Relationship between obesity and metabolic syndrome among Argentinean elementary school children

Argentina has experienced marked increases in the prevalence of childhood overweight (OW)/obesity over the last few decades.

We examined (1) the distribution of the mean values of lipids, glucose, and HOMA-IR according to the presence of OW/obesity, age, and sex and (2) the association between metabolic syndrome and OW/obesity, Tanner stage, gender, and HOMA-IR.

Data were collected from 1009 children (508 males) in 10 elementary schools between April and September 2007. BMI, waist circumference, blood pressure, Tanner, lipids, insulin, and glucose were determined. Criteria analogous to ATPIII were used for metabolic syndrome in children.

Over 1009 children (508 males) aged 9.4 + or - 2.0 years were evaluated. One hundred and sixty-five (16.4%) were obese (>95th percentile), and 166 (16.5%) were OW (85-95th). Twenty-five (2.5%) were severely obese (BMI>99th). Most of the children (62%; 613/979) were at Tanner 1. Triglycerides, insulin, and HOMA-IR were higher (p<0.001) and HDL-C lower (p<0.001) in OW/obesity in both age groups and genders. The prevalence of metabolic syndrome was 5.8% overall, 32% in severely obese, 16.4% in OW/obese and 0.4% in normal weight children. Multiple logistic regression showed that BMI (OR 24.48; 95% CI 9.14-65.57), and HOMA-IR (OR 2.09; 95% CI 1.04-4.18) were associated with metabolic syndrome adjusted by gender and Tanner stage. Multiple linear regression also showed that BMI and HOMA-IR were independently associated with the number of metabolic syndrome components (R(2)=0.46).

A substantial number of OW/obese children have the metabolic syndrome. HOMA-IR and BMI were strong predictors of metabolic syndrome in children suggesting that OW/obese school children are at a higher risk for future cardiovascular disease.