Frequency of the metabolic syndrome in obese Spanish pediatric population
Marta López-Capapé1, Milagros Alonso, Esmeralda Colino
1Pediatric Endocrine and Radiology Units, Ramón y Cajal Hospital, University of Alcalá, Ctra, Colmenar Km. 9,100, 28034 Madrid, Spain.
Insights
Metabolic syndrome (MS) affects 18% of obese Spanish children, with higher rates in Hispanic populations. Insulin resistance (IR) is a strong predictor of MS development in this group.
Area of Science:
- Pediatrics
- Endocrinology
- Cardiovascular Health
Background:
- Obesity in children is linked to insulin resistance (IR), type 2 diabetes (T2D), and cardiovascular risk factors, collectively known as metabolic syndrome (MS).
- Understanding the prevalence and predictors of MS in pediatric populations is crucial for early intervention.
Purpose of the Study:
- To determine the frequency of MS in obese Spanish children.
- To analyze the contribution of individual MS components and their predictive potential for developing the syndrome.
Main Methods:
- A cohort of 429 obese Spanish children (ages 4-18) was assessed.
- Metabolic syndrome was defined using modified NCEP ATP III criteria (≥3 of obesity, low HDL, hypertriglyceridemia, hypertension, impaired glucose metabolism).
- Insulin resistance was defined by HOMA-IR index and/or fasting insulin levels.
Main Results:
- Metabolic syndrome was present in 18% of the obese pediatric cohort, with a higher prevalence (32%) in Hispanic children compared to Caucasians (16%).
- Prevalence of individual MS components included low HDL (27%), hypertension (23%), hypertriglyceridemia (16%), and impaired glucose metabolism (7%).
- Insulin resistance was identified in 35% of patients, and among these, MS prevalence reached 28%; IR independently predicted MS development.
Conclusions:
- Metabolic syndrome is a significant concern in obese Spanish children, affecting 18% of the study population.
- Insulin resistance is strongly associated with MS components and serves as a key predictor for its development in pediatric obesity.
Objective:
Obesity is associated with insulin-resistance (IR), type 2 diabetes (T2D) and a constellation of cardiovascular risk factors at the early years of life. These features define the so-called metabolic syndrome (MS).
Aims:
To assess the frequency of the MS among obese pediatric Spanish population and analyse the individual contribution and the predictive potential of individual components to the development of the syndrome.
Patients And Methods:
A total of 429 patients, 220 boys and 209 girls, aged 4-18 years, with a body mass index of >2 standard deviation scores for Spanish normative charts, were included in the study. Forty-seven percent were prepubertal and ten percent had Hispanic ethnicity. HbA1c, lipids, liver enzymes and uric acid levels were determined from blood and a standard 2-h oral glucose tolerance test was performed. MS was defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria modified by Cook as having at least three features among: obesity, low high-density lipoprotein (HDL), hypertriglyceridemia, hypertension (HTA) or impaired glucose metabolism (IGM). We defined IR as homeostatic model assessment of IR index and/or fasting insulin levels>95th centile of the control population.
Results:
Almost 18% of the patients had MS, with significantly higher frequency in Hispanic (32%) than in Caucasian (16%) population. There were no differences by sex or pubertal status. Prevalence of low HDL, HTA, hypertriglyceridemia and IGM were 27, 23, 16 and 7% respectively. No silent T2D was identified. According to International Obesity Task Force charts, 22% of the patients were overweight and not obese, but no differences in the frequency of individual features of MS between these two groups were observed. Among IR patients (35% of our population), the frequency of MS reached 28%. IR predicted the presence of MS independently from age and race.
Conclusion:
MS is present in 18% of our obese pediatric population. IR is closely associated with the components of MS and strongly predicts its development.
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