Importance of racial/ethnic disparities in rates of metabolic syndrome in Duchenne Muscular Dystrophy


Clinical Management

Poster Number: T323


Sarah Wright, DO, Children's National Medical Center

Metabolic syndrome is a composition of specific components—obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, and hyperglycemia, which places patients at higher risk of diabetes and heart disease. Duchenne Muscular Dystrophy (DMD) is associated with increased risk of endocrine complications, including obesity and its comorbidities, in large part due to prolonged corticosteroid use. The American Academy of Pediatrics recommends screening all children for dyslipidemia between 9-11; consensus statements for DMD also advise screening random lipid profiles and random blood glucose/hemoglobin A1C annually. Prior studies have demonstrated that Caucasian-non-Hispanic and Caucasian-Hispanic adolescent males have higher odds of metabolic syndrome. We sought to analyze our cohort of patients with DMD to assess for racial/ethnic discrepancies in rates of metabolic syndrome, as this may impact care guidelines for monitoring for metabolic syndrome. We conducted a retrospective chart review of all patients seen with DMD 9 years or older (n=51). 27 of the 51 males had blood work performed. Of the 27, 2 boys screened were found to have both dyslipidemia and elevated glucose (HbA1c). An additional 2 boys had isolated findings of dyslipidemia and 3 boys had findings of elevated HbA1C. Boys from families who identified as Caucasian-Hispanic (37.5%) or Caucasian-Non-Hispanic (33%) were more likely to have lab abnormalities as compared to patients of Asian (0%), African American (0%) or Other Race (14.3%). BMI ≥30 at the time of lab draw correlated to higher risk of dyslipidemia or elevated HbA1C. Blood pressure at the time of blood draw and length of time on steroids did not appear to correlate with rates of metabolic syndrome. Despite its limitations, these findings highlight the importance of vigilant screening for metabolic syndrome in DMD and suggest that more frequent monitoring is required for adolescents with obesity, particularly in boys from higher risk racial backgrounds.