Goodman E, Daniels S, Morrison J, Huang B, Dolan LM. Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents

Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts 02454, USA. <>
Journal of Pediatrics (Impact Factor: 3.74). 11/2004; 145(4):445-51. DOI: 10.1016/j.jpeds.2004.04.059
Source: PubMed

ABSTRACT To determine prevalence of metabolic syndrome (MS) among adolescents by using definitions from the National Cholesterol Education Program Adult Treatment Panel III (NCEP) and World Health Organization (WHO) guidelines and to compare the populations identified by these definitions.
School-based, cross-sectional study of 1513 black, white, and Hispanic teens who had a fasting morning blood sample drawn and a physical examination.
Overall, the prevalence of NCEP-defined MS was 4.2% and of WHO-defined MS was 8.4%. MS was found almost exclusively among obese teens, for whom prevalence of NCEP-defined MS was 19.5% and prevalence of WHO-defined MS was 38.9%. Agreement between definitions was poor (kappa statistic=0.41). No race or sex differences were present for NCEP-defined MS. However, nonwhite teens were more likely to have MS by WHO criteria (RR, 1.40; 95% CI, 1.04, 1.87), and MS was more common among girls if the WHO-based definition was used (RR, 1.26; 95% CI, 1.08, 1.88).
Among adolescents, obesity is a powerful risk for MS. Important demographic and clinical differences exist in the typology of MS, depending on the definition. Such discrepancies suggest that the concept of a common pathologic syndrome or etiologic mechanism underlying MS as defined by these guidelines may be flawed.

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Available from: Elizabeth Goodman, Feb 24, 2014
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    • "In fact, risk factors in growing children can be delimited only by age/gender related, percentile-based thresholds, that often do not correspond to adult thresholds , particularly in overlapping ranges of age between adolescents and adults [12]. Consequently, very different MS prevalence rates are obtained according to the chosen MS criteria [13]. Several studies have investigated the clustering of the risk factors included in the MS definition by statistical methods, mainly by the principal component analysis, an exploratory analysis that clusters the MS risk factors in fewer highly intercorrelated factors [14] [15]. "
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    • "This is not surprising as both MS and PCOS were linked to insulin resistance at the cellular level, suggesting different degrees of genetic and functional defects, also affecting other members of the same family (Kohen-Avramoglu et al., 2003; Yildiz et al., 2003). Both PCOS and MS can be detected during adolescence (Kent and Legro, 2002; Goodman et al., 2004). Screening programmes including a family history may help to identify adolescents at risk for future cardiovascular and endocrine disturbances. "
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