Metabolic syndrome in children and adolescents from Mérida city, Venezuela: Comparison of results using local and international reference values (CREDEFAR study).
OBJECTIVE
To obtain local reference values for blood lipids and blood pressure (BP), and to determine the prevalence of metabolic syndrome (MS) in children and adolescents from Mérida, Venezuela, and to compare results using local and international cut-off values.


METHODS
The study enrolled 916 participants of both sexes aged 9-18 years of age from educational institutions. Demographic, anthropometric, and BP data were collected. Fasting blood glucose and lipid profile were measured. Percentile distribution of lipid and BP values was done by age group and sex. Prevalence of MS was estimated based on the NCEP-ATPIII classification (as modified by Cook et al.) and the classification of the International Diabetes Federation, using percentiles of Mérida and the USA as cut-off points. Agreement between both classifications was estimated using the kappa test (κ).


RESULTS
Prevalence of MS was 2.2% by Cook-Merida percentiles, as compared to 1.8% by Cook-USA percentiles, a moderate agreement (κ=0.54). Agreement between Cook et al. and IDF using Merida percentiles was weak (κ=0.28). There was a higher frequency of abdominal obesity, hypertriglyceridemia and hypertension, and a lower frequency of low HDL-C using Mérida percentiles. The risk (odds ratio) of having MS is greater if abdominal obesity exists (OR: 98.63, CI: 22.45-433.35, p=0.0001). MS was significantly more common in obese subjects (18.3%, p=0.0001).


CONCLUSIONS
Prevalence of MS in this sample of children and adolescents was 2.2%. Lipid and BP values were lower in Venezuelan as compared to US, European, and Asian children and adolescents, and similar to those in Latin-American references. Own reference values are required for accurate diagnosis of MS, as well as a worldwide consensus on its diagnostic criteria.
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Marjorie
M
Villalobos Reyes
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Maracelly
M
Mederico
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela. Electronic address: paolimariela@hotmail.com.
Mariela
M
Paoli de Valeri
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Yajaira
Y
Briceño
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Yajaira
Y
Zerpa
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Roald
R
Gómez-Pérez
Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Nolis
N
Camacho
Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
José Luis
JL
Martínez
Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
Lenín
L
Valeri
Laboratorio de Neuroendocrinología y Reproducción, Departamento de Fisiopatología, Universidad de Los Andes, Mérida, Venezuela.
Gabriela
G
Arata-Bellabarba
D000293:Adolescent; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D005260:Female; D014943:Global Health; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D012016:Reference Values; D014505:Urban Population / Q000706:statistics & numerical data; D014687:Venezuela / Q000453:epidemiology
D001786:Blood Glucose; D008055:Lipids
Children and adolescents; Lipid and blood pressure local references; Metabolic syndrome; Mérida; Niños y adolescentes; Referencias locales de lípidos y presión arterial; Síndrome metabólico; Venezuela