The prevalence of pediatric metabolic syndrome—a critical look on the discrepancies between definitions and its clinical importance

Abstract

Introduction The Metabolic Syndrome (MetS) describes the clustering of cardio-metabolic risk factors—including abdominal obesity, insulin resistance, elevated blood pressure, high levels of triglycerides, and low levels of high-density lipoproteins—that increase the risk for developing cardiovascular diseases and type 2 diabetes mellitus. However, a generally accepted definition of MetS in pediatric patients is still lacking. Objectives The aim was to summarize current prevalence data of childhood MetS as well as to discuss the continuing disagreement between different pediatric definitions and the clinical importance of such diagnosis. Methodology A systematic literature search on the prevalence of pediatric MetS was conducted. Articles that were published during the past 5 years (2014–2019), using at least one of four predetermined classifications (International Diabetes Federation, Cook et al., Ford et al., and de Ferranti et al.), were included. Results The search resulted in 1167 articles, of which 31 publications met all inclusion criteria. Discussion The prevalence of MetS ranged between 0.3 and 26.4%, whereby the rising number of children and adolescents with MetS partly depended on the definition used. The IDF definition generally provided the lowest prevalences (0.3–9.5%), whereas the classification of de Ferranti et al. yielded the highest (4.0–26.4%). In order to develop a more valid definition, further research on long-term consequences of childhood risk factors such as abdominal obesity, insulin resistance, hypertension, and dyslipidemia is needed. There is also a temptation to suggest one valid, globally accepted definition of metabolic syndrome for pediatric populations but we believe that it is more appropriate to suggest definitions of MetS that are specific to males vs. females, as well as being specific to race/ethnicity or geographic region. Finally, while this notion of definitions of MetS specific to certain subgroups is important, it still needs to be tested in future research.

Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies

“…The findings of the recent systematic review also revealed that the prevalence of MetS in the pediatric population ranged from 0.3 to 26.4%, with the lower prevalence recorded in the IDF criteria (0.3-9.5%). But, the prevalence was relatively higher in the de Ferranti et al criteria (4-26.4%) [140]. Thus, the current findings are in line with the findings in this study.…”

Changes in the Prevalence of Metabolic Syndrome and Its Components as Well as in Relevant Preventive Medication between 2006 and 2018 in the Northeast Hungarian Population

“…In our present study, the prevalence of decreased HDL-C levels also increased significantly, from 21.21% to 36.73% ( p = 0.016), in the subgroups aged 20–34 years, while there was no significant change in the other age groups between 2006 and 2018. High prevalence of MetS was also detected among young adults (aged 18–30 years) in a study recently published [ 39 ] on the Ellisras (town in the Limpopo province of South Africa) rural population, and increasing prevalence of MetS even among children and adolescents seems to be a worldwide phenomenon [ 40 , 41 , 42 ]. These observations are interpreted as outcomes of severe nutritional changes and missing preventive interventions targeting healthy diet [ 40 , 41 , 42 ].…”

“…High prevalence of MetS was also detected among young adults (aged 18–30 years) in a study recently published [ 39 ] on the Ellisras (town in the Limpopo province of South Africa) rural population, and increasing prevalence of MetS even among children and adolescents seems to be a worldwide phenomenon [ 40 , 41 , 42 ]. These observations are interpreted as outcomes of severe nutritional changes and missing preventive interventions targeting healthy diet [ 40 , 41 , 42 ]. Several studies have found that young adults are at increased risk for the development of cardiovascular diseases [ 43 , 44 , 45 ] and for mental disorders [ 46 , 47 ] in the presence of metabolic syndrome.…”

A Multivariate Pattern Analysis of Metabolic Profile in Neurologically Impaired Children and Adolescents

“…Metabolic syndrome (MetS) refers to a clustering of co-incident and interrelated risk factors that place a subject at high risk of developing cardiovascular disease (CVD) and diabetes type 2 (DT2), thus increasing mortality risk [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. These factors include central obesity, dysglycemia/insulin resistance (IR), hypertension, high levels of triglycerides (TG), and low high-density lipoprotein cholesterol (HDL cholesterol) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”

“…The prevalence of pediatric MetS ranges from 0.3 to 26.4%. This variation in prevalence is due to the large number of different pediatric definitions of MetS [ 9 ]. MetS is usually closely linked to overweight and obesity, and it predicts DT2, CVD, and all-cause mortality in adults [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”