Cardio-metabolic Risk Variables in Pre-Adolescent Children: A Factor Analysis

Background: Atherosclerosis begins during pre-adolescence and is occurring at an accelerated rate. This acceleration has been linked to poor lifestyle behaviors and subsequent cardio-metabolic complications. Although the clustering of cardio-metabolic risk factors has been recognized for over two decades, previous studies in children have predominantly examined the relationships between atherosclerosis and individual cardio-metabolic risk factors, or have grouped together pre-adolescent and adolescent children. Further, no known studies have included glycosylated haemoglobin (HbA1c), or central hemodynamic measures such as central systolic blood pressure (cSBP) and augmentation index (AIx). Methods and Results: Principal component analysis was performed on a cross-sectional sample of 392 children (9.5 y, 50% F) from three representative sample sites across New Zealand. Four factors explained 60% of the variance in the measured variables. In order of variance explained, the factors were: blood pressure (cSBP, peripheral systolic and diastolic blood pressure), adiposity (waist circumference, body mass index, HbA1c), lipids (total cholesterol, low-density lipoproteins, high-density lipoproteins) and vascular (AIx, heart rate, fasting blood glucose [FBG]). Conclusions: In accordance with previous findings in adults and adolescents, one common factor is unlikely to define cardio-metabolic health in pre-adolescent children. Each of the factors, except vascular, which was predominantly explained by AIx, are in agreement with previous findings in adolescents. An additional novel finding was that HbA1c and FBG loaded on to different factors, supporting previous work suggesting that FBG indicates short-term glycemic control whereas HbA1c reflects chronic glycemic control. Clinical Trial Registration: ID: ACTRN12614000433606, URL: www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366098