Cardiovascular and metabolic risk factors in a healthy Norwegian child population: The Health Oriented Pedagogical Project (HOPP) - a cross-sectional study

Background: Risk of developing cardiometabolic diseases (CMDs) can already be found in child populations. This risk is known to track from childhood into adulthood and in some cases concludes in cardiovascular or metabolic diseases. Studying the clustering of a number of known risk factors is likely a better predictor of future disease risk than single components. Increasing severity of multiple factors increases the probability of multiple comorbidities. Moreover, analyzing degree of clustering allows for stratified analyses and targeted preventive strategies. Nationally representative studies are necessary to monitor development of CMD risk among children. The primary aim of this thesis was to investigate the clustering of risk factors for cardiovascular and metabolic diseases in a large, healthy representative Norwegian child population. Methods: Baseline (2015) data (n = 1056) from The Health Oriented Pedagogical Project (HOPP) was analyzed for clustering of CMD risk factors. A correlation analysis was used to select factors for the risk score. A CMD risk score was calculated by adding number of factors in the least desirable quartile. A relative risk ratio >1 to an expected binomial probability distribution was defined as non-random clustering of risk factors. Results: Following the correlation analysis, five of eleven components were included: waist circumference (WC), total serum cholesterol/serum high-density lipoprotein cholesterol-ratio (TC/HDL-ratio), systolic blood pressure (SBP), haemoglobin-A1c (HbA1c), and the Andersen fitness test. No significant clustering of risk factors was found for any of the 0-5 CMD risk scores despite a risk ratio of 5.8 (95% CI = 0.7-46.9) at five risk factors. Conclusions: There was no clustering of risk factors among Norwegian children aged 6-12 years based on this sample. The present results using a continuous CMD risk score could regardless provide useful insights for future studies