412 Prevalence and Clinical Features of Metabolic Syndrome in Overweight and Obese Children

Abstract

Aim of the study: To evaluate the prevalence of metabolic syndrome (MetS) and its clinical and biochemical features in an overweight or obese pediatric population. Methods: 202 consecutive subjects (M/F 94/108; mean age 10.9 ± 2.6 years, range 4-16 years) with overweight or obesity according to WHO definition were enrolled at the outpatient pediatric clinic of our Institution from January 2008 to December 2009. All subjects had physical examination with measurement of body weight, waist and hip circumference, and blood pressure. Serum levels of glucose, insulin, HDL-cholesterol, tryglicerides and C-reactive protein were assessed. MetS was diagnosed according to modified ATP III criteria. Results: MetS was demonstrated in 19.3% of cases. 76.9% of them presented BMI >95th percentile, 64.1% HDL-cholesterol < 5th percentile, 76.9% tryglicerides >95th percentile, and 51.3% systolic blood pressure >95th percentile. MetS prevalence was greater, although not statistically significant, in males than in females (24.5% vs 15%, respectively). Waist/Hip ratio and basal glicemia were significantly higher in males (p=0.02 and p=0.05, respectively). HDL-cholesterol levels were significantly lower in females than in males (p=0.04). Children with MetS showed significantly higher insulin levels, but HOMA index values were not significantly greater than in subjects without MetS. Linear regression analysis demonstrated that predisposing factors for MetS were HDL-cholesterol values < 5th percentile (p=0.001), tryglicerides values >95th percentile (p=0.03) and systolic blood pressure values >95th percentile (p=0.045). Conclusions: Our data confirm that a correct diet, through tryglicerides decrease, and physical activity, through HDL-cholesterol increase, are the basis for the treatment of pediatric obesity.