Design of a Cardiometabolic Risk Scale for Apparently Healthy Adolescents

Authors

Keywords:

adolescents, cardiometabolic risk factors, obesity, metabolic syndrome, cardiovascular risk.

Abstract

Introduction: Instruments to estimate cardiometabolic risk in pediatric age constitute an increasing need in the prevention of chronic diseases. Objective: To design a cardiometabolic risk scale for apparently healthy Cuban adolescents. Methods: An observational, analytical and cohort study was carried out in 180 adolescents from a pre-university school, from September 1, 2021 to July 31, 2023. A multivariate binary logistic regression analysis was performed to relate the epidemiological, anthropometric, clinical, biochemical variables, and the atherogenic indices that would be included in the models. Once the final model was selected, according to the regression coefficients of each variable, the predictive scale was created by converting the decimal numbers into integers. The scale performance was determined and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for the different cut-off points. Results: The variables that made up the scale were body mass index ≥ 90 percentile, family history of arterial hypertension, smoking habit, waist circumference ≥ 90 percentile and uric acid > 345 μmol/L. The 5-6 point score presented a specificity and positive predictive value of 98.9% and 96.2% respectively, with an accuracy greater than 60% for all scores. Conclusions: The proposed scale had good predictive performance and allowed estimating the cardiometabolic risk in the adolescents studied.

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References

1. Magdariaga A, Hierrezuelo N, Velásquez L, Ávila M, Videaux S. Factores de riesgo cardiometabólicos en adolescentes. Rev Cuba Cardiol Cir Cardiovasc. 2023 [acceso 07/05/2024];29(1):1-8. Disponible en: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/1354

2. Quinn RC, Campisi SC, McCrindle BW, Korczak DJ. Adolescent cardiometabolic risk scores: A scoping review. Nutrition, Metabolism & Cardiovascular Diseases. 2022;32(12):2669-76. Disponible en: https://doi.org/10.1016/j.numecd.2022.08.022

3. Freitas PHU, Lamas JLT, Gothardo ACLO, Sofiato TC, Girardi MR, Bastos CC, et al. Cardiometabolic risk in adolescents students of high school: influence of work. Rev Bras Enferm. 2020;73(4). Disponible en: https://doi.org/10.1590/0034-7167-2019-0041

4. Cota BC, Suhett LG, Leite NN, Pereira PF, Ribeiro SAV, Franceschini SCC. Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review. Public Health Nutrition. 2021;24(5):870-81. Disponible en: https://doi.org/10.1017/S1368980020004863

5. Bloch KV, Klein CH, Szklo M, Kuschnir MCC, Abreu GA, Barufaldi LA, et al. ERICA: Prevalencias de hipertensión y obesidad en adolescentes brasileños. Rev Saúda Pública. 2016;50(1). Disponible en: https://doi.org/10.1590/S01518-8787.2016050006685

6. Burrows R, Correa-Burrows P, Rogan J, Cheng E, Blanco E, Gahagan S. Long-term vs. recent-onset obesity: their contribution to cardiometabolic risk in adolescence. Pediatric Research. 2019;86:776-82. Disponible en: https://doi.org/10.1038/s41390-019-0543-0

7. Li K, Haynie DL, Gao X, Lipsky LM, Nansel T, Iannotti RJ, et al. Validation of a continuous measure of cardiometabolic risk among adolescents. J Pediatr Endocrinol Metab. 2021;34(6):763-70. Disponible en: https://doi.org/10.1515/jpem-2020-0600

8. Letswalo BP, Schmid-Zalaudek K, Brix B, Ngoakoana E, Klosz F, Obernhumer N, et al. Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents. BMJ Open 2021;11. Disponible en: https://doi.org/10.1136/bmjopen-2020-042955

9. Nakhleh A, Sakhnini R, Furman E, Shehadeh N. Cardiometabolic risk factors among children and adolescents with overweight and Class 1 obesity: A cross-sectional study. Insights from stratification of Class 1 obesity. Front Endocrinol. 2023;14(1). Disponible en: https://doi.org/10.3389/fendo.2023.1108618

10. Grupo de Trabajo de Puericultura, Departamento Materno Infantil. Consulta de puericultura. 3 ed. La Habana: Ecimed; 2016. [acceso 05/05/2018]. Disponible en: https://temas.sld.cu/puericultura/files/2014/07/Puericultura-FINAL-HIGHT-1-2-16.pdf

11. Zermeño Ugalde P, Gallegos García V, Castro Ramírez RA, Gaytan Hernández D. Relación del índice cintura-talla (ICT) con circunferencia cintura e índice de cintura cadera, como predictor para obesidad y riesgo metabólico en adolescentes de secundaria. Rev Salud Pública Nurición. 2020;19(3):19-27. Disponible en: https://doi.org/10.29105/respyn19.3-3

12. Cornish R, Bartlett J, Macleod J. Complete case logistic regression with a dichotomized continuous outcome led to biased estimates. J Clin Epidemiol. 2023;154(2023):33-41. Disponible en: https://doi.org/10.1016/j.jclinepi.2022.11.022

13. Sullivan LM, Massaro JM, D’Agostino RB. Presentation of multivariate data for clinical use: The Framinghan Study risk score functions. Stat Med. 2004;23(10):1631-60. Disponible en: https://doi.org/10.1002/sim.1742

14. Han K, Song K, Choi BW. How to Develop, Validate, and Compare Clinical Prediction Models Involving Radiological Parameters: Study Design and Statistical Methods. Korean J Radiol. 2016;17(3):339-50 Disponible en: https://doi.org/10.3348/kjr.2016.17.3.339

15. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20):2191-4. Disponible en: https://doi.org/10.1001/jama.2013.281053

16. Dring KJ, Cooper SB, Williams RA, Morris JG, Sunderland C, Foulds GA, et al. Effect of adiposity and physical fitness on cardiometabolic risk factors in adolescents: A 2-year longitudinal study. Front Sports Act Living. 2022;4(2022). Disponible en: https://doi.org/10.3389/fspor.2022.1060530

17. De Morais NS, Azevedo FM, de Freitas AR, Morais DC, Ribeiro SAV, Gonçalves VSS, et al. Body Fat is Superior to Body Mass Index in Predicting Cardiometabolic Risk Factors in Adolescents. Int J Environ Res Public Health. 2023;20(3):2074. Disponible en: https://doi.org/10.3390/ijerph20032074

18. Fontes PAS, Siqueira JH, Martins HX, Oliosa PR, Zaniqueli D, Mill JG, et al. Comportamento Sedentário, Hábitos Alimentares e Risco Cardiometabólico em Crianças e Adolescentes Fisicamente Ativos. Arq Bras Cardiol. 2023;120(2). Disponible en: https://doi.org/10.36660/abc.20220357

19. Alvarez Cruz J, Alvarez Bellet N, Marrero García M, Carassou Gutiérrez M, Romero Reinaldo Y, Plasencia Vital J, et al. Síndrome metabólico en niños y adolescentes con obesidad. Rev Cubana Med Milit. 2024 [acceso 20/06/2024];53(1). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/22975

20. Hernández L, Camacho N, Paoli M, Sierra L, Jurado A, Páez LH, et al. Indicadores antropométricos como pronóstico del espesor del tejido adiposo epicárdico y riesgo cardiometabólico en pediatría. Arch Venez Puer Ped. 2020 [acceso 20/06/2024];83(3):70-7. Disponible en: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0004-06492020000300070&lng=es

21. Reyes Y, Paoli M, Camacho N, Molina Y, Santiago J, Lima M. Espesor del tejido epicárdico en niños y adolescentes con factores de riesgo cardiometabólico. Endocrinol Nutr. 2016;63(2):70-8. Disponible en: https://doi.org/10.1016/j.endonu.2015.09.007

22. Carassou Gutiérrez M, Ferrer Arrocha M, Plasencia Vital J, Alvarez Cruz J, Castillo Menduiña Y. Señales tempranas de aterogénesis en adolescentes. Rev Cubana Med Milit. 2023 [acceso 20/06/2024];52(2). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2072

23. Arnaiz P, Acevedo M, Díaz C, Bancalari R, Barja S, Aglony M, et al. Razón cintura estatura como predictor de riesgo cardiometabólico en niños. Rev Chilena Cardiol. 2010;29(3):281-8. Disponible en: https://doi.org/10.4067/S0718-85602010000300001

24. Ciudad D, Arellano E, Díaz P, Donoso R, Rival Y, Rojas V, et al. Respuesta a la prueba de caminata de seis minutos en niños con riesgo cardiovascular. Rev Chil Pediatr. 2020;91(4):561-7. Disponible en: https://doi.org/10.32641/rchped.vi91i4.1634

25. De Ferranti SD, Steinberger J, Ameduri R, Baker A, Gooding H, Kelly AS, et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association. Circulation. 2019;139(13):603-34. Disponible en: https://doi.org/10.1161/cir.0000000000000618

26. Khoury M, Kavey RW, St Pierre J, McCrindle BW. Incorporating risk stratification into the practice of pediatric preventive cardiology. Can J Cardiol. 2020;36(9):1417-28. Disponible en: https://doi.org/10.1016/j.cjca.2020.06.025

Published

2025-03-17

How to Cite

1.
Alvarez Cruz J, Blanco del Frade A, Blanco Aspiazu M Ángel, Arteche Hidalgo LL, Carassou Gutiérrez M. Design of a Cardiometabolic Risk Scale for Apparently Healthy Adolescents. Rev Cubana Pediatría [Internet]. 2025 Mar. 17 [cited 2025 Jul. 1];97. Available from: https://revpediatria.sld.cu/index.php/ped/article/view/7442