| Summary: | 博士 === 高雄醫學大學 === 公共衛生學系環境暨職業安全衛生博士班 === 105 === Clustering of cardio-metabolic risk factors within individual, named metabolic syndrome (MetS), is commonly seen among obese people and has been known to be associated with increasing risks of type 2 diabetes and cardiovascular diseases in adults. Metabolic syndrome also can be seen among obese youth. Atherosclerosis, the underlying cause of cardiovascular disease, can develop early in childhood. Early identification and intervention could be beneficial for prevention of cardiovascular disease. The purpose of the study was to investigate the effects of parental cardio-metabolic disease, overweight/obesity and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents. Representative adolescents (n = 2727; age, 12–16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Multiple linear regression, binary logistic regression and multinomial logistic regression were used for analyzing the prevalence ratio of a risk factor for metabolic syndrome after adjusting for potential confounding factors. Additive and multiplicative interaction effects between parameters on risk of MetS were examined, a p-value < 0.05 was considered statistical significant. The results showed that prevalence of MetS in adolescents were 1.4%-11.9%, according to the definition used. Obesity and insulin resistance were independently associated with MetS in adolescents. Adolescents whose parents were overweight/obese, or with diabetes and hypertension, adolescents with low physical activity level, long screen time and high sugar-sweetened beverage intake were associated with increased risk of MetS. The adolescent BMI accounted for a majority of the effects of parental overweight/obesity and adolescent long screen time on the risk of adolescent MetS. A significantly additive synergistic effect on MetS was observed among overweight/obesity adolescents with parental T2D. The risk of sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity. Overweight/obese adolescents who did not consume sugar-sweetened beverage or had higher level of physical activity was associated with a lower risk of MetS compared with overweight/obese adolescents who consume more sugar-sweetened beverage and with low physical activity. Our results suggest that multifaceted intervention including control of sugar-sweetened beverage consumption and increase physical activity among high risk family with obese adolescents and parental T2DM should be prioritized.
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