OPEN ACCESS Research Article
Human & Veterinary Medicine International Journal of the Bioflux Society
Metabolic syndrome in children Melinda Morea, Nicolae Miu
Pediatric Emergency County Hospital Cluj Napoca, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, România. Abstract. Objective: To determine the prevalence of the metabolic syndrome (MS) in children. Material and methods: We performed a cross sectional, retrospective study. A total of 395 children aged between 2-19 years old were examined.. The children have undergone physical examination; weight, height, waist circumference, blood pressure (BP) were measured. The nutritional status of the children was assessed by body mass index (BMI) and laboratory tests needed to diagnose MS were performed. IDF criteria for MS were used in children 10 years and older and age and gender specific cut-off points in children younger than 10 years. The statistical analysis of the data was descriptive and inferential analysis. In the bivariate analysis of association between qualitative variables, we used the Chi-Square test and the exact Fisher test. The statistical analysis was performed with SPSS v 13.0. Results: Eighty-two (20.8%) children were normal weight, 150 (37.9%) were overweight and 163 (41.2%) were obese. One (1.2%) of the normal weight children, 21 (14%) of the overweight and 30 (18.4%) of the obese ones had MS. Twentyfour (12.5%) of the girl and 28 (13.79%) of the boys had MS. According to the age groups 21 (11.53%) subject under 10 years, 26 (13.83%) between 10-16 years and 5 (20%) older than 16 years had MS.Conclusions: Prevalence of the metabolic syndrome was higher in obese children than in overweight and normal weight children. There were no significant differences of the MS prevalence between sexes and age groups. Key Words: obesity, overweight, metabolic syndrome, children. Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Corresponding Author: M. Morea,
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Introduction Although the interest in the metabolic syndrome (MS) in children has increased as a result of the increase of the prevalence of obesity in children and of the large number of adults with the MS and related diseases, there is still no standardized definition of the MS in children. The importance of early identification of obese children, of those with increased risk of developing MS, type 2 diabetes and cardiovascular diseases in adulthood, cannot be neglected, as it has been demonstrated that obesity and cardiovascular risk factors associated with obesity persist until adulthood (Ford & Giles et al 2002). Most clinical manifestations of cardiovascular diseases occur in adulthood, but research conducted over the past 40 years indicates that the atherosclerotic process begins in childhood and evolves throughout life (Newman & Freedman et al 1986). Reduction of carotid elasticity was highlighted in children with the MS and in adults who had elements of the MS as children (Juonala & Jarvisalo et al 2005;Iannuzzi & Licenziati et al 2006). Detecting children with MS elements would mean timely identification of those who will develop comorbidities (cardiovascular diseases or type 2 diabetes), allowing early intervention. There are many controversies related to the definition of this syndrome in children, to the reference values that would be relevant to the future progress and to the importance of diagnosing this syndrome in children, as some authors suggest that it would be useful to highlight the syndrome components separately. The problem of defining the syndrome as such is complicated by the fact that the syndrome elements appear gradually, in evolution and the full picture is not present at a young
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age. Moreover, the pathophysiological changes and syndrome components are also influenced by growth, puberty, not just by gender and ethnicity as in the case of adults (Chen & Bao et al 2000). Because of these features, criteria used for adults should be applied with great caution (Goodman 2006; Jones 2006). However, in the studies conducted in children the criteria were largely the same as those used in the studies on adults, with some changes. After examining the definitions used by different researchers, Ford et al found 27 published articles which used 46 diagnostic criteria, most of which were based on the NCEP ATP III definition. The number of MS components considered necessary for diagnosis also ranged, though generally speaking, the individuals chosen had at least three components of the syndrome (Earl & Chaoyang 2008). The results of the studies vary because of the great diversity of the criteria used, of the reference values, of the study design, of the criteria for inclusion in the group, which is why the results are difficult to compare (Golley et al 2006). The prevalence of the MS established in children ranges between 20-58% in our geographic area, depending on the definition used, while the number of the studies is very small. (Pop 2011; Puha Preda & Matasaru 2011) The objective of the study was to determine the prevalence of the MS in children.
Materials and methods We performed a cross sectional retrospective study, on a group of 395 subjects, children aged between 2-19 years old, who presented at the Pediatric Clinic no. 2 in Cluj-Napoca and children from 2 schools in the same city. The study was performed
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Morea et al 2013
Table I. Metabolic syndrome in children-definition criteria Metabolic syndrome in children-definition criteria Age
WC
16 years
>p90
TG >p90 and/or ≥150mg/dl
HDL
