Frequency of the metabolic syndrome in obese Spanish pediatric population

Abstract

Objective: Obesity is associated with insulin-resistance (IR), type 2 diabetes (T2D) and a constellation of cardiovascular risk factors at the early years of life. These features define the so-called metabolic syndrome (MS). Aims: To assess the frequency of the MS among obese pediatric Spanish population and analyse the individual contribution and the predictive potential of individual components to the development of the syndrome. Patients and methods: A total of 429 patients, 220 boys and 209 girls, aged 4-18 years, with a body mass index of O2 standard deviation scores for Spanish normative charts, were included in the study. Forty-seven percent were prepubertal and ten percent had Hispanic ethnicity. HbA1c, lipids, liver enzymes and uric acid levels were determined from blood and a standard 2-h oral glucose tolerance test was performed. MS was defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria modified by Cook as having at least three features among: obesity, low high-density lipoprotein (HDL), hypertriglyceridemia, hypertension (HTA) or impaired glucose metabolism (IGM). We defined IR as homeostatic model assessment of IR index and/or fasting insulin levelsO95th centile of the control population. Results: Almost 18% of the patients had MS, with significantly higher frequency in Hispanic (32%) than in Caucasian (16%) population. There were no differences by sex or pubertal status. Prevalence of low HDL, HTA, hypertriglyceridemia and IGM were 27, 23, 16 and 7% respectively. No silent T2D was identified. According to International Obesity Task Force charts, 22% of the patients were overweight and not obese, but no differences in the frequency of individual features of MS between these two groups were observed. Among IR patients (35% of our population), the frequency of MS reached 28%. IR predicted the presence of MS independently from age and race. Conclusion: MS is present in 18% of our obese pediatric population. IR is closely associated with the components of MS and strongly predicts its development.European Journal of Endocrinology 155 313-319

Leptin and Metabolic Syndrome in Obese Pediatric Population: A Crosssectional Study

“…The comparison of these results with those described by other authors reveals that the prevalence found is similar than references from Cook (28.7%) [18], Cruz (30%) [22], Weiss (38.7%) [23] Viner (30%) [24] and Ferranti (31.2%) [25] in obese UK or American children and adolescents, although slightly higher than references from Olza (16.8%) [13], Lopez-Capapé (18%) [26] and Tapia (18.6%) [27] in Spanish obese pediatric population. Nevertheless, the contrast of the rate of prevalence from different Studies has a relative value, since the criteria applied are different, and even different cut points for each component of MS are used [28].…”

“…This syndrome is characterized by a cluster of symptoms associated to obesity, such as insulin resistance, arterial hypertension and dyslipidemia, and its interest lies in the high predictive value for cardiovascular disease and type 2 diabetes in adulthood, especially when it is already present in school children and/or adolescents [5][6][7][8][9]. Even when the International Diabetes Federation (IDF) [10] refers to the inability for diagnosis in school age, epidemiological data allow suspecting that metabolic syndrome or its components are already present at early stages [11][12][13][14].…”

Metabolic Syndrome in School Children in Mardin, South-Eastern of Turkey

“…Also, the prevalence of MES in normal-weight adolescents was found to be less than 1% [20]. Studies conducted on prevalence of MES in obese children indicate varied numbers in European countries (in France 15.9%, in Italy 13.9%, in Spain 18%) [21][22][23]]. Weiss's study, examining the correlation between obesity grades and the prevalence of MES, states a prevalence of 38.7% in moderate obese adolescents (VKI z score 2-2.5) and a prevalence of 49.7% in severely obese adolescents (VKI z score >2.5) [24].…”

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

“…12 Nonetheless, the three proposed definitions have been used in several studies carried out in pediatric populations, which reported high-prevalence of the MS in obese children and adolescents. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The results of these studies varied according to the selected diagnostic criteria used, as established by a recent comparison study. 34 Moreover, in an evaluation of the different prevalence yields using different definition, Goodman et al 35 found that ATP III definition identified half as many children and adolescents as having MS as did WHO definition in the same population.…”