Annals of Nutrition and Metabolism

Original Paper

Presence of the Metabolic Syndrome in Obese Children at Prepubertal Age

Olza J.a · Gil-Campos M.b · Leis R.c · Bueno G.d · Aguilera C.M.a · Valle M.f · Cañete R.b · Tojo R.c · Moreno L.A.e · Gil A.a

Author affiliations

aDepartment of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center of Biomedical Research, Lab 123, University of Granada, Armilla, bUnit of Pediatric Endocrinology, Reina Sofía University Hospital, Córdoba, cUnit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Pediatrics, University Clinical Hospital of Santiago, University of Santiago de Compostela, Santiago de Compostela, dDepartment of Pediatrics, Lozano Blesa University Clinical Hospital, eSchool of Health Sciences, University of Zaragoza, Zaragoza, and fUnit of Clinical Analyses, Valle de los Pedroches Hospital, Pozoblanco, Spain

Related Articles for ""

Ann Nutr Metab 2011;58:343–350

Log in to MyKarger to check if you already have access to this content.


Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select
* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 08, 2011
Accepted: August 22, 2011
Published online: October 13, 2011
Issue release date: October 2011

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM

Abstract

Background/Aims: There is a strong debate on the diagnosis and early phenotypic expression of the metabolic syndrome in children. The aim of the present study was to examine the frequency of the metabolic syndrome using various definitions in obese prepubertal and pubertal children. Methods: 478 (213 females and 265 males) obese children were recruited in three provinces of Spain. Blood pressure (BP), waist circumference, and weight and height were measured, and body mass index was calculated. Glucose, insulin, high-density lipoprotein cholesterol and triacylglycerols were determined. We classified the children according to seven different proposed definitions of the metabolic syndrome. Results: Regardless of the definition used, the prevalence of the metabolic syndrome (8.3–34.2%) was relatively high in obese children in the prepubertal period as well as in pubertal children (9.7–41.2%). We performed a principal-factor analysis to explain correlations among features of the metabolic syndrome and found that glucose metabolism (factor 1), dyslipidemia (factor 2) and obesity/BP (factor 3) explained 72% of the total variance. Conclusion: Irrespective of the classification used, the metabolic syndrome is not only present in pubertal but also in prepubertal children. International definitions of the metabolic syndrome should also consider criteria specific for children in the prepubertal period, i.e. children aged <10 years.

© 2011 S. Karger AG, Basel




Related Articles:


References

  1. Brambilla P, Lissau I, Flodmark CE, Moreno LA, Widhalm K, Wabitsch M, Pietrobelli A: Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome. Int J Obes (Lond) 2007;31:591–600.
  2. Goodman E, Dolan LM, Morrison JA, Daniels SR: Factor analysis of clustered cardiovascular risks in adolescence: obesity is the predominant correlate of risk among youth. Circulation 2005;111:1970–1977.
  3. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–2374.
  4. Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, Mietus-Snyder ML, American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, Council on Nutrition, Physical Activity, and Metabolism: Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 2009;119:628–647.
  5. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S, IDF Consensus Group: The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatr Diabetes 2007;8:299–306.
  6. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH: Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003;157:821–827.
  7. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N: Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494–2497.
  8. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI: The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 2004;89:108–113.
  9. Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P: Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child 2005;90:10–14.
  10. Ford ES, Ajani UA, Morkdad AH: The metabolic syndrome and concentration of C-reactive protein among U.S. youth. Diabetes Care 2005;28:878–881.
  11. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–1243.
  12. Ford ES, Li CH, Zhao G, Pearson WJ, Mokdad A: Prevalence of the metabolic syndrome among U.S. adolescents using the definition from the International Diabetes Federation. Diabetes Care 2008;31:587–589.
  13. Sobradillo B, Aguirre A, Aresti U, Bilbao A, Fernández-Ramos C, Lizárraga A, Lorenzo H, Madariaga L, Rica I, Ruiz I, Sánchez E, Santamaría C, Serrano JM, Zabala A, Zurimendi B, Hernández M: Curvas y tablas de crecimiento (estudios longitudinal y transversal). Madrid, Fundación Faustino Orbegozo Eizaguirre, 2004.
  14. Moreno LA, Pineda I, Rodriguez G, Fleta J, Sarria A, Bueno M: Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr 2002;91:1307–1312.
  15. McCrindle BW: Assessment and management of hypertension in children and adolescent. Nat Rev Cardiol 2010;7:155–163.
  16. Li C, Ford ES, Mokdad AH, Cook S: Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics 2006;118:e1390–e1398.
  17. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996;98:649–658.
  18. National Cholesterol Education Program. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Bethesda, National Heart, Lung, and Blood Institute, 1991, NIH 91-2732.
  19. Type 2 diabetes in children and adolescents. American Diabetes Association. Diabetes Care 2000;23:381–389.
    External Resources
  20. Zhu S, Wang Z, Heshka S, Heo M, Faith MS, Heymsfield SB: Waist circumference and obesity associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 2002;76:743–749.
  21. Plasma lipid distributions in selected North American populations: the Lipid Research Clinics Program Prevalence Study. The Lipid Research Clinics Program Epidemiology Committee. Circulation 1979;60:427–439.
  22. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Final Report. Bethesda, National Heart, Lung, and Blood Institute, 2002, NIH 02-5215.
  23. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL: CDC growth charts: United States. Advanced data from vital and health statistics. No. 314. Hyattsville, National Center for Health Statistics, 2000, pp 1–27.
  24. NGHS Coordinating Center: NHLBI Growth and Health Study (NGHS) Data Monitoring Report. Baltimore, Maryland Medical Research, 1998.
  25. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1999;22(suppl 1):S5–S19.
    External Resources
  26. Fernández JR, Redden DT, Pietrobelli A, Allison DB: Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004;145:439–444.
  27. Hickman TB, Briefel RR, Carroll MD, Rifkind BM, Cleeman JI, Maurer KR, Johnson CL: Distributions and trends of serum lipid levels among United States children and adolescents ages 4–19 years: data from the Third National Health and Nutrition Examination Survey. Prev Med 1998;27:879–890.
  28. American Diabetes Association: Clinical practice recommendations. Diabetes Care 2002;25(suppl 1):S1–S147.
    External Resources
  29. Task Force on Blood Pressure Control in Children: Report of the Second Task Force on Blood Pressure Control in children – 1987. Pediatrics 1987;79:1–25.
  30. Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539–553.
  31. Goran MI, Gower BA: Longitudinal study on pubertal insulin resistance. Diabetes 2001;50:2444–2450.
  32. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C, American Heart Association, National Heart, Lung, and Blood Institute: Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433–438.
  33. Alberti KG, Zimmet PZ, Shaw JE: The metabolic syndrome – a new world-wide definition from the International Diabetes Federation Consensus. Lancet 2005;366:1059–1062.
  34. Third National Health and Nutrition Examination Survey (NHANES III) Public-Use Data Files. Atlanta, National Center for Health Statistics, 1994. www.cdc.gov/nchs/products/elec_prods/subject/nhanes3.htm. (accessed Oct 5, 2008).
  35. Chi C, Wang Y, Wilson DM, Robinson TN: Definition of metabolic syndrome in preadolescent girls. J Pediatr 2006;148:788–792.
  36. Reinehr T, de Sousa G, Toschke AM, Andler W: Comparison of metabolic syndrome prevalence using eight different definitions: a critical approach. Arch Dis Child 2007;92:1067–1072.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 08, 2011
Accepted: August 22, 2011
Published online: October 13, 2011
Issue release date: October 2011

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
TOP