EVIDENCE OF A MAJOR GENE WITH PLEIOTROPIC ACTION FOR A CARDIOVASCULAR-DISEASE RISK SYNDROME IN CHILDREN YOUNGER THAN 14 YEARS

Objective.-To test the plausibility of the existence of a genetically based syndrome involving obesity, hypertension, and a central deposition of body fat. Design.-Survey of a random stratified sample of the US population. Participants.-Male and female children aged 13 years or younger (mean, 5.3 years; SD, 3.7 years; median, 4.0 years; range, 6 months to 13 years) were chosen from National Health and Nutrition Examination Survey II data. Interventions.-None. Measurements/Main Results.-Using multivariate commingling analysis, we evaluated the hypothesis that a major gene produces a syndrome involving the phenotypic indicators of body mass index (in kilograms per square meter), subscapular-to-triceps skinfold thickness ratio, systolic blood pressure, and diastolic blood pressure. Maximum likelihood estimation was used to test competing models. A model with three component distributions and unequal variance-covariance matrices fit significantly better than any competing model. Conclusions.-Our findings support the existence of a distinct cardiovascular disease risk syndrome in children and suggest that it may be the result of a major gene with pleiotropic effects.