and biomarkers. Investigators also intend to examine the correlation
      between biomarkers and these measured vascular parameters in children with preMetS.

      Therefore, investigators will recruit 150 children and adolescents age 6 to 18 yr with
      overweight/obesity or prehypertension/hypertension and 50 normal age-matched controls to
      reach the following research goals:

      1) To identify biomarkers as risk factors; 2) To characterize that impact of vascular
      assessment in preMetS children; and 3) To examine the relationship among biomarkers, vascular
      assessment parameters, and metabolic phenotypes.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Children aged 6-18 years visit pediatric nephrology clinic during study period
      
Biospecimen description: 
      Plasma