The Association of Cardiometabolic Risk Factors in Parent-Child Dyads in Guam: PICCAH Study

Abstract Objectives To determine metabolic syndrome (MetS) prevalence among adults and children at-risk in Guam as part of the larger Pacific Island's Cohort for Cardiometabolic Health (PICCAH) study during 2017–2020. Embedded in the primary objective is to evaluate the associations of parent and child risk factors and identify prevalent modifiable risk factors in children. Methods Preliminary data from 338 adults (21–50 y) and 214 children (3–9 y) who completed lifestyle surveys, anthropometric and (fasting) biochemical measures were analyzed. The prevalence of MetS and MetS risk factors were calculated for adults and children, respectively, and MetS severity Z-scores for both. Pearson correlation and multiple linear regression was used to estimate the linear association between parent and child MetS Z-scores. Demographic data and metabolic lifestyle factors such as sleep, sedentary and physical activity, and stress were evaluated. Results The majority of adults (92.3%) had abdominal obesity. Metabolic factors in adults and children (respectively) were high serum triglycerides (18.5% and 2.7%) and high glucose (25% and 1.8%) and, in adults only, were high blood pressure (31.8%) and low level of HDL (60.4%). Adults and children in this study did not meet sleep (57.3% and 50.0%), screen time for children (83.8%), sedentary activity (e.g., time spent sitting) for adults (61.9%), and physical activity for adults (52.4%) recommendations. Adults reported low-level stress (Mean = 19.3, SD = 5.7 on 12–48 scale) on the Depression Anxiety Stress Scale (DASS21). Using the International Diabetes Federation criteria, 38.7% of adults had MetS and 8.2% children were at-risk for MetS. Children MetS Z-scores were significantly correlated with parent MetS Z-scores (Pearson correlation = 0.288, P < 0.001). The multiple regression model showed that child MetS Z-score can be predicted by using parent MetS Z-score even after adjusting for parent education level and income, and child's age (F(4190) = 4.82, P = .001). Conclusions Guam is an island in the Western Pacific with the highest diabetes prevalence in the world. This is the first study in Guam to describe MetS and its risk factors in child-parent dyads. Findings will support intervention programs for MetS and diabetes prevention in Guam and the Western Pacific. Funding Sources NIH/NIMHD (1U24MD011201–01).