Predictors of Cardiometabolic Risk Among Adults With Cerebral Palsy

Peterson MD, Haapala HJ, Hurvitz EA. Predictors of cardiometabolic risk among adults with cerebral palsy. Arch Phys Med Rehabil 2012;93:816-21. Objective: To examine the independent association between various anthropometric indicators and standard clinical markers of cardiometabolic health risk among adults with cerebral palsy (CP). Design: Cross-sectional study. Setting: Clinical center for CP treatment and rehabilitation. Participants: Adults with CP (N=43) with a mean age +/- SD of 37.3 +/- 13.2 years, and Gross Motor Function Classification System (GMFCS) levels of I-V. Interventions: Not applicable. Main Outcome Measures: Adults with CP were assessed for body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), and serum lipid profiles. Data were analyzed with multiple regression analysis and general linear models, and are reported as means +/- SDs. Results: Mean BMI was 29.1 +/- 7.8kg/m(2). BMI was not associated with any measures of cardiometabolic risk. Using GMFCS categories (2 groups: GMFCS levels I-III and IV-V), BMI was significantly lower among GMFCS levels IV-V (24.2 +/- 6.2kg/m(2)) versus GMFCS levels I-III (30.1 +/- 7.6kg/m(2)). WC and WtHR were not correlated with any cardiometabolic outcomes. Conversely, measures of WHR were independently associated with various indices of risk, including total cholesterol to high-density lipoprotein (HDL) cholesterol ratio (r=.45; P<.05), HDL cholesterol (r=.51; P<.01), and triglycerides (r=.40; P<.05), suggesting that greater WHR was indicative of elevated risk. Conclusions: It is likely that WHR represents a stronger predictor of risk, because this measure was robustly and independently associated with 3 primary clinical markers of cardiometabolic health in adults with CP.