Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents

Smetanina, Natalija; Valickas, Raimondas; Vitkauskienė, Astra; Albertsson‐Wikland, Kerstin; Verkauskienė, Rasa

doi:10.1159/000514720

Cited by 8 publications

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“…The 15 primary studies included in our systematic review were all cross-sectional studies [ 13 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], and no new articles were included after the snowballing process.…”

Section: Resultsmentioning

confidence: 99%

“…The data regarding the epidemiological impact of MetS depended on the diagnostic criteria used, resulting in variations observed across different countries. More than half of the studies included ( n = 11, 73.2%) based their analysis on the IDF consensus for children and adolescents [ 16 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 26 , 28 , 29 ]. One study [ 19 ] (6.7%) compared MetS prevalence obtained based on adopting two definitions of MetS: that of the National Cholesterol Education Program Program’s Adult Treatment Panel III (NCEP-ATPIII), revised by Cook/Ford [ 30 ], and that based on the IDF criteria.…”

Section: Resultsmentioning

confidence: 99%

“…All the studies included in our review reported epidemiological data in terms of prevalence, except for one, which calculated the MetS incidence in children and adolescents [ 20 ]. According to the literature data analyzed, MetS mostly affects males, with prevalence ranging between 1.4% and 55.8% [ 16 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review

Orsini,

D’Ambrosio,

Scardigno

et al. 2023

Nutrients

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The prevalence of overweight and obesity is continuously increasing, both in the adult and pediatric populations, posing a substantial challenge to public health. Understanding the epidemiological burden of metabolic syndrome (MetS) among children, particularly regarding its complications and long-term effects in adulthood, is crucial for identifying effective preventive measures and enhancing the clinical care of obese children. Therefore, by searching two databases, a systematic review was conducted in order to evaluate studies that specifically addressed the epidemiological MetS impact among overweight/obese European children and adolescents. Overall, 15 studies were considered. The epidemiological data concerning the MetS impact were contingent on the diagnostic criteria used and varied across countries, resulting in a prevalence range of 1.44% to 55.8%. Spanish studies were the most numerous (34%), revealing a country prevalence rate ranging from 2.5% to 19.6%. Males (prevalence range: 1.4–55.8%) and subjects with overweight/obesity (prevalence range: 12.9–55.8%) were mainly affected. Obesity emerged as the main risk factor in the MetS development and the consequent onset of cardiovascular complications and diabetes. Knowing the MetS burden and its risk factors could improve their prevention, detection, and treatment, and guide the development of targeted public health interventions to appropriately address the health needs of younger patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review

Orsini,

D’Ambrosio,

Scardigno

et al. 2023

Nutrients

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“…However, the definition of MS in children and adolescents is still unclear, as there is no golden standard of diagnostic criteria for the paediatric population 25.9 % with severe obesity degree (Smetanina et al, 2021).…”

Section: Prevalence and Diagnostic Criteria Of Metabolic Syndrome In ...mentioning

confidence: 99%

Risk Factors, Complications and Characteristics of Metabolic Syndrome in Obese Children and Adolescents. Summary of the Doctoral Thesis

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Introduction. Public health research indicates that the prevalence of obesity is rapidly increasing not only among adults, but especially is rapidly increasing among adolescents, slightly less among young children. In Latvia, the prevalence of overweight and obesity is higher in seven-year-old boys compared to girls, 23.7 % and 21.8 %, respectively. However, for girls, this proportion has gradually increased since 2008 from 18.3 % to 21.8 %. Children and adolescents with obesity are at risk of early cardiovascular disease, arterial hypertension, dyslipidemia, metabolic syndrome, insulin resistance, type 2 diabetes mellitus, various types of tumors, orthopedic problems, serious psychological and neurological problems, and other health problems. Metabolic syndrome has a special role in adulthood and is associated with a higer risk for type 2 diabetes mellitus and cardiovascular disease. However, the definition, diagnostic criteria, risk factors, prevention, and treatment of metabolic syndrome in children and adolescents have not yet been standardized.Aim. To study the risk factors, complications and features of metabolic syndrome in children and adolescents with obesity.Materials and methods. The study included 198 children according to inclusion and exclusion criteria, including 181 children with obesity and 17 children with normal body weight. In the first phase of the study, the children were divided into groups according to weight and age, study group I – children 10 years and older with obesity, study group II – children under ten years with obesity, control group – children with normal body weight. In this study phase, prenatal and postnatal obesity risk factors were evaluated, and obesity complications were screened. The second phase of the study evaluated metabolic syndrome as defined by the International Federation of Diabetes at 10 years of age, only in children in study group I (n = 143). All research data were summarized in an Excel database and analyzed using RStudio V.1.4.1103. Differences were considered statistically significant if the significance level was p < 0.05.Results. There were no statistically significant differences regarding prenatal obesity risk factors, large birth weight (p = 0.530), maternal weight gain during pregnancy (p = 0.787), and a positive family history of type 2 diabetes mellitus (p > 0.999) between obese and normal weight children. No statistically significant differences were found in the duration of breast feeding (p = 0.120) between obese and normal weight children. A statistically significant difference was observed in the study groups only for the postnatal obesity risk factor – parental obesity (p = 0.004). Children with obesity had a high prevalence of parental obesity in study group I and group II, 79.8 % and 63.0 %, respectively, compared to children of normal weight. In children of normal weight, parental obesity was detected in only 33.3 % of the cases. Screening for obesity complications has shown statistically significant changes in cardiovascular disease, insulin resistance, and other biochemical parameters in obese children compared to normal weight children. In study group I, the median systolic blood pressure 123.0 (IQR 116.0; 132.0) and the median diastolic blood pressure 78.0 (IQR 71.5; 83.0) were significantly higher compared to controls, with the median systolic blood pressure 115.0 (IQR 110.0; 120.0) and the median diastolic blood pressure 70.0 (IQR 65.0; 76.0) (p = 0.012). No child had an elevated total cholesterol above 5.2 mmol/l in the control group, compared to 8.8 % in study group I. Children with obesity had a statistically significant higher median HOMA-IR in both study group I and group II, 3.9 (IQR 2.6; 5.6) and 2.3 (IQR 1.5; 3.4) in control group, respectively. The median HOMA-IR for children of normal weight was 1.1 (IQR 0.8; 2.1) (p < 0.001).In children in study group I, metabolic syndrome was diagnosed in 21 % (n = 30) according to the criteria developed by the International Federation of Diabetes. The incidence of metabolic syndrome in the study population increased with age, with 17.1 % of children diagnosed with metabolic syndrome between aged 10 to 16 years and 38.5 % of children over 16 years of age diagnosed with MS. Children with metabolic syndrome had significantly higher median weight (p < 0.001) and lower insulin sensitivity (p = 0.039) compared to children without metabolic syndrome. There was no evidence of prenatal risk factors for obesity such as large birth weight (p = 0.145), excessive weight gain during maternal pregnancy (p = 0.625), a positive family history of type 2 diabetes mellitus (p = 0.519) had an effect on the development of metabolic syndrome. The postnatal risk factor for obesity – the duration of exclusive breastfeeding also did not affect the development of metabolic syndrome (p > 0.999). The risk of metabolic syndrome in children increased with increasing body mass index, and the risk of metabolic syndrome was 11.13 times higher in the case of paternal obesity. Conclusions. Risk factors for cardiovascular disease and type 2 diabetes mellitus have been observed early in obese children. Children with obesity over 10 years of age had higher blood pressure, elevated total cholesterol and increased insulin resistance and HOMA-IR ratio. The diagnosis of metabolic syndrome was confirmed in almost a quarter of the pediatric study population. The risk of metabolic syndrome increased significantly with both the degree of obesity and the level of parental obesity.

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“…Arī Smetanina un līdzautoru veiktais pētījums pierāda tiešo ĶMI ietekmi uz MS izplatību bērnu populācijā. MS tika konstatēts 10,7 % bērnu ar virssvaru; 22,8 %ar aptaukošanos; 25,9 % -ar smagu aptaukošanās pakāpi(Smetanina et al, 2021). zīdīšana var aizsargāt pret MS, taču ir nepieciešami turpmāki pētījumi.…”

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Metaboliskā sindroma riska faktori, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Promocijas darbs

Gailite¹

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Ievads. Sabiedrības veselības pētījumi norāda uz strauju aptaukošanās izplatību ne tikai pieaugušajiem, bet īpaši strauja izplatība tiek novērota arī pusaudžiem un pirmsskolas vecuma bērniem. Latvijā augstāka liekā svara izplatība ir septiņgadīgiem zēniem, salīdzinot ar meitenēm, attiecīgi 23,7 % un 21,8 %. Taču meitenēm šis īpatsvars kopš 2008. gada ir pakāpeniski palielinājies no 18,3 % līdz 21,8 %. Bērniem un pusaudžiem ar aptaukošanos agrīni draud attīstīties sirds un asinsvadu sistēmas slimības, arteriāla hipertensija, dislipidēmija, metaboliskais sindroms, insulīna rezistence, 2. tipa cukura diabēts, dažādu veidu audzēji, ortopēdiskas, nopietnas psiholoģiskas un neiroloģiskas problēmas, kā arī citi hroniski traucējumi. Metaboliskā sindroma īpašā nozīme pieaugušo vecumā ir saistīta ar iespēju identificēt personas, kurām ir liels gan 2. tipa cukura diabēta, gan sirds un asinsvadu sistēmas slimību risks. Attiecībā uz bērnu metabolisko sindromu autoru viedoklis atšķiras.Mērķis. Pētīt metaboliskā sindroma riska faktorus, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Materiāls un metodes. Pētījumā atbilstoši iekļaušanas un izslēgšanas kritērijiem iekļauti 198 bērni, no tiem 181 bērns ar aptaukošanos un 17 bērni ar normālu ķermeņa svaru. Pirmajā pētījuma etapā bērni iedalīti grupās attiecīgi pēc svara un vecuma: I pētījuma grupa –10 gadu veci un vecāki bērni ar aptaukošanos, II pētījuma grupa – bērni līdz 10 gadu vecumam ar aptaukošanos, kontroles grupa – bērni ar normālu ķermeņa svaru. Šajā etapā pētījuma bērniem veikts aptaukošanās prenatālo un postnatālo riska faktoru novērtējums un aptaukošanās komplikāciju skrīnings. Otrajā pētījuma etapā pēc Starptautiskās diabēta federācijas izstrādātajiem kritērijiem izvērtēts metaboliskais sindroms bērniem no 10 gadu vecuma, t. i., tikai I pētījuma grupas (n = 143) bērniem. Visi iegūtie dati apkopoti Excel datubāzē un analizēti, izmantojot RStudio V.1.4.1103. Atšķirības uzskatītas par statistiski nozīmīgām, ja nozīmības līmenis p bija < 0,05. Rezultāti. Aptaukošanās prenatālie riska faktori, kā dzimšanas svars (p = 0,530), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,787), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p > 0,999), statistiski nozīmīgi neatšķīrās bērniem ar aptaukošanos un normālu ķermeņa svaru. Arī aptaukošanās postanatālam riska faktoram, ekskluzīvas zīdīšanas ilgumam (p = 0,120) netika atrasta statistiski nozīmīga atšķirība starp bērniem ar aptaukošanos un normālu svaru. Statistiski nozīmīga atšķirība pētījuma grupās tika novērota tikai postnatālam aptaukošanās riska faktoram – vecāku aptaukošanās faktam (p = 0,004). Bērniem ar aptaukošanos gan I grupā, gan arī II grupā bija augsta vecāku aptaukošanās izplatība, attiecīgi 79,8 % un 63,0 %, salīdzinot ar normāla svara bērniem. Bērniem ar normālu svaru vecāku aptaukošanās konstatēta tikai 33,3 % gadījumu. Veicot aptaukošanās komplikāciju skrīningu, bērniem ar lieko svaru novērotas statistiski nozīmīgas sirds un asinsvadu sistēmas slimību, insulīna rezistences un citu bioķīmisko rādītāju izmaiņas, salīdzinot ar normāla svara bērniem. I pētījumā grupā gan sistoliskā asinsspiediena mediāna 123,0 (IQR 116,0; 132,0), gan arī diastoliskā asinsspiediena mediāna 78,0 (IQR 71,5; 83,0) bija nozīmīgi augstāka, salīdzinot ar kontroles grupu, kurā sistoliskā asinsspiediena mediāna bija 115,0 (IQR 110,0; 120,0), bet diastoliskā asinsspiediena mediāna 70,0 (IQR 65,0; 76,0) (p = 0,012). Kontroles grupā nevienam bērnam nebija konstatēts paaugstināts kopējā holesterīna līmenis virs 5,2 mmol/l, bet I pētījuma grupā tāds bija 8,8 % bērnu. Bērniem ar aptaukošanos gan I, gan arī II pētījuma grupā statistiski nozīmīgi augstāka bija insulīna rezistences koeficienta HOMA-IR mediāna, attiecīgi 3,9 (IQR 2,6; 5,6) un 2,3 (IQR 1,5; 3,4), salīdzinot ar normāla svara bērniem – 1,1 (IQR 0,8; 2,1) (p < 0,001). I grupas bērniem metaboliskais sindroms, izvērtējot to atbilstoši Starptautiskās diabēta federācijas izstrādātajiem kritērijiem, tika diagnosticēts 21 % (n = 30) gadījumu. Metaboliskā sindroma incidence pētāmajā populācijā pieauga līdz ar bērnu vecumu: vecumā no 10 līdz 16 gadiem metaboliskais sindroms tika diagnosticēts 17,1 %, bet 16 gadu un vecāku bērnu grupā – 38,5 % bērnu. Bērniem ar metabolisko sindromu bija nozīmīgi lielāka svara mediāna (p < 0,001) un zemāka jutība pret insulīnu (p = 0,039), salīdzinot ar bērniem bez metaboliskā sindroma. Pētījuma laikā netika apstiprināta aptaukošanās prenatālu riska faktoru – tādu kā dzimšanas svars (p = 0,145), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,625), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p = 0,519) – ietekme uz metaboliskā sindroma attīstību. Aptaukošanās postnatālais riska faktors, ekskluzīvas zīdīšanas ilgums, arī neietekmēja metaboliskā sindroma attīstību (p > 0,999). Metaboliskā sindroma varbūtība bērniem pieauga, palielinoties ķermeņa masas indeksam, un 11,13 reizes varbūtību palielināja tēva aptaukošanās.Secinājumi. Bērniem ar aptaukošanos jau agrīni tika novēroti sirds un asinsvadu sistēmas slimību un 2. tipa cukura diabēta riska faktori. Desmitgadīgiem un vecākiem bērniem ar aptaukošanos bija augstāks asinsspiediens, paaugstināts kopējā holesterīna daudzums un augstāks insulīna rezistences koeficients HOMA-IR. Metaboliskā sindroma diagnoze tika apstiprināta gandrīz ceturtdaļai bērnu pētāmajā populācijā. Metaboliskā sindroma varbūtību nozīmīgi palielināja gan aptaukošanās pakāpe, gan arī vecāku aptaukošanās.

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Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents

Cited by 8 publications

References 67 publications

Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review

Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review

Risk Factors, Complications and Characteristics of Metabolic Syndrome in Obese Children and Adolescents. Summary of the Doctoral Thesis

Metaboliskā sindroma riska faktori, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Promocijas darbs

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