Efficacy of Adipocytokines, Cpeptide and Ghrelin for Detecting Cardiometabolic Risk in Pre-Adolescent Hispanic Children
Background. The diagnosis of metabolic syndrome is currently based on synthesizing measurements on five different biochemical and anthropometric scales. The logistics involved makes it less than an ideal screening test of cardiometabolic risk. Adipocytokines, c-peptide and ghrelin have emerged as important non-traditional biomarkers for understanding cardio-metabolic risk, and offer potential as tests of cardiometabolic risk. However, optimal sensitivity and specificity cut-offs of non-traditional biomarkers for detecting cardiometabolic risk are scarce, especially in pre-adolescent ethnic minorities. Objective. To assess the efficacy of 7 non-traditional biomarkers for detecting 3 or more cardiometabolic risk factors in pre-adolescent Hispanic children. Methods. The study population consisted of a healthy control group of 23 children and an at-risk group of 15 children aged 2-10 years with 3 or more cardiometabolic risk factors (blood pressure>=90th percentile; waist circumference >=90th percentile; triglycerides>=95th percentile; and HDL<5th percentile) who were recruited as part of a larger pilot study of metabolic syndrome in Hispanic children receiving well-child care at a community health center in Johnson City, TN, from June 2015 to September 2016. T-test, Mann-Whitney U and Chi-squared tests were used to assess differences in characteristics of the two groups. Spearman’s correlation analysis was used to assess the relationship between biomarkers and cardiometabolic risk factors. ROC analysis and the Youden’s J statistic=maximum (sensitivity +(specificity-1)) were used to determine biomarker cut-off for optimal sensitivity and specificity. Data analysis was performed using SAS 9.4. Results. The mean age of the sample was 6.48 years (SD=2.74). About half of the sample were girls (50.5%). The at-risk group had significantly higher systolic blood pressure, triglyceride levels, waist circumference, leptin and C-peptide levels, but significantly lower HDL-C levels than participants in the control group. Leptin [r (38) = 0.3, p<0.05] and C-peptide [r (38) = 0.3, p<0.05] were significantly positively correlated with triglyceride level; Leptin [r (38) = 0.39, p<0.05] and C-peptide [r (38) = 0.3, p<0.05] were also positively correlated with waist circumference. TNF-α [r (38) = 0.37, p<0.05] had a significant inverse correlation with HDL-C; Leptin [r (38) = 0.32, p<0.05], IL-6 [r (38) = 0.34, p<0.05] and TNF-α [r (38) = 0.37, p<0.05] had a significant positive correlation with systolic blood pressure. The best cut-off for predicting cardiometabolic risk are: leptin 5.95 ng/ml (AUC=70, sensitivity= 68% specificity=79%, p=0.05); C-peptide at 0.73 ng/ml (AUC=70, sensitivity=100% specificity=48%, p=0.03); and TNF-alpha at 4.28 pg/ml (AUC=75, sensitivity=93% specificity=58%, p=0.0035). Conclusion. We found significant correlations between adipocytokines, c-peptide, and cardiometabolic risk. Leptin, c-peptide and TNF-α were identified as having optimal sensitivity and/or specificity for detecting 3 or more cardiometabolic risk factors in pre-adolescent Hispanic children. Results could help in detecting at risk children for metabolic syndrome.
Alhassam, Basil A.; Cutshaw, Lee; Marrs, Jo-Ann; Peterson, Jonathan M.; Clark, William Andrew; and Alamian, Arsham. 2017. Efficacy of Adipocytokines, Cpeptide and Ghrelin for Detecting Cardiometabolic Risk in Pre-Adolescent Hispanic Children. Poster presentation. American Public Health Association 145th Annual Meeting and Exposition, Atlanta, GA. https://apha.confex.com/apha/2017/meetingapp.cgi/Paper/390923