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Prevalence of metabolic syndrome higher in boys, older children
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The prevalence of metabolic syndrome may increase with age in adolescents, according to a study published in Diabetes Care.
Researchers from Atlanta examined data from 2,014 adolescents aged 12 to 17 years who participated in the National Health and Nutrition Examination Survey from 1999 to 2004. The researchers used the 2007 pediatric International Diabetes Federation definition to determine the prevalence of metabolic syndrome in this population.
According to the researchers, the prevalence of metabolic syndrome increased with age and was higher among boys (6.7%) than girls (2.1%) (P=.006). The overall prevalence was about 4.5% between 1999 and 2004. Mexican-American adolescents had the highest prevalence at 7.1%. Based on postcensal data, the researchers estimated that about 1.1 million adolescents had metabolic syndrome in 2006.
Though the researchers found the prevalence of metabolic syndrome increased with age, the occurrence rates were fairly stable over the course of six years: 4.5% from 1999 to 2000, 4.4% to 4.5% from 2001 to 2002, and 3.7% to 3.9% from 2003 to 2004 (P for linear trend >.050), according to the study. – by Stacey L. Adams
Diabetes Care. 2008;31:587-589.
This study shows the magnitude of the problem of metabolic syndrome as of November 2006, and 4.5% of the population has metabolic syndrome, which accounts for about 1.1 million young adults aged 12 to 17 years.
There are a million kids out there, and it's a big problem. There are kids out there that have signs, that are overweight, or they have evidence of insulin resistance, or low protective HDL levels, or high triglycerides, high blood pressure or high glucose. The criteria used in this study stated that the children had to be greater than 90 percentile for waist circumference and have two of the following: high triglycerides, high HDL, high blood pressure and high fasting glucose. That's a pretty big spectrum. This is a big and terrible problem.
In the past, and even in this paper, there has been controversy about what standard should be applied. If you read the paper carefully, there are still some differences of opinion about that issue. They've actually retained adult standards for these children for some of these parameters like triglycerides and HDL. If anything, using these standards may be underestimating. If the children have these same problems defined by adult standards, then they probably have quite a serious problem. And now there's a standard language that people should talk about, which is which criteria to use. Physicians should be aware of that and they should look for it in practice and target these people. This is part of the major epidemic of obesity that we have in this country and the marked increase in the incidence of type 2 diabetes. What the metabolic syndrome is telling us is that altogether, this is now going to lead to bigger problems; for instance, if a patient has low HDL, high triglycerides, high blood pressure and they are prone to diabetes and have high blood sugar, then they have a much greater chance of having atherosclerotic heart disease by the time they reach their 30s and 40s.
I'm sure this is going to generate some discussion because not everyone agrees with the criteria that are being applied to children, and this paper demonstrates a major ethnic difference. The ethnic differences are such that the prevalence of the metabolic syndrome is exaggerated in African Americans or Mexican Americans, according to this paper. So, this is an important paper and, indeed, a wake-up call.
– Mark A. Sperling, MD
Endocrine Today Editorial Board member