Distinct racial and ethnic metabolic syndrome characteristics: A comparative assessment in low‐income children 7–10 years of age

Abstract

Summary Background Pediatric MetS prevalence varies due to lack of consensus on evaluative criteria and associated thresholds, with most not recommending a diagnosis <10 years. However, MetS risk components are becoming evident earlier in life and affect races and ethnicities disproportionately. Objectives To compare the prevalence of MetS based on existing definitions and elucidate racial‐ and ethnic‐specific characteristics associated with MetS prevalence. Methods The baseline and follow‐up samples included 900 and 557 children 7–10 years, respectively. Waist circumference, BMI percentile, blood pressure, fasting plasma glucose (FPG), insulin, triglycerides, and high‐density lipoprotein cholesterol (HDL‐C) were measured. Agreement between MetS definitions was quantified via kappa statistics. MetS and risk factor prevalence and the predictability of metabolic parameters on MetS eight months later was evaluated via logistic regression. McFadden pseudo‐R2 was reported as a measure of predictive ability, and the Akaike information criterion evaluated fit of each model. Results The baseline sample was 55.0% male and 71.6% Hispanic, followed by non‐Hispanic White (NHW) (17.3%) and non‐Hispanic Black (NHB) (11.1%), with an average age of 9.2 years. MetS prevalence ranged from 7.6% to 21.4%, highest in Hispanic (9.0%–24.0%) and lowest in NHB children (4.0%–14.0%). Highest agreement was between Ford et al. and Cook et al. definitions (K = 0.88) and lowest agreements were consistently with the International Diabetes Federation criteria (K ≤ 0.57). Compared to NHW children, Hispanic children had higher odds for MetS (OR: 1.7; p = 0.03) and waist circumference, HDL‐C, and FPG risk factors (p < 0.05), while NHB children had higher odds for the FPG risk factor (p ≤ 0.007) and lower odds for the plasma triglycerides risk factor (p = 0.002), across multiple MetS definitions. In longitudinal analyses, HDL‐C was the strongest independent predictor of MetS in Hispanic and NHW children (p < 0.001 and p < 0.01, respectively), while plasma triglycerides was the strongest independent predictor of MetS in NHB children (p < 0.05). Conclusions MetS prevalence was high in children ≤10 years, and proposed criteria are susceptible to racial and ethnic bias, diagnosing some populations more than other populations with high cardiovascular risk. Earlier preventative measures should be imposed in clinical settings, accounting for racial and ethnic differences, to mitigate disease onset.

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

“…Diagnosis of MetS, according to the recommendations for children and adolescents, does not include the assessment of liver enzymes [ 1 , 12 ].…”

Association of total and pancreatic serum amylase enzymatic activity with insulin resistance and the glucose and insulin responses to oral starch test in Mexican children

“…Weight and height were measured in all the participants with a digital scale (Seca, Hamburg, Germany) and a portable stadiometer (Seca 225, Hamburg, Germany), respectively. Body mass index (BMI) was calculated as weight (kg)/height (m) 2 . BMI was converted to age-and gender-adjusted standard deviation scores (BMI-SDS) using the guidelines from the Centers for Disease Control.…”

“…Among the main comorbidities of obesity are insulin resistance (IR), type 2 diabetes, and premature mortality 1 . Regarding pediatric population, recent studies report that Hispanic child show a higher risk of developing metabolic syndrome compared with non‐Hispanic white and black children 2 . To date, Mexico has the largest overweight burden on the gross domestic product (GDP) in all the Organization for Economic Co‐operation and Development (OECD) countries (5.6%) 3 .…”

“… 1 Regarding pediatric population, recent studies report that Hispanic child show a higher risk of developing metabolic syndrome compared with non‐Hispanic white and black children. 2 To date, Mexico has the largest overweight burden on the gross domestic product (GDP) in all the Organization for Economic Co‐operation and Development (OECD) countries (5.6%). 3 The last national survey of health and nutrition in 2020 reported the prevalence of obesity for children (5–11 years), adolescents (12 and 19 years), and adults (≥20 years) was 18.6%, 17.0%, and 40.2%, respectively.…”

Association of Lifetime Exposure to Glyphosate and Aminomethylphosphonic Acid (AMPA) with Liver Inflammation and Metabolic Syndrome at Young Adulthood: Findings from the CHAMACOS Study

“…The prevalence of childhood obesity and metabolic syndrome has increased at an alarming rate in the United States, 1 , 2 particularly among populations of color. 1 – 3 Accompanying this, has been an increase in nonalcoholic fatty liver disease (NAFLD), 4 a condition that can lead to cirrhosis and hepatocellular carcinoma later in life. 5 Although diet and physical activity play an important role in cardiometabolic and liver disorders, some hypothesize that exposure to synthetic chemicals may also be involved.…”