Identifying the metabolic syndrome in obese children and adolescents: do age and definition matter?
OBJECTIVE
To assess the prevalence of the metabolic syndrome (MetS) in overweight/obese children and adolescents of an out-patient clinic, and to compare two definitions of MetS in adolescents.


METHODS
In total, 528 overweight / obese children (3-16 years), of multi-ethnic origin, underwent an oral glucose tolerance test, blood collections and anthropometric measurements. In children <10 years, MetS was assessed according to child-specific cut-off values (MetS-child). In adolescents, MetS-child and MetS-adolescent (the recommendation of the International Diabetes Federation for adolescents) were compared.


RESULTS
The prevalence of MetS-child within the cohort (median age 11.3, range 3.1-16.4 yrs) was 18.6% (children <10 years vs. adolescents: 14.1% vs. 20.7%, P=0.073). Insulin resistance was present in 47.7% (children <10 years vs. adolescents: 21.8% vs. 60.1%, P<0.001). MetS-child was highly prevalent, and not statistically significant between age groups. In adolescents, the prevalence of MetS-adolescent was higher than MetS-child (33.2% vs. 20.7%, P<0.001). The agreement between the MetS definitions was moderate (kappa =0.51), with the agreement for the MetS-criteria for abnormal lipid levels being substantial to very good (kappa =0.71 to 0.80).


CONCLUSIONS
MetS-child was highly prevalent in overweight/obese children and adolescents. A higher prevalence of MetS according to adolescent- as compared to child-specific criteria was found.
van Vliet
Mariska
M
Department of Endocrinology/Diabetes Centre, VU University Medical Centre, De Boelelaan 1118, 1081HV Amsterdam, The Netherlands. ma.vanvliet@vumc.nl
von Rosenstiel
Inès A
IA
Schindhelm
Roger K
RK
Brandjes
Dees P M
DP
Beijnen
Jos H
JH
Diamant
Michaela
M
D000293:Adolescent; D000367:Age Factors; D000554:Ambulatory Care Facilities; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D006305:Health Status Indicators; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D009626:Terminology as Topic; D055105:Waist Circumference
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids