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Abstract
Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.
Highlights
The findings of this study showed that joint association of high screen time (ST) and low physical activity (PA) have direct association with abdominal obesity, overweight and low high density lipoprotein-cholesterol (HDL-C) and indirect association with elevated total cholesterol (TC)
The modified criteria for children and adolescents have been defined as follow: Abdominal obesity as waist to height ratio (WHtR) more than 0.5; Elevated BP: either systolic or diastolic BP 90th percentile for age, sex and height; Low HDL-C: HDL-C40 mg/dl; High TG: TG100 mg/dl) was taken as the 90th percentile value for age; High Fasting blood glucose (FBG): FBG levels of 100 mg/dl[45].Five criteria of Metabolic syndrome (MetS) and TC, low-density lipoprotein cholesterol (LDL-C), and general obesity were included in this study as cardiometabolic risk factors
The method and variables, which was used for calculating Socioeconomic status (SES) was approved previously in the Progress in the International Reading Literacy Study (PIRLS) [48] Using principle component analysis (PCA) method variables including parental education, parents’ job, possessing private car, school type, and having personal computer in home were summarized in one main component
Summary
Metabolic syndrome (MetS) is defined as a cluster of risk factors for various non-communicable diseases, namely diabetes mellitus (DM) and cardiovascular diseases (CVD) [1]. Some studies have explored the notion of persistence of MetS and other cardiometabolic risk factors into adulthood [1,7,19]. This combination of risk factors, rather than each of them, contributes to additional risks, beyond the sum of risks attributed to each individual risk factors [20]. Sedentary lifestyle including low physical activity (PA) and prolonged screen time (ST)are considered as one of the major health problems in the pediatric population of developing and developed countries[25,26,27]. The present study was designed to examine the associations of the ST, PA and their joint association with MetS and cardiometabolic risk factors in Iranian adolescents
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