Prevalence of metabolic syndrome in a cohort of Chinese schoolchildren: comparison of two definitions and assessment of adipokines as components by factor analysis

Abstract

BackgroundAlthough attention to metabolic syndrome (MetS) in children has increased, there is still no universally accepted definition and its pathogenesis remains unclear. Our aim was to compare the current definitions of childhood MetS in a Chinese cohort and to examine the clustering pattern of MetS risk factors, particularly inclusion of leptin and adiponectin as additional components.Methods3373 schoolchildren aged 6 to 18 years were recruited. Anthropometric and biochemical parameters and adipokines were measured. MetS was identified using both the International Diabetes Federation (IDF) and a modified Adult Treatment Panel III (ATP III) definitions. Exploratory factor analysis was performed to establish grouping of metabolic characteristics.ResultsFor children ≥10 years, the prevalence of MetS was 14.3% in the obese group and 3.7% in the overweight group according to the new IDF definition, and 32.3% in the obese group and 8.4% in the overweight group according to the modified ATPIII definition. Frequency of hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), impaired fasting glucose, elevated blood pressure, and central obesity according to the new IDF definition was 16.7%, 20.7%, 15.8%, 25.5% and 75.5% in obese boys and 14.7%, 24.0%, 12.0%, 11.0% and 89.0% in obese girls, respectively. Metabolic abnormalities in children under 10 years of age were also noted. Using factor analysis on eight conventional variables led to the extraction of 3 factors. Waist circumference (WC) provided a connection between two factors in boys and all three factors in girls, suggesting its central role in the clustering of metabolic risk factors. Addition of leptin and adiponectin also led to the extraction of 3 factors, with leptin providing a connection between two factors in girls. When using WC, mean arterial pressure, triglyceride/HDL-C ratio, HOMA-IR and leptin/adiponectin ratio as variables, a single-factor model was extracted. WC had the biggest factor loading, followed by leptin/adiponectin ratio.ConclusionsMetS was highly prevalent amongst obese children and adolescents in this cohort, regardless of the definition used. Central obesity is the key player in the clustering of metabolic risk factors in children, supporting the new IDF definition. Moreover, our findings suggest that a common factor may underlie MetS. Leptin/adiponectin ratio as a possible component of MetS deserves further consideration.

Association between sleep duration and cardiac structure in youths at risk for metabolic syndrome

“…Subjects were participants in the cohort of BCAMS1718. The BCAMS is a prospective cohort study, which aims to identify cardiovascular risk factors from childhood to adulthood.…”

Reference Values for The Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Non-High-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2007-2013

“…However, recent studies have demonstrated that non-HDL-C can be used as an accurate predictor of cardiovascular disease 6) . The TG/HDL-C ratio has been suggested as a measure to identify overweight individuals with insulin resistance 7, 8) . In recent studies, the TG/HDL-C ratio was found to be associated with cardiovascular mortality 9) .…”

Increased Leptin/Adiponectin Ratio and Free Leptin Index Are Markers of Insulin Resistance in Obese Girls during Pubertal Development

“…Subsequently, many researchers have reported that the L/A ratio is a consistent marker of IR in patients with and without diabetes in comparison with other indicators [58] and may be used as an atherogenic index, providing additional information on the risk of MS [59]. We found a correlation between the L/A index and insulin values during OGTT and with HOMA values, suggesting again the possible utility of this ratio to predict the presence of IR, better than adiponectin or leptin alone [54].…”