Prevalence and Trends of a Metabolic Syndrome Phenotype Among U.S. Adolescents, 1999–2000

Duncan, Glen E.; Li, Sierra M.; Zhou, Xiao‐Hua

doi:10.2337/diacare.27.10.2438

Cited by 435 publications

(376 citation statements)

References 37 publications

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“…99 Safe and effective treatments for central obesity in youth are urgently needed, given the increasing prevalence of overweight in youth, [1][2][3][4][5] and that the prevalence of 'metabolic syndrome' in overweight children and adolescents has been reported to be as high as 29-50%, 10,13 and rising. 100 Numerous studies have found that physically active boys and girls are at decreased risk of metabolic syndrome compared with those less active. 101,102 Although regular exercise should be prescribed for disease prevention because it increases total physical activity level, the efficacy of exercise in the treatment of metabolic syndrome in boys and girls is yet to be established.…”

Section: Central Obesitymentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

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Section: Central Obesitymentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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“…In Table 1 we present 15 papers, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] all of which used different sets of variables, number of criteria and cutoff points to define the risk-factors associated with the MS. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] The main differences concern the techniques used to estimate adiposity (body mass index (BMI) and/or waist circumference (WC)), and the variable(s) chosen to evaluate glucose metabolism (fasting glucose, …”

Section: Actual Featuresmentioning

confidence: 99%

“…59,69 Published papers concerning the MS in children and adolescents reported a high prevalence, ranging up to 50% of the obese patients studied. 18,19,22,24,27,29 This figure is definitely alarming, but we know that the prevalence recorded strongly depends on the definition chosen, with the estimate being much higher if insulin is part of the definition. 34 Regardless of insulin, a low-discrimination power parameter is the presence of obesity itself in the definition, either directly via BMI or indirectly via WC.…”

Section: Major Concernsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2007

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Background: The diagnostic criteria of the metabolic syndrome (MS) have been applied in studies of obese adults to estimate the metabolic risk-associated with obesity, even though no general consensus exists concerning its definition and clinical value. We reviewed the current literature on the MS, focusing on those studies that used the MS diagnostic criteria to analyze children, and we observed extreme heterogeneity for the sets of variables and cutoff values chosen. Objectives: To discuss concerns regarding the use of the existing definition of the MS (as defined in adults) in children and adolescents, analyzing the scientific evidence needed to detect a clustering of cardiovascular risk-factors. Finally, we propose a new methodological approach for estimating metabolic risk-factor clustering in children and adolescents. Results: Major concerns were the lack of information on the background derived from a child's family and personal history; the lack of consensus on insulin levels, lipid parameters, markers of inflammation or steato-hepatitis; the lack of an additive relevant effect of the MS definition to obesity per se. We propose the adoption of 10 evidence-based items from which to quantify metabolic risk-factor clustering, collected in a multilevel Metabolic Individual Risk-factor And CLustering Estimation (MIRACLE) approach, and thus avoiding the use of the current MS term in children. Conclusion: Pediatricians should consider a novel and specific approach to assessing children/adolescents and should not simply derive or adapt definitions from adults. Evaluation of insulin and lipid levels should be included only when specific references for the relation of age, gender, pubertal status and ethnic origin to health risk become available. This new approach could be useful for improving the overall quality of patient evaluation and for optimizing the use of the limited resources available facing to the obesity epidemic.

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“…For children and adolescents, although diverse definitions of metabolic syndrome have been used in various populations (Katzmarzyk et al, 2001;Cook et al, 2003;de Ferranti et al, 2004;Weiss et al, 2004;Yoshinaga et al, 2005), a strong association between overweight and metabolic syndrome among adolescents has been suggested regardless of ethnicity (Cook et al, 2003;Duncan et al, 2004;Weiss et al, 2004;Yoshinaga et al, 2005;Esmaillzadeh et al, 2006). The National Health and Nutrition Examination Survey 1999-2000 among adolescents aged 12-19 years (n ¼ 991) showed that metabolic syndrome was present in 32.1% of overweight adolescents (Cook et al, 2003), compared with 7.1% of those at risk for overweight (body mass index (BMI) between 85th and 95th percentiles).…”

Section: Introductionmentioning

confidence: 99%

Relationship between the change in overweight status from childhood to adolescence and metabolic syndrome phenotypes: a 9-year retrospective study

Kim

Choi

2007

Eur J Clin Nutr

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Objective: To evaluate how the changes in overweight status from childhood to adolescence are related to metabolic syndrome phenotypes in adolescents. Subjects and methods: A total 375 adolescents aged 16 years. The overweight status from childhood to adolescence (from 7 years of age to 16 years) was determined by body mass index (BMI, kg/m 2 ) calculated from records of the School Physical Examination data. The change in body weight was classified into four groups: normal weight to normal weight (NW-NW); overweight to normal (OW-NW); normal to overweight (NW-OW); overweight to overweight (OW-OW). Metabolic syndrome phenotypes were examined from a cross-sectional survey. Results:The mean values of all phenotypes except for body fatness (BMI and waist) and the cluster score of phenotypes at 16 years of age were not different between the NW-NW group and the OW-NW group, nor between the NW-OW group and the OW-OW group. However, the score as well as the level of body fatness and blood glucose were significantly different between current overweight and normal adolescents regardless of overweight status during childhood (Po0.05). Conclusion: There was a linear relationship between overweight status during childhood and metabolic syndrome phenotypes in adolescence but current overweight status (adolescence overweight) was more closely related to the adolescent risk of metabolic syndrome than childhood overweight status.

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Prevalence and Trends of a Metabolic Syndrome Phenotype Among U.S. Adolescents, 1999–2000

Cited by 435 publications

References 37 publications

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

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

Relationship between the change in overweight status from childhood to adolescence and metabolic syndrome phenotypes: a 9-year retrospective study

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