title: Comparison of definitions for the metabolic syndrome in adolescents. The HELENA study.
abstract: Various definitions are used to define metabolic syndrome in adolescents. This study aimed to compare, in terms of prevalence and differences, five frequently used definitions for this population: International Diabetes Federation, National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP) modified by Cook, pediatric American Heart Association (AHA), World Health Organization, and Jolliffe and Janssen. A sample of 1004 adolescents (12.5-17.0 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study was considered. The components of the definitions (waist circumference/BMI, plasma lipids, glycemia, and blood pressure) were applied, and definitions were compared by using crosstabs, sensitivity, specificity, and kappa coefficient. The prevalence of metabolic syndrome varied from 1.6 to 3.8% depending on the used definitions. Crosstabs comparing the definitions showed the fewest cases being misclassified (having metabolic syndrome or not) between NCEP-ATP and AHA. Analyses for kappa coefficient, sensitivity, and specificity confirmed this finding.
  
  
  CONCLUSIONS
  The different definitions do not classify the same adolescents as having MS and prevalence varied between diagnostic methods. The modified NCEP-ATP and the AHA definitions were most analogous in defining subjects as having metabolic syndrome or not. What is known? • Metabolic syndrome is not only a problem of adulthood but is already present in children and adolescents. • Several diagnostic methods are used to define metabolic syndrome in adolescents. What is new? • Comparing the most frequently used definitions of metabolic syndrome in adolescents showed that they do not indicate the same adolescents as having metabolic syndrome. • The modified National Cholesterol Education Program Adult Treatment Panel III and the pediatric American Heart Association definitions were most analogous in defining subjects as having metabolic syndrome or not.
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Tine
authors.initials: T
authors.lastname: Vanlancker
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Emmily
authors.initials: E
authors.lastname: Schaubroeck
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Krishna
authors.initials: K
authors.lastname: Vyncke
authors.affiliation: PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cadenas-Sanchez
authors.affiliation: Institut für Ernährungs und Lebensmittelwissenschaften Ernährungphysiologie, Rheinische Friedrich Wilhelms, Universität Bonn, Bonn, Germany.|ImFINE Research Group, Faculty of Physical Activity and Sport-INEF, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain.
authors.forename: Christina
authors.initials: C
authors.lastname: Breidenassel
authors.affiliation: ImFINE Research Group, Faculty of Physical Activity and Sport-INEF, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain.|CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: González-Gross
authors.affiliation: Inserm, CHU Lille, U995-LIRIC-Lille Inflammation Research International Center, Université Lille, 59000, Lille, France.|Inserm, CHU Lille, CIC 1403-Centre d'investigation clinique, Université Lille, 59000, Lille, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: GENUD-Growth, Exercise, Nutrition and Development, University of Zaragoza, Zaragoza, Spain.|School of Health Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Inserm, CHU Lille, U995-LIRIC-Lille Inflammation Research International Center, Université Lille, 59000, Lille, France.|Inserm, CHU Lille, CIC 1403-Centre d'investigation clinique, Université Lille, 59000, Lille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Beghin
authors.affiliation: Medical Faculty, Department of Paediatrics, University of Pécs, Pécs, Hungary.
authors.forename: Denes
authors.initials: D
authors.lastname: Molnár
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.affiliation: Department of Paediatrics, Private Medical University Salzburg, Salzburg, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.affiliation: INRAN (National Research Institute on Food and Nutrition), Rome, Italy.
authors.forename: Catherine
authors.initials: C
authors.lastname: Leclercq
authors.affiliation: Department of Epidemiology and Public Health, U-744 INSERM, Institut Pasteur de Lille, Universite Lille Nord de France, Lille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.affiliation: Food Science and Technology and Nutrition Institute, Spanish National Research Council, Metabolism and Nutrition, Immunonutrition Research Group, Madrid, Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ascensión
authors.affiliation: School of Medicine, Preventive Medicine and Nutrition Unit, Heraklion, University of Crete, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: Department of Medical Physiology, School of Medicine, Granada University, Granada, Spain.
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Castillo
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.|Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium. huybrechtsi@iarc.fr.|International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France. huybrechtsi@iarc.fr.
authors.forename: Inge
authors.initials: I
authors.lastname: Huybrechts
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Insulin resistance; Metabolic criteria; Metabolic risk factors; Youth