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      Subgrouping of Iranian children and adolescents based on cardiometabolic risk factors using latent class analysis: The CASPIAN-V study

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          Abstract

          Background:

          Cardiometabolic syndrome indicates the clustering of several risk factors. The aims of this study were to identify the subgroups of the Iranian children and adolescents on the basis of the components of the cardio-metabolic syndrome and assess the role of demographic characteristics, socioeconomic status and lifestyle-related behaviors on the membership of participants in each latent class.

          Methods:

          This cross-sectional study was performed on 3730 Iranian students in 2015 using stratified cluster. All students in each class completed anonymous and structured questionnaires. Abdominal obesity, high triglyceride (TG), low high-density lipoprotein (HDL), high blood pressure (BP), high fasting blood sugar (FBS), high low-density lipoprotein (LDL), high cholesterol and obesity were used for assessing the pattern of cardio metabolic risk as a latent variable. Data analysis was performed using PROC LCA in SAS software.

          Results:

          Four latent classes were identified in this study; namely 1) healthy (59.6%), 2) low risk (20.4%), 3) moderate risk (13.7%) and 4) high risk (6.4%). Being a female (OR=0.59, 95% CI: 0.46-0.74), living in a rural area (OR=0.45, 95% CI;0.33-0.60), high screen time (OR=1.56, 95% CI:1.09-2.24), and parental obesity (OR=1.52, 95% CI: 1.18-1.95) were associated with moderate risk class. Only living in rural areas (OR=0.71, 95% CI; 0.51-0.99) was associated with high risk class.

          Conclusion:

          About 20% of the students are in the moderate risk and high risk classes. Design and implement interventions according to risk-based class that seem necessary by considering probably risk and protective factors for the prevention of complications of cardiometabolic syndrome.

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          Most cited references24

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          Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement.

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            WHO Child Growth Standards based on length/height, weight and age

            To describe the methods used to construct the WHO Child Growth Standards based on length/height, weight and age, and to present resulting growth charts.
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              Childhood adiposity, adult adiposity, and cardiovascular risk factors.

              Obesity in childhood is associated with increased cardiovascular risk. It is uncertain whether this risk is attenuated in persons who are overweight or obese as children but not obese as adults. We analyzed data from four prospective cohort studies that measured childhood and adult body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). The mean length of follow-up was 23 years. To define high adiposity status, international age-specific and sex-specific BMI cutoff points for overweight and obesity were used for children, and a BMI cutoff point of 30 was used for adults. Data were available for 6328 subjects. Subjects with consistently high adiposity status from childhood to adulthood, as compared with persons who had a normal BMI as children and were nonobese as adults, had an increased risk of type 2 diabetes (relative risk, 5.4; 95% confidence interval [CI], 3.4 to 8.5), hypertension (relative risk, 2.7; 95% CI, 2.2 to 3.3), elevated low-density lipoprotein cholesterol levels (relative risk, 1.8; 95% CI, 1.4 to 2.3), reduced high-density lipoprotein cholesterol levels (relative risk, 2.1; 95% CI, 1.8 to 2.5), elevated triglyceride levels (relative risk, 3.0; 95% CI, 2.4 to 3.8), and carotid-artery atherosclerosis (increased intima-media thickness of the carotid artery) (relative risk, 1.7; 95% CI, 1.4 to 2.2) (P ≤ 0.002 for all comparisons). Persons who were overweight or obese during childhood but were nonobese as adults had risks of the outcomes that were similar to those of persons who had a normal BMI consistently from childhood to adulthood (P>0.20 for all comparisons). Overweight or obese children who were obese as adults had increased risks of type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks of these outcomes among overweight or obese children who became nonobese by adulthood were similar to those among persons who were never obese. (Funded by the Academy of Finland and others.).
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                Author and article information

                Journal
                Caspian J Intern Med
                Caspian J Intern Med
                CJIM
                Caspian Journal of Internal Medicine
                Babol University of Medical Sciences (Babol, Iran )
                2008-6164
                2008-6172
                Autumn 2020
                : 11
                : 4
                : 370-376
                Affiliations
                [1 ]Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
                [2 ]Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                [3 ]School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
                [4 ]Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [5 ]Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
                [6 ]Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
                [7 ]Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                [8 ]Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                [* ]Correspondence: Mostafa Qorbani, Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. E-mail: mqorbani1379@yahoo.com, Tel: 00989145927737
                Article
                10.22088/cjim.11.4.370
                7911770
                f53ddc64-bc60-4156-aa90-79353314b853
                Copyright © 2020, Babol University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 February 2019
                : 9 February 2020
                : 24 February 2020
                Categories
                Original Article

                cardiometabolic,metabolic syndrome,latent class analysis,children and adolescents,iran

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