Screening of metabolic syndrome in obese children: a primary care concern
Domenico Viggiano1, Gianpaolo De Filippo, Domenico Rendina
1Primary Care Pediatrics, ASL Salerno, Italy.
Insights
Metabolic syndrome (MS) affects 30.8% of obese children in primary care. The waist-to-height ratio can help identify children at risk for MS, supporting the need for pediatric obesity screening programs.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Public Health
Background:
- Metabolic syndrome (MS) is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.
- Obesity is a primary risk factor for MS, and its prevalence is increasing in pediatric populations worldwide.
- Early identification and intervention are crucial to mitigate the long-term health consequences of MS in children.
Purpose of the Study:
- To determine the prevalence of metabolic syndrome (MS) in a primary care pediatric setting.
- To identify clinical and biochemical predictors of MS in obese children.
- To assess the feasibility of implementing pediatric obesity screening programs.
Main Methods:
- A cohort of 415 obese children was enrolled in a primary care pediatric setting.
- Subjects were screened for MS, defined as obesity plus at least two other criteria: fasting hyperglycemia, low high-density lipoprotein cholesterol, hypertriglyceridemia, or hypertension.
- Clinical and biochemical data were collected, and the waist-to-height ratio was evaluated as a predictor of MS.
Main Results:
- The overall prevalence of MS among obese children was 30.8%.
- The most common MS components were low high-density lipoprotein cholesterol (46.2%), hypertension (23.6%), and hypertriglyceridemia (22.2%).
- The waist-to-height ratio demonstrated a strong association with MS, comparable to insulin resistance in predictive power.
Conclusions:
- Metabolic syndrome is prevalent in seemingly healthy obese children.
- The waist-to-height ratio is a simple, effective clinical parameter for identifying at-risk children.
- These findings support the development of pediatric networks for obesity and MS screening programs.
Objective:
To determine the prevalence of metabolic syndrome (MS) in a primary care pediatric setting and to collect clinical and biochemical data, allowing for a prediction of its presence in a supposedly healthy population.
Methods:
Belonging to a pediatric population followed by pediatricians of the Italian National Health Service, 415 subjects with obesity as a unique selection criterion were enrolled. The entire cohort was screened for MS, which was defined as the presence of at least 2 other findings out of obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and hypertension.
Results:
The overall prevalence of MS was 30.8%. Major findings (out of obesity) were low high-density lipoproteins cholesterol levels (46.2%), hypertension (23.6%), hypertriglyceridemia (22.2%), and fasting hyperglycemia (16.6%). Waist-to-height ratio was the only clinical parameter directly related to MS, with the same predictive power of insulin resistance.
Conclusions:
Metabolic syndrome can be present in a significant percentage of "healthy" obese children, and a simple clinical parameter could identify at-risk subjects. This observation justifies the development and implementation of pediatric networks for obesity screening programs.
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