Cardiovascular
The Impact of Life’s Essential 8 on Metabolic Syndrome Development in Adolescents: A Longitudinal Study Jyun-Hao Guan* Jyun-Hao Guan Pei-Wen Wu Yu-Ting Chin Pei-Tung Lin Sheng-Hung Chu Chien-Hung Lee
Background: Cardiovascular health (CVH) and metabolic syndrome (MetS) during adolescence significantly influence the development of cardiovascular disease in adulthood. The American Heart Association’s Life’s Essential 8 (LE8) outlines eight metrics for assessing CVH across the life course, which may substantially impact adolescent MetS. This longitudinal study aimed to investigate the associations between CVH scores and the transition of MetS in adolescents over a follow-up period of 2.1 years.
Methods: This ongoing prospective cohort study was initiated in 2020. We have examined 729 adolescents aged 15-19 years, randomly selected from 10 senior high schools in Taiwan. Data were collected on LE8 health behaviors and factors, including diet, physical activity, nicotine exposure, body mass index (BMI), blood lipid, blood pressure, blood glucose, and sleep health. Adolescent MetS was defined using combined criteria from the International Diabetes Federation and the Taiwan Pediatric Association. We used Cox proportional hazards models to analyze the relationship between changes in LE8 components and transitions in MetS.
Results: The incidence of MetS at follow-up among adolescents without MetS at baseline was 3.7%. Among those with MetS, the proportions of persistent and remitted MetS were 65.2% and 34.8%, respectively. After adjusting for covariates, an increased number of abnormal LE8 components was associated with a 1.4-fold higher hazard ratio (HR) for incident MetS. Compared to adolescents with moderate-to-high levels of LE8, those with low LE8 levels had a 13.1-fold HR for persistent MetS. Additionally, abnormal BMI and blood lipid levels were the major contributors to the occurrence of MetS after 2.1 years of follow-up.
Conclusion: This study demonstrates the impact of cardiovascular health, as measured by LE8, on the development and persistence of MetS in adolescents, underscoring the importance of early interventions to enhance cardiovascular health.