Metabolic syndrome in a sample of the 6- to 16-year-old overweight or obese pediatric population: a comparison of two definitions

Abstract

PurposeThe purpose of this study was to estimate the presence of metabolic syndrome (MS) in a group of children and adolescents with a body mass index (BMI) above the 85th percentile for their age and sex in Qazvin Province, Iran; to evaluate the relationship between obesity and metabolic abnormalities; and to compare two proposed definitions of MS.Patients and methodsThe study was conducted on 100 healthy subjects aged between 6 and 16 years (average age, 10.52 ± 2.51 years) with a high BMI for their age and sex. Fifty- eight percent of subjects were female. Physical examination including evaluation of weight, height, BMI, and blood pressure measurement was performed (“overweight” was defined as a BMI between the 85th and 95th percentiles for children of the same age and sex; “obese” was defined as a BMI over the 95th percentile for children of the same age and sex). Blood levels of glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and uric acid were measured after a 12-hour overnight fast. The authors used and compared two definitions of MS: the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III) criteria and a modified definition by Weiss et al. Variables were compared using the Student’s t-test and chi-square and Mann-Whitney U tests, and agreement between the two definitions was analyzed using kappa values.ResultsThe subjects had a mean BMI of 26.02 ± 4.38 and 80% had obesity. Insulin resistance was found in 81% of the study population. MS was present in ten (50%) of the overweight and 53 (66.2%) of the obese subjects using the NCEP ATP III criteria. MS was present in five (25%) of the overweight and 34 (42.5%) of the obese subjects using the definition by Weiss et al. The overall kappa value for the two definitions of MS was 0.533. There were no statistically significant differences between the two definitions of MS in participants.ConclusionThe prevalence of MS in children and adolescents depends on the criteria chosen and their respective cutoff points. The NCEP ATP III criteria, the parameters of which include higher cutoff values for high-density lipoprotein cholesterol and triglycerides, detected the higher prevalence and therefore the NCEP ATP III criteria are able to diagnose a larger number of children and adolescents at metabolic risk.

Association of Total and High Molecular Weight Adiponectin with Components of Metabolic Syndrome in Mexican Children

“…The analysis of anthropometric variables according to weight status has confirmed that each component of the MetS worsens with increasing weight, independent of sex (27). As has been reported previously (26,28,29) and was found in our study, several parameters did not show significant differences between overweight and obese children, except for a significantly higher WC in the obese group, which reinforces its importance as a risk indicator. The impaired levels of insulin, HOMA-IR, TG, HDL-C, and total-and HMW-adiponectin in the obese group compared to the normal group confirm the remarkable impact of obesity on metabolic disorders.…”

Fatores associados ao comportamento sedentário em escolares de 9-12 anos de idade

“…A identificação precoce da SM em crianças e adolescentes é importante, a fim de evitar a morbi-mortalidade que geralmente é causada por esta síndrome. Contudo, a avaliação dos fatores de risco para SM exige valores apropriados para diferentes idades e sexos (Saffari, Jalilolghadr, Esmailzadehha, & Azinfar, 2012) e, dessa forma, necessita definição padronizada e internacionalmente aceita para seu diagnóstico, pois as prevalências de SM em crianças e adolescentes variam não só por causa de diferentes populações estudadas, como também pela adoção de definições diferentes (Andaki, Tinoco, Mendes, & Amorim, 2012).…”

Some Inflammatory and Endothelial Dysfunction Biomarker levels in Obese Pre-pubertal Children

“…The increasing incidenceof childhood obesity and the earlier onset of insulinresistance, hypertension, and dyslipidemia increased risk factors forcardiovascular disease. These metabolic abnormalities in children may predict that diabetesand cardiovascular disease complications may appear earlier than previously thought [3,4]. The pathogenesis of obesity-related insulin resistance and type 2 diabetes involve chronic low-grade inflammation and production of inflammatory cytokinescontributing tovascular reactivity,endothelial dysfunctionanddiabetic vascular complications [5].…”

“…Its prevalence has increased so significantly in recent years that many consider it a major health concern of the developed world [1].Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years [2]and has been known as a major risk factor for insulin resistance in children with metabolic syndrome [3]. The increasing incidenceof childhood obesity and the earlier onset of insulinresistance, hypertension, and dyslipidemia increased risk factors forcardiovascular disease.…”