The Stability of Metabolic Syndrome in Children and Adolescents
ABSTRACT Some studies suggest the presence of metabolic syndrome before adulthood may identify those at high risk for later cardiovascular morbidity, but there are few data examining the reliability of pediatric metabolic syndrome.
To examine the short- and long-term stability of pediatric metabolic syndrome.
Metabolic syndrome was defined as having at least three of the following: waist circumference, blood pressure, and fasting serum triglycerides in the 90th or higher percentile for age/sex; high-density lipoprotein-cholesterol 10th or lower percentile for age/sex; and fasting serum glucose of at least 100 mg/dl. Short-term metabolic syndrome stability (repeated measurements within 60 d) was assessed in obese youth ages 6-17 yr. Long-term metabolic syndrome stability (repeated measurements more than 1.5 yr apart) was studied in 146 obese and nonobese children age 6-12 yr at baseline.
Convenience samples of obese and nonobese youth ages 6-17 yr participating in research studies were collected at a clinical research hospital.
Short-term metabolic syndrome stability (repeat measurements performed 19.7 +/- 13.1 d apart) was assessed in 220 children. The diagnosis of metabolic syndrome was unstable in 31.6% of cases. At their short-term follow-up visit, incidence of metabolic syndrome among participants who did not have metabolic syndrome at baseline was 24%. In the long term (repeat measurements performed 5.6 +/- 1.9 yr apart), the diagnosis of metabolic syndrome was unstable in 45.5% of cases.
Cutoff-point-based definitions for pediatric metabolic syndrome have substantial instability in the short and long term. The value of making a cutoff-point-based diagnosis of metabolic syndrome during childhood or adolescence remains in question.
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- "Metabolic syndrome defined using age-and sex-specific percentile-based cut-off definition commonly used in previous reports (Gustafson et al., 2009; Vikram et al., 2006): values of at least 90 th percentile for waist circumference, systolic or diastolic blood pressure, and triglycerides (Biltoft & Muir, 2009) and no higher than 10 th percentile for HDL cholesterol, and a fasting glucose value of at least 100 mg/dL was used to indicate impaired fasting glucose. Metabolic syndrome was considered present when a child met the cut-points for at least three of these factors. "
ABSTRACT: Preliminary data in adults suggest that binge eating is associated with greater prevalence of metabolic syndrome (MetS) components. However, there are limited data in youth, and little is known of the role of binge episode size in these relationships. We examined the relationship between loss of control eating and metabolic characteristics in a convenience sample of 329 treatment-seeking and non-treatment-seeking adolescent boys and girls. The sample was enriched by design with adolescents who were overweight or obese and with individuals who reported episodes of loss of control over their eating (either objectively large binge episodes, OBEs or subjectively large binge episodes, SBEs, in the past month), as assessed by clinical interview. MetS components (blood pressure, lipids, glucose, and waist circumference) were the primary variables of interest. 46% of the cohort reported loss of control eating; among those, 53% reported SBEs only and 47% reported OBEs. Youth with loss of control eating had higher systolic blood pressure (p=.001) and higher low-density lipoprotein cholesterol (LDL-c) (p=.002) compared to those without loss of control eating, in analyses adjusted for intervention-seeking status, fat mass and sociodemographic characteristics. Youth reporting OBEs had higher LDL-c (p=.013) compared to those reporting only SBEs. Adolescents reporting loss of control episodes had greater dysfunction in some components of the MetS compared to youth without loss of control; episode size may contribute to metabolic dysfunction. Published by Elsevier Ltd.Eating Behaviors 07/2015; 19:86-89. DOI:10.1016/j.eatbeh.2015.07.002 · 1.58 Impact Factor
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ABSTRACT: The growing use of the Metabolic Syndrome in pediatric age need a critical approach, on the basis of recent concerns on definition and usefulness for individual management in clinical practice. We reviewed these aspects from a pediatric point of view, providing a set of questions about what the Metabolic Syndrome means in a clinical setting. The new proposed pediatric definition by IDF was discussed, by outlying how it does not fully consider the peculiarities of children and adolescents. The comparison between two cases of obese children was used in order to show how this diagnosis could be confusing for a correct management. We stressed the need for health-related limits for each component of the Metabolic Syndrome instead of percentile-derived cut-points, as well as the opportunity to extend the estimation to other family or individual risk factors by means of a multiple-items screening form. In conclusion, Metabolic Syndrome use in pediatric age suffers at present from important limitations (i.e., adult derived definition, possibility to rule-in but not to rule-out the individual metabolic risk, instability of MetS during adolescence, poor usefulness of the diagnosis for specific treatment). Consequently, a prudent use of Metabolic Syndrome for children and adolescents seems to be the best and honest position for paediatricians, waiting for long term, longitudinal follow-up studies that could clarify the entire question.Italian Journal of Pediatrics 12/2009; 35:41. DOI:10.1186/1824-7288-35-41 · 1.52 Impact Factor