Abstract P399: Cardiovascular Risk Factors and Measures of Early Atherosclerosis in Children with Down Syndrome

Background: Children with Down syndrome (DS) have unique cardiovascular (CV) risk profiles compared to the general population. Early markers of atherosclerosis can be measured and are associated with CV risk factors, although limited data are available for children with DS. Methods: A multicenter, cross-sectional study of children with DS between 8-18 years. CV risks assessed: BMI, blood pressure, diet, activity, smoke exposure, congenital heart disease, hypothyroid, cancer, apnea, family history of early coronary disease, lipids, lipoprotein subfractions, glucose, insulin, and HS-CRP. Vascular testing included pulse wave velocity (PWV) and carotid intimal medial thickness (CIMT). Prevalence of categorical CV risks were compared to population prevalence from NHANES data using Fisher’s exact or chi squared. Vascular measures were converted to Z scores using height and compared to population means with single sample t test, and linear regression evaluating associations between CV risks and vascular measures. Results: A total of 55 children with DS participated, 28 (51%) female, mean age 14.3 years (range 8.1-18.9). Compared to NHANES, DS children were more likely to have triglycerides >90 mg/dL (63% DS vs. 10% NHANES, p=<0.001) and non-HDL-cholesterol >120 mg/dL (54% DS vs. 22% NHANES, p = <0.001). PWV and CIMT Z scores were not significantly different from general population with mean (SD) of -0.1 (1.0) and 0.27 (1.5), respectively. Univariable analysis for PWV showed significant associations with systolic blood pressure [coefficient (95% CI): 0.04 (0.02, 0.06)] and smoke exposure [1.70 (0.35, 3.05)]. No associations were found for CIMT. Multivariable models are shown in Table 1. PWV was associated with BMI percentile and smoke exposure. No associations were found for CIMT. Conclusion: Children with DS had higher rates of lipid abnormalities compared to the general population. Lipid abnormalities were not associated with CIMT or PWV, and vascular measures adjusted for height were similar to children without DS.