Continuous metabolic syndrome score in cardiovascular risk assessment in adolescents

This study aimed to determine the metabolic syndrome (MS) prevalence in a sample of adolescents, to calculate their continuous metabolic syndrome scores, and to determine the associations of continuous metabolic syndrome score with overweight/obesity and selected cardiometabolic and lifestyle factors.

We enrolled a sample of 2,590 adolescents (1,180 males, mean age 17.1 ± 1.04 years) from 14 grammar schools and 48 secondary schools in the Bratislava Self-Governing Region, Slovakia. Data were collected from a standard anthropometric examination, biochemical analysis of fasting venous blood, blood pressure measurement, physical fitness assessment, and a comprehensive questionnaire focused on selected lifestyle characteristics. Continuous metabolic syndrome score and paediatric simple metabolic syndrome scores were calculated.

The criteria for the MS diagnosis according to the International Diabetes Federation (IDF) guidelines for children and adolescents were fulfilled in the whole sample by 38 (1.4%) adolescents; all were classified as overweight/obese. In the obese subgroup (n = 270), the MS prevalence rose to 13.3%. The largest number of adolescents was in the group without any of the MS components (67.5%). In the groups with 1, 2 or 3 MS components, males predominated; 0.6% of males and no females had 4 components of MS. The increasing number of individual components of MS is accompanied by a continuous increase (in the case of HDL-cholesterol - a decrease) of mean values mostly of blood lipid levels. Mean values of blood pressure (BP) and anthropometric parameters were highest in the group with three MS components. Significant correlations with body fat content or with selected lifestyle factors were not found. Using the continuous MS score calculation we found 31 adolescents, of whom 14 (45.2%) had only 1 or at most 2 MS components, i.e., they did not meet the criteria for the MS diagnosis.

From the point of view of atherosclerosis prevention and early intervention, it is extremely important to monitor the MS prevalence in children and adolescents, especially in the current obesity pandemic. The paediatric MS score calculation is simple and accurate, allowing assessment of the severity of cardiometabolic risk in individuals even before the diagnosis of MS. The continuous MS score is useful in identifying individuals at increased risk and in the management of preventive health care for children and youth.