Short stature has been associated with coronary heart disease in adults (Paajanen et al, 2010), but similar
effects have not been established in children. We aim to identify cardiovascular and metabolic health
indicators that are associated with height-for-age in children. These consist of any measures of
cardiovascular health and metabolic syndrome such as, but not limited to: abdominal obesity; atherogenic
dyslipidaemia; hypertension; hyperglycaemia; insulin resistance; body-mass-index, height-adjusted fat mass,
pulse rate, insulin-resistance, triglycerides, low density lipoprotein cholesterol, high density lipoprotein
cholesterol, and structural and electrical cardiac dysfunction

David Oxborough (7244114)

Emma ODonnell (1384770)

Hugo Azcorra (503077)

Maria Ines Varela Silva (7238876)

Nina Mendez (7244117)

Samantha Sanchez (7241132)

Susana Monserrat-Revillo (1252428)

English

Loughborough University Institutional Repository

 PROSPEROInternational prospective register of systematic reviews The effects of short-stature-for-age on cardiovascular and metabolic health in children: asystematic reviewInes Varela-Silva, Emma O'Donnell, Hugo Azcorra, David Oxborough, Susana Monserrat-Revillo, SamanthaSanchez, Nina Mendez CitationInes Varela-Silva, Emma O'Donnell, Hugo Azcorra, David Oxborough, Susana Monserrat-Revillo,Samantha Sanchez, Nina Mendez. The effects of short-stature-for-age on cardiovascular andmetabolic health in children: a systematic review. PROSPERO 2019 CRD42019123014 Availablefrom: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019123014 Review questionHow does short stature-for-age in children associate with indicators of cardiovascular and metabolic health? Searches- NCBI (MeSH and PubMed)- Scopus- Web of ScienceWe are restricting the search to:1) Studies published in English2) Studies with human samples only Types of study to be includedObservational studies (longitudinal and cross-sectional) from original articles and short reports. Condition or domain being studiedShort stature has been associated with coronary heart disease in adults (Paajanen et al, 2010), but similareffects have not been established in children. We aim to identify cardiovascular and metabolic healthindicators that are associated with height-for-age in children. These consist of any measures ofcardiovascular health and metabolic syndrome such as, but not limited to: abdominal obesity; atherogenicdyslipidaemia; hypertension; hyperglycaemia; insulin resistance; body-mass-index, height-adjusted fat mass,pulse rate, insulin-resistance, triglycerides, low density lipoprotein cholesterol, high density lipoproteincholesterol, and structural and electrical cardiac dysfunction.Paajaneen et al (2010).European Heart Journal (2010) 31, 1802–1809 doi:10.1093/eurheartj/ehq155 Participants/populationChildren (male or female) aged 4 to 12 years, without congenital anomalies or known clinical pathologies . Intervention(s), exposure(s)Metabolic syndrome is defined as a cluster of symptoms that are risk factors for cardiovascular diseases andtype 2 diabetes mellitus. The major components of metabolic syndrome include abdominal obesity;atherogenic dyslipidemia; hypertension; hyperglycemia; insulin resistance; a proinflammatory state; and aprothrombotic (thrombosis) state (NCBI-MeSH Definition). Cardiovascular disfunction is defined as disfunction of the heart and the blood vessels (NCBI-MeSHdefinition).Early life adverse factors , affecting growth and health in general, may potentiate the onset of one or moreone of these outcomes in childhood.                               Page: 1 / 5 PROSPEROInternational prospective register of systematic reviews Comparator(s)/controlWe will use:a) Cut-off points to define short stature-for-age defined by:  i) the WHO standards (children up to 5 years of age) or the WHO references (5+years of age) as -2standard deviations (SD) of the median value of height-for-age, by sex;ii) NHANES/CDC references as height-for-age below the 5th percentileb) Cut-off points for blood pressure, glycemia, and dyslipidaemia reference values set by the American HeartAssociation. c) Cut-off points for body-mass index-for-age (International Obesity Task Force - IOTF, WHO and Centersfor Disease Control d) Cut-off points for abdominal obesity and other remaining metabolic syndrome reference values set by theWHO. ContextAll measurement outcomes must have been taken by trained research staff or a medical professional.Studies that rely on any subjective, self-reported data will not be included. Outcomes can be measured inchildren between ages of 4 and 12 but must be measured before any intervention or treatment. Therefore,only baseline observational studies will be included. Main outcome(s)The primary outcome are cardiovascular and metabolic indicators associated with stature-for-age in children.The secondary outcome consists of any are other measures of metabolic syndrome such as, but not limitedto: abdominal obesity; atherogenic dyslipidaemia; hypertension; hyperglycaemia; insulin resistance; body-mass-index, height-adjusted fat mass, pulse rate, insulin-resitance, triglycerides, and high-density lipoproteincholesterol, ow density lipoprotein cholesterol, and structural or electrical cardiac disfunction.Timing and effect measuresWe will only consider baseline studies in which no interventions have been conducted. We will be narrowingour time search to the last 10 years, which means that it is unlikely that secular trends in height will bias theinterpretation of the results. The mentioning of short-stature or any of the metabolic outcomes are not, per se, a condition for inclusion.The articles must show that they tested for effects of height upon the cardiovascular and metabolicoutcomes. Additional outcome(s)None at this stage. Data extraction (selection and coding)Stage I. Ines Varela-Silva (IVS) will screen for title and abstract according to the eligibility criteria. Articlesthat do not meet the inclusion criteria will be excluded. Articles that do not clearly show they meet theinclusion criteria, from the title and abstract, will pass to stage II. Articles that meet the inclusion criteria willpass to stage II.Stage II. Potentially eligible full texts will be obtained and screened by IVS against the inclusion criteria.Studies not meeting the inclusion criteria will be excluded at this stage, and the reasons for exclusion will benoted.Stage III. Nina Mendez (NM) and Emma O’Donnell (EO) will double screen 10% of the full texts included instage II. If any discrepancies on eligibility occur at this stage these will be discussed and solved by the entireteam.                               Page: 2 / 5 PROSPEROInternational prospective register of systematic reviewsStage IV. Other key papers identified by the team that have been missed in the searches will be included atthis stage. Full-texts of such papers will be obtained and screened against the inclusion criteria by IVS, andthose meeting the criteria will be included in the review.Data to be extracted:- Citation details (title, year of publication, authors, study ID, country of origin,)- Study details (design, time, duration, setting, sample size, country/region, study objectives)- Participant details (baseline participant characteristics)- Journal of publication- Outcome(s)- Methods of statistical analysis used to assess the association of interest- Key statistical analyses results- Details on any confounding/mediating factors where adjustments were made, for the association of interest.Data will be extracted and tabulated by IVS. NM will extract and tabulate information on 10% of the papersincluded for quality control. If any uncertainty or discrepancies arise after these steps, it will be recorded. Risk of bias (quality) assessmentWe will design and use a specific rubric (quantitative and qualitative instrument) to reduce the risks of bias. Arubric is a guide that list specific criteria for grading and/or scoring academic papers, projects, or tests.Therefore, the articles will be scored both quantitatively and qualitatively. Specific checklists to score theincluded papers and to reduce the risk of bias will be developed by the team. As a starting point, higherscores will be given to papers which use the standard/references cut-off points, detailed in question 21.Lower scores will be given to papers that associate stature with any cardiovascular and metabolic syndromeoutcomes, but do not use standard/references cut-off points. The lowest scores will be given to papers thatinclude associations between height and any of the markers but whose aim was not primarily focused on thisassociation. Strategy for data synthesis- A narrative synthesis of the findings will be provided and organised around the association found betweenheight and cardiovascular and metabolic syndrome indicators.- A descriptive synthesis of the outcomes will be tabulated and the quantitative scores regarding the qualityof the papers will be provided.- If suitable (pending the number of articles included for analysis), comparison of the presence/absence ofthe main outcomes, across studies, will be developed and discussed. Analysis of subgroups or subsetsIf suitable, analysis will be performed by race/ethnic group, gender, socioeconomic status (SES) or povertylevel for any relevant cardiovascular and metabolic syndrome outcomes included in the search criteria. Contact details for further information                               Page: 3 / 5 PROSPEROInternational prospective register of systematic reviewsInes Varela-Silvam.i.o.varela-silva@lboro.ac.uk Organisational affiliation of the reviewLoughborough Universityhttp://lboro.ac.uk Review team members and their organisational affiliationsDr Ines Varela-Silva. Loughborough UniversityDr Emma O'Donnell. Loughborough UniversityDr Hugo Azcorra. Cinvestav, Ecologia Humana, MeridaDr David Oxborough. Liverpool John Moores UniversityDr Susana Monserrat-Revillo. Loughborough UniversityMs Samantha Sanchez. Cinvestav, Ecologia Humana, MeridaDr Nina Mendez. Universidad Marista de Merida Anticipated or actual start date18 February 2019 Anticipated completion date30 September 2019 Funding sources/sponsorsNone Conflicts of interest LanguageEnglish CountryEngland, Mexico Stage of reviewReview_Ongoing Subject index terms statusSubject indexing assigned by CRD Subject index termsCardiovascular System; Child; Dwarfism; Growth Disorders; Humans Date of registration in PROSPERO14 February 2019 Date of publication of this version14 February 2019 Details of any existing review of the same topic by the same authors Stage of review at time of this submission                               Page: 4 / 5 PROSPEROInternational prospective register of systematic reviews Stage Started CompletedPreliminary searches No NoPiloting of the study selection process Yes NoFormal screening of search results against eligibility criteria Yes YesData extraction No NoRisk of bias (quality) assessment No NoData analysis No No Versions14 February 2019PROSPEROThis information has been provided by the named contact for this review. CRD has accepted this information in goodfaith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registrationrecord, any associated files or external websites. Powered by TCPDF (www.tcpdf.org)                               Page: 5 / 5

The effects of short-stature-for-age on cardiovascular and metabolic health in children: a systematic review.

https://repository.lboro.ac.uk/articles/The_effects_of_short-stature-for-age_on_cardiovascular_and_metabolic_health_in_children_a_systematic_review_/9621827/files/17269580.pdf

The effects of short-stature-for-age on cardiovascular and metabolic health in children: a systematic review.

Abstract

Similar works

Full text

Available Versions

Loughborough University Institutional Repository