Prevalence of metabolic syndrome high in Hispanic youth

Issue: April 2008

There is no standard definition for classification of metabolic syndrome in children, and based on findings from a new study, researchers are recommending working toward a consensus definition.

Researchers from Arizona State University and the University of Southern California analyzed 218 Hispanic children enrolled in the Latino Adolescents at Risk Diabetes Project. They used three published pediatric definitions to estimate the prevalence of metabolic syndrome. A child was classified as having metabolic syndrome with three of more of these characteristics:

Cook et al: elevated blood pressure >90th percentile for age/sex/height; elevated triglycerides >110 mg/dL; low HDL cholesterol <40 mg/dL; abdominal adiposity >90th percentile for age/sex; and hyperglycemia.
Cruz et al: elevated blood pressure >90th percentile for age/sex/height; elevated triglycerides >90th percentile for age/sex; low HDL cholesterol <10th percentile for age/sex; abdominal adiposity >90th percentile for age/sex/ethnicity; and hyperglycemia.
Weiss et al: elevated blood pressure >90th percentile for age/sex/height; elevated triglycerides >95th percentile for age/sex/ethnicity; low HDL cholesterol <5th percentile for age/sex/ethnicity; abdominal adiposity, BMI z-score >2; and hyperglycemia.

The analysis revealed that 25.7% to 39% of the children had metabolic syndrome, with moderate to substantial agreement between the three definitions. There was a relationship between metabolic risk and insulin sensitivity regardless of definition. Further, children with metabolic syndrome had 51% to 60% lower insulin sensitivity than children without the risk factors (P<.01). – by Katie Kalvaitis

Prevalence of Metabolic Syndrome in Hispanic Youth

Based on Three Different Published Definitions

Characteristics	Cook et al	Cruz et al	Weiss et al
metabolic syndrome	39%	30.7%	25.7%
hypertension	20.1%	20.1%	12.4%
high triglycerides	39%	20.6%	24.3%
low HDL cholesterol	66.5%	57.3%	60.6%
hyperglycemia	11.9%	25.2%	25.2%
abdominal adiposity	72%	70.2%	63.3%

For more information:

Shaibi GQ, Goran MI. Examining metabolic syndrome definitions in overweight Hispanic youth: a focus on insulin resistance. J Pediatr. 2008;152:171-176.

Individuals identified as having metabolic syndrome had lower insulin sensivity, regardless of definition. This paper reiterates the integral role of insulin resistance in the development of the cluster of cardiovascular risk factors, which constitute metabolic syndrome. Insulin resistance occurs early and, therefore, all high-risk youth, including those who are overweight, have a family history of type 2 diabetes or have acanthosis nigricans, polycystic ovary syndrome or hypertension should be tested for abnormal lipids, AST and ALT and abnormal carbohydrate metabolism.

– Janet H. Silverstein, MD

Endocrine Today Editorial Board member