EARLY-ONSET METABOLIC AND CARDIOVASCULAR RISK FACTORS: PATTERNS AND HEALTH OUTCOMES

Early-onset metabolic and cardiovascular risk factors are crucial in determining long-term cardiovascular health. Conditions such as obesity and diabetes mellitus, among others, when present in childhood, significantly increase the likelihood of developing non-communicable (cardiovascular) diseases in adulthood. These risk factors tend to track into later life, and early detection, combined with appropriate management, is essential for reducing the future burden of cardiovascular diseases. Childhood obesity has become a significant global concern, with rates continuing to rise across various regions and socioeconomic groups. This increase is strongly associated with lifestyle factors such as poor diet, lack of physical activity, and increased sedentary behavior. The rising prevalence of obesity in children is alarming due to its connection with a variety of health issues, such as type 2 diabetes mellitus, hypertension, dyslipidemias, and other early cardiovascular risk factors. This thesis investigates the potential impact of antibiotic use and socioeconomic factors as risk factors for childhood obesity. Early antibiotic use has been linked to changes in the gut microbiome, which might influence metabolic pathways and contribute to obesity. Socioeconomic factors also play a significant role, as children from lower-income families may have limited access to healthy food, safe environments for physical activity, and adequate healthcare. Moreover, chronic diseases such as obesity and type 1 diabetes mellitus may develop complications during childhood without obvious symptoms, complicating early detection and intervention. These asymptomatic complications can contribute to long-term health problems, including cardiovascular disease, kidney damage, and neuropathy. The thesis emphasizes the importance of regular screenings and early intervention to detect these complications in their early stages, thereby minimizing their long-term effects and improving health outcomes for affected children. A major focus of this research is indeed represented by the early complications of type 1 diabetes mellitus (T1DM) in children. Complications such as retinopathy, neuropathy, and cardiomyopathy, which are more commonly associated with the adult-stage of the disease, can also develop in childhood, frequently without any symptoms. Early detection of these complications is critical to preventing permanent damage. The research presented in this thesis seeks to identify markers for early signs of retinopathy, neuropathy, and cardiomyopathy, enabling timely intervention that can reduce the severity of these conditions. In addition to chronic conditions, newly recognized acute diseases, such as Multisystem Inflammatory Syndrome in Children (MIS-C), pose emerging risks for long-term cardiovascular health. MIS-C, which has been associated with prior COVID-19 infection, can lead to severe cardiovascular complications, including myocarditis, coronary artery dilation, and other issues. For that reason, this thesis investigates markers of severity in MIS-C to optimize its clinical management and improve patient outcomes. Identifying biomarkers that correlate with the severity of the disease can help clinicians predict its progression and tailor treatments to the individual needs of patients. In conclusion, this thesis explores the critical role that early metabolic and cardiovascular risk factors play in shaping the health outcomes of children. Through the examination of various chronic and acute factors, the research offers a comprehensive understanding of how these elements contribute to long-term cardiovascular risk. The findings underscore the importance of early detection, management, and intervention to prevent the onset of chronic diseases and mitigate their impact on the health of future generations.