Prevalence of the Metabolic Syndrome in Overweight Children and Adolescents

Author(s)

Abstract
Background— the prevalence of overweight and obesity among children and adolescents is increasing worldwide. Concordantly with the increase in obesity the prevalence of the metabolic syndrome is raising in children and youth. The metabolic syndrome imposes a substantial risk for type 2 diabetes mellitus and premature coronary heart disease. Methods— Metabolic syndrome is defined by the Third Report of the Adult Treatment Panel (ATP III) using criteria easily applied by clinicians and researchers for adults. There is no standard pediatric definition. We defined pediatric metabolic syndrome using criteria analogous to ATP III as 3 of the following: (1) fasting triglycerides over 95 th percentile for age and gender; (2) high density lipoprotein (HDL) cholesterol level below 5 th percentile for age and gender; (3) fasting glucose ≥6.1 mmol/L (110 mg/dL); (4) body mass index (BMI) ≥ 95 th percentile for age and gender; and (5) systolic blood pressure over 95 th percentile for age and gender. We used the Homoeostasis model assessment score (HOMA score) to detect the degree of insulin resistance. Results —The study included 484 children and adolescents aged 4 to 18 years (290 girls and 194 boys; mean age10.58 years; mean BMI: 11.11). Metabolic syndrome was present in 30.7% of overweight adolescents (BMI ≥95 th percentile) compared with 3.7% of at-risk adolescents (85 th to 95 th BMI percentile) and none of those with a BMI below the 85 th percentile (P<.001). About 36.4% of normal weight subjects, 54.5% of at risk of overweight subjects and 55.7% of overweight had at least 1 metabolic abnormality (fasting glucose≥110 mg/dl, high triglyceride, low HDL). Mean HOMA index is 2.16 in normal weight subjects, 2.60 in at risk of overweight subjects and 3.85 in overweight subjects. HOMA score =3.18 had 67% sensitivity and 60.8% specificity for predict of metabolic syndrome in overweight subjects. Conclusions—Metabolic syndrome is common in overweight Iranian children and adolescents and they have similar prevalence of metabolic derangements associated with obesity. Because childhood metabolic syndrome likely tracks into adulthood, early identification may help target interventions to improve future cardiovascular health.

Keywords
metabolic syndrome _ pediatrics _ overweight _ HOMA index

Cite this paper
Kobra Shiasi Arani, Kobra Shiasi Arani, MD, Prevalence of the Metabolic Syndrome in Overweight Children and Adolescents , SCIREA Journal of Clinical Medicine. Volume 1, Issue 1, October 2016 | PP. 63-74.

References