Problems of metabolic syndrome diagnostics in children

Increasing prevalence of exogenous obesity in children appears possibly related to changes in their lipid and carbohydrate metabolism resulting from insulin resistance which, together with obesity and arterial hypertension, are among the components of metabolic syndrome. The aim of this study was to evaluate the age related incidence of obesity complications and the prevalence of metabolic syndrome in children according to the latest criteria.

A total of 98 obese children were divided in two age groups (5 to 10 and 10 to 16 years). In all patients the BMI was calculated, standard deviation score of BMI (SDS BMI) was estimated according to the data by anthropometric surveys Slovakia and obesity was defined as SDS BMI >2 which is equal to 97th percentile for the appropriate age and gender. Blood pressure >95th percentile for the appropriate gender, age and body was classified as hypertension. Fasting glycemia, total and HDL cholesterol and triglycerides were determined in serum and oral glucose tolerance test was performed. Insulin resistance was classified according to HOMA index.

Among 21 children less than 10 years of age lower HOMA values and no impaired glucose tolerance appeared, but hypercholesterolemia was found in 8 cases (38.1 %). Among 77 patients aged 10 to 16 years increased frequency of cases was found with insulin resistance (37.7 %), increased triglycerides (53.3 %), decreased HDL cholesterol (54.4 %) and impaired glucose tolerance (7.8 %). In this group 32.5 % of children showed metabolic syndrome based on modified IDF criteria, while such prevalence rose to 39.0 % if borderline criteria for blood pressure were used.

The treatment of referred pathological states requires lifestyle changes and follow up at the specialized clinic.