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Metabolic syndrome in Mexican children: Low effectiveness of diagnostic definitions

Barbara Itzel Peña-Espinoza1, María de Los Ángeles Granados-Silvestre2, Katy Sánchez-Pozos2

  • 1Laboratorio de Genómica de la Diabetes, Facultad de Química en la Unidad Académica de Ciencia y Tecnología de la UNAM, Yucatán, Mérida, Yucatán, México.

Endocrinologia, Diabetes Y Nutricion
|July 27, 2017
PubMed

Insights

Diagnosing metabolic syndrome (MS) in children is challenging due to varied criteria. Including insulin resistance markers like HOMA-IR improves accuracy and identifies more at-risk youth.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Public Health

Background:

  • Early identification of metabolic syndrome (MS) in children is crucial for preventing adult diabetes and cardiovascular disease.
  • Current diagnostic criteria for MS in children vary, leading to inconsistent detection and delayed preventive actions.
  • Insulin resistance (IR) is a key factor in MS, necessitating the evaluation of markers such as HOMA-IR and metabolic index (MI).

Purpose of the Study:

  • To compare the prevalence of MS in Mexican children using five different diagnostic definitions (IDF, NCEP-ATP-III, Cook, de Ferranti, Weiss).
  • To assess the impact of incorporating insulin resistance markers (HOMA-IR and/or MI) into MS diagnostic criteria.
  • To evaluate the effectiveness of current MS diagnostic criteria and identify areas for improvement in early detection.

Main Methods:

  • A cross-sectional study involving 508 Mexican children aged 9–13 years from seven schools.
  • Collection of somatometric, biochemical, and hormonal data, including HOMA-IR and MI.
  • Analysis of MS prevalence across different definitions and assessment of agreement with and without IR markers.

Main Results:

  • MS prevalence varied significantly (2.4–45.9%) depending on the definition used.
  • Insulin resistance was present in 12.4–25.2% (HOMA-IR) and 4.0–16.3% (MI) of children not diagnosed with MS.
  • Including HOMA-IR or MI in MS definitions increased prevalence (8.5–50.2% and 7.7–46.9% respectively) and improved agreement between criteria (kappa > 0.8).

Conclusions:

  • Current criteria for diagnosing MS in Mexican children are poorly effective, evidenced by definition variability and undetected IR.
  • Incorporating HOMA-IR and/or MI into MS diagnostic criteria enhances diagnostic agreement and reduces the likelihood of excluding at-risk children.
  • Standardizing MS definitions with IR markers is essential for accurate prevalence estimation and effective intervention in pediatric populations.
Abstract

Keywords:
ChildrenInsulin resistanceMetabolic indexMetabolic syndromeNiñosResistencia a la insulinaSíndrome metabólicoÍndice Metabólico

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