title: Prevalence of metabolic syndrome (MS) in children and adolescents with varying degrees of obesity.
abstract: OBJECTIVE
  Childhood obesity is increasingly common and is associated with health problems; in particular, obesity plays a central role in the metabolic syndrome (MS). We estimated the prevalence of MS in Caucasian children and adolescents with varying degrees of obesity.
  
  
  METHODS
  We studied 191 obese [body mass index (BMI) > 97th percentile] children and adolescents. Obesity was stratified on the basis of a threshold BMI z-score and subjects were classified as moderately (z-score 2-2.5) or severely obese (z-score > 2.5). Seventy-six, nonobese subjects were recruited into a comparison group. Thirty-one of them were of normal weight (BMI < 75th percentile) and 45 overweight (BMI 75th-97th percentile). Patients were classified as having MS if they met three or more of the following criteria for age and sex: BMI > 97th percentile, triglyceride levels > 95th percentile, high density lipoprotein (HDL) cholesterol level < 5th percentile, systolic or diastolic blood pressure > 95th percentile and impaired glucose tolerance (blood glucose level: 7.8-11.1 mmol/l at 2 h). Insulin resistance was calculated using the homeostasis model assessment for insulin resistance (HOMA-IR) and impaired insulin sensitivity was defined as a HOMA-IR > or = 2.5 in prepubertal patients and HOMA-IR > 4 in pubertal subjects.
  
  
  RESULTS
  The overall prevalence of MS was 13.9% and was present in 12.0% of moderately obese and 31.1% of severely obese subjects; no overweight or normal weight subjects met the criteria for MS. The rate of the MS increased progressively with increasing BMI categories (P < 0.001). Severely obese patients had a threefold increased risk with respect to moderately obese patients.
  
  
  CONCLUSIONS
  The prevalence of the MS is higher in obese as opposed to nonobese subjects and increases with severity of obesity.
authors.affiliation: Department of Pediatric Sciences, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy. v.calcaterra@smatteo.pv.it
authors.forename: V
authors.initials: V
authors.lastname: Calcaterra
authors.forename: C
authors.initials: C
authors.lastname: Klersy
authors.forename: T
authors.initials: T
authors.lastname: Muratori
authors.forename: S
authors.initials: S
authors.lastname: Telli
authors.forename: C
authors.initials: C
authors.lastname: Caramagna
authors.forename: F
authors.initials: F
authors.lastname: Scaglia
authors.forename: M
authors.initials: M
authors.lastname: Cisternino
authors.forename: D
authors.initials: D
authors.lastname: Larizza
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence; D012727:Sex Characteristics