title: Comparison of two classifications of metabolic syndrome in the pediatric population and the impact of cholesterol.
abstract: BACKGROUND
  To establish the rate of agreement in predicting metabolic syndrome (MS) in different pediatric classifications using percentiles or fixed cut-offs, as well as exploring the influence of cholesterol.
  
  
  METHODS
  Cross-sectional study in a tertiary care center. Nine hundred and twenty-three obese children and adolescents were evaluated for metabolic characteristics, cholesterol levels, the agreement rate and prevalence of MS across age subgroups with pediatric National Cholesterol Education Program/ Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) classifications.
  
  
  RESULTS
  The overall prevalence of MS was 36.2% and 56.7% with NCEPATP III and IDF. The overall concordance was fair (k: 0.269), with substantial values observed only in children older than 10 (k: 0.708) and 16 yr (0.694). Concordant subjects for both classifications, ≤6 yr, had higher triglycerides, blood pressure (p<0.05) and lower HDL-cholesterol (p<0.0001), with respect to those found to be discordant. Concordant subjects ranging 6-10 yr had all parameters higher than those discordant for IDF (p<0.01) and insulin resistance (p<0.05) than those discordant for NCEP-ATP III. Concordant subjects ≥10 yr presented more altered parameters than those included only in NCEP-ATP III (p<0.05). Overt glucose alterations were uncommon (7.4%; confidence interval 95% 0.1-14.9%), although glucose was modestly higher in MS subjects (p<0.01). Total and LDL-cholesterol was lower in subjects with MS than in those without (p<0.05), and in concordant rather than discordant subjects (p<0.05).
  
  
  CONCLUSIONS
  Classifications of MS do not identify the same pediatric population. Subjects who satisfied any classification were the most compromised. Lipid alterations were precocious in the youngest. Obese youths with MS presented lower total and LDL-cholesterol.
authors.affiliation: SCDU of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", via Solaroli 17, 28100 Novara, Italy. flavia.prodam@med.unipmn.it
authors.forename: F
authors.initials: F
authors.lastname: Prodam
authors.forename: R
authors.initials: R
authors.lastname: Ricotti
authors.forename: G
authors.initials: G
authors.lastname: Genoni
authors.forename: S
authors.initials: S
authors.lastname: Parlamento
authors.forename: A
authors.initials: A
authors.lastname: Petri
authors.forename: C
authors.initials: C
authors.lastname: Balossini
authors.forename: S
authors.initials: S
authors.lastname: Savastio
authors.forename: G
authors.initials: G
authors.lastname: Bona
authors.forename: S
authors.initials: S
authors.lastname: Bellone
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification* / Q000453:epidemiology; D015995:Prevalence; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol