Cardiometabolic profiles in adolescents in the Pollution and Asthma Risk: an Infant Study cohort

BACKGROUND: Metabolic syndrome (MetS) is known as a risk factor for cardiovascular disease and diabetes but its definition is not yet consensual for teenagers. Thus, we aimed to identify cardiometabolic health profiles in adolescents from the PARIS birth cohort. METHODS: At 15/16 years old, PARIS participants underwent a health check-up including a blood test, handgrip strength measure, self-administered and parent-filled questionnaires. Cardiometabolic profiles, in the whole population and by gender, were identified by K-means partitioning. A MetS risk score was also calculated. Characteristics of cardiometabolic profiles were compared using Chi2/Fisher exact test or Student's t-test. RESULTS: This study included 529 adolescents (49% females) with a mean BMI of 20.2±3.2 kg/m(2). MetS prevalence ranged from 0.2% to 1.3%. Two profiles were identified in the whole population and by gender: ‘healthy’ (67.1%) and ‘cardiometabolic risk’ (32.9%) profiles. The main predictive factors of profiles were weight and either waist-to-height ratio or waist circumference (R(2)>87%). Compared to “healthy” profiles, adolescents from ‘cardiometabolic risk’ lived more with obesity and pre-hypertension, had most frequently waist-to-height ratio over 0.5 and hypertriglyceridemia (unobserved in females). They also had higher cardiometabolic risk score and their parents were more often overweight. They had higher birth weight, earlier rebound age and puberty, and lower relative handgrip strength. CONCLUSIONS: The identified cardiometabolic profiles were linked to early signals and handgrip strength, a marker of overall health, emphasizing the importance of early monitoring. The waist-to-height ratio appears to be easy to use and a useful clinical tool for screening adolescents at risk of cardiometabolic pathologies, and thus requiring a clinical follow-up. KEY MESSAGES: • We innovatively classified adolescents based on their cardiometabolic health into two groups, with one group potentially requiring monitoring to prevent adult health issues. • The waist-to-height ratio is a simple clinical tool usable for screening adolescents at cardiometabolic risk.