Metabolic syndrome among children and adolescents in Low and Middle Income Countries: A systematic review and meta-analysis

Abstract

Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs.Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females.Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

Clustered cardiovascular disease risk among children aged 8–13 years from lower socioeconomic schools in Gqeberha, South Africa

“…However, these results are relative to pubertal development25 26 and should be interpreted with caution as 9.92% of girls in the current sample had self-reported age at menarche. Our findings correlate with a recently published study which also found depressed HDL-C to be a common risk factor in a sample of 142 142 children and adolescents 27. A general and yet consistent finding is for total cholesterol to decrease during sexual maturation while patterns of change vary across studies for triglycerides and lipoprotein-cholesterol fractions 25…”

“…Tailor et al 29 provided a worldwide update on the prevalence of MetS among children and adolescents, ranging from 1.2% to 22.6%; however, none of the included studies were from Africa. A systematic review and meta-analysis27 of 76 studies reported a pooled prevalence of MetS in Africa (6.03%, 95% CI 0.24% to 11.28% for the IDF definition; and 6.71%, 95% CI 5.51% to 7.91% for the ATP III definition) which only included two studies from SA,9 10 the other study was from Ethiopia (a prevalence of 12.4% was reported among an adolescent sample) 30. The two South African studies included children older than 10 years old.…”

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

“…In a meta-analysis including data from 76 studies with 142 142 children and adolescents residing in low- to middle-income countries, the pooled prevalence of MetS was 4.0% (IDF), 6.7% (ATP III), and 8.9% (de Ferranti). 296 Among obese or overweight children and adolescents, pooled prevalence was estimated at 24.1%, 36.5%, and 56.3% with the IDF, ATP III, and de Ferranti criteria, respectively.…”

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

“…In a meta-analysis including data from 76 studies with 142 142 children and adolescents residing in low- to middle-income countries, the pooled prevalence of MetS was 4.0% (International Diabetes Federation), 6.7% (ATP III), and 8.9% (de Ferranti). 297 Among obese or overweight children and adolescents, pooled prevalence was estimated at 24.1%, 36.5%, and 56.3% with the International Diabetes Federation, ATP III, and de Ferranti criteria, respectively.…”