Dysglycemia and carotid intima-media thickness in children and youth with obesity
Notice bibliographique
Résumé
INTRODUCTION: The prevalence of obesity in Canadian adults is high and is mirrored in the pediatric population. The collective increase of childhood obesity over the last three decades has been associated with a corresponding rise in the deterioration in cardiometabolic health. Abnormally high measures of blood glucose are indicative of impaired glucose metabolism that is related to the development of adverse adult conditions such as type 2 diabetes mellitus (T2DM) and/or cardiovascular disease (CVD). Prediabetes is a transient state of abnormally elevated blood glucose levels that, in adults, has comparable cardiovascular risk to diagnosed diabetes. Previous studies have demonstrated that children with prediabetes can progress to T2DM over a short period of time. Given that up to 21% of children with obesity have abnormal glucose parameters, it is critical to manage risk at early stages of life in this population in order to prevent adverse adult outcomes. PURPOSE: The purpose of this study was to evaluate if there is a contributing role of prediabetes on vascular structure, assessed via carotid intima-media thickness (cIMT), in children and youth with obesity. Given the high prevalence of adverse health indicators, we aimed to characterize the relationships between these clinical measures and early structural changes associated with atherosclerosis progression. As protocols used to measure cIMT in pediatric studies vary, an additional aim of this project was to assess comparability of cIMT protocols reported in the literature. HYPOTHESIS: It is hypothesized that children with obesity and prediabetes will have greater mean cIMT compared to normal glycemic controls and that mean cIMT will be significantly different across varying cIMT methodologies. METHODS: We recruited 165 participants (ages 5-17y) into this cross-sectional study, a sub-study of the CANadian Pediatric Weight Management Registry (CANPWR). This study assessed cIMT via B-mode ultrasonography in children and youth at time of entry into a weight management program. Clinical measures were obtained via prospective clinical chart review and were evaluated to identify potential relationships between modifiable and non-modifiable cardiovascular health indicators and measures of cIMT, using univariable and multivariable regression analyses. To compare methodologies, we assessed differences of mean cIMT (mm) using an intra-class correlation and a Bland-Altman plot. RESULTS: Fasting plasma glucose was related to mean cIMT (mm) in univariable analyses (p=0.047), but no measure of glycemia was independently correlated to arterial thickness. Segment-specific thickening contributed to significant differences in mean cIMT (mm) between methodologies that included all arterial segments (far and near wall of the common carotid artery, carotid bulb, and internal carotid artery; 12-segment) compared to those limited to the far wall of the common carotid artery (2-segment) (p<0.001). Intra-class correlation between these cIMT methodologies indicated moderate resemblance (ICC: 0.65, 95%CI: 0.55 to 0.73), however, a significant difference between means (mean difference: 0.012mm, 95%CI: -0.016 to -0.009, p<0.001) and a positive proportional bias (r=0.19, 95%CI: 0.06 to 0.31, p=0.003) were present. Furthermore, correlates of mean cIMT were inconsistent between varying methodologies commonly used to assess cIMT in children. CONCLUSIONS: In this study, dysglycemia did not predict on arterial thickness in children and youth with obesity. By comparing determinants and absolute differences between measures of cIMT, this study emphasizes the heterogeneity between the two methodologies and suggests that they should not be used interchangeably.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».