Elsevier

The American Journal of Cardiology

Volume 179, 15 September 2022, Pages 90-95
The American Journal of Cardiology

Prevalence of Metabolic Syndrome in Young Adults With Congenital Heart Disease

https://doi.org/10.1016/j.amjcard.2022.05.031Get rights and content

Adults with congenital heart disease (ACHD) are at risk of developing metabolic syndrome (MetS) at a younger age. We sought to obtain the prevalence of MetS in ACHD from a large population-based database in the United States. We conducted a retrospective cohort study of patients with ACHD in Explorys (IBM Inc., Armonk, New York) database from 2008 to 2019. The ACHD cohort included patients aged 20 to 39 years, with moderate and severe congenital heart disease, as defined by ACHD anatomic and physiologic classification. Patients were diagnosed with MetS using the modified International Diabetes Federation's diagnostic criteria. Logistic regression analysis was performed to compare the risk of MetS in the ACHD cohort. MetS was diagnosed in 1,860 of 6,720 patients with ACHD (27.6%). Among 7,359,470 controls, MetS was seen in 742,010 (10.1%). The average age of MetS in ACHD was 31.5 and 32.7 years in controls (p <0.001). The risk of MetS was higher in ACHD versus controls (odds ratio [OR] 2.75 [2.61 to 2.89], p <0.001). The risk of MetS in ACHD was higher in men (OR 3.01 [2.78 to 3.26], p <0.001) and those aged <25 years (men OR 7.57 [6.31 to 9.07], women OR 4.66 [3.85 to 5.63]; p <0.001). The risk of MetS was higher in patients with severe versus moderate ACHD (OR 1.4 [1.56 to 1.74], p <0.001). In conclusion, MetS and its risk factors are more common in young ACHD than in the general population.

Section snippets

Methods

In July 2019, we performed a retrospective analysis for the time period from 2008 to 2019 using the Explorys platform (IBM Inc., Armonk, New York), which is a validated large real-world population database, providing pooled aggregated health care information of more than 63 million unique outpatients and inpatients from 26 integrated healthcare systems across the United States. The database was started in 1999 and is updated every week. IBM Inc. provides access privileges to all contributing

Results

The ACHD cohort comprised 21,370 patients with moderate or severe CHD. Within this cohort, clinical and laboratory data necessary to diagnose MetS were available in 6,720 patients (31.4%), with 1,860 patients (27.6%) meeting the diagnosis of MetS. There were approximately 16 million patients in the control group of which 7,359,470 patients had the necessary data for analysis (Figure 1). Of all patients with MetS and ACHD, 55% had moderate CHD. The prevalence of MetS was higher in the ACHD group

Discussion

Our study showed that almost 30% of young individuals with ACHD with moderate and severe CHD were diagnosed with MetS in the United States using a large real-world nationwide database. Moreover, the relative risk of MetS in ACHD was higher in men and in younger age groups. Although the prevalence of MetS increased with age in both groups, the rate of increase of MetS in ACHD was not high, leading to decreased odds in the older age group with ACHD. Perhaps, the most significant finding is that

Disclosures

The authors have no conflicts of interest to declare.

References (30)

  • AC Zomer et al.

    Social burden and lifestyle in adults with congenital heart disease

    Am J Cardiol

    (2012)
  • JE Caterini et al.

    Physical activity promotion in pediatric congenital heart disease: are we running late?

    Can J Cardiol

    (2020)
  • K. Niwa

    Metabolic syndrome in adult congenital heart disease

    Korean Circ J

    (2019)
  • CP Benziger et al.

    Projected growth of the adult congenital heart disease population in the United States to 2050: an integrative systems modeling approach

    Popul Health Metr

    (2015)
  • S Malik et al.

    Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults

    Circulation

    (2004)
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