The prevalence of metabolic syndrome in adolescents according to 3 different diagnostic criteria

Abstract

Objective To evaluate the differences and consistency of different diagnostic criteria for metabolic syndrome(MetS)in adolescents. Methods This cross-sectional study enrolled 920 healthy middle school students(aged 11-16 years, 53.2% males). All participants underwent anthropometric and biochemical examinations, and were diagnosed as MetS separately using criterion of the Pediatric Academy of Chinese Medical Association(abbreviated as Chinese criterion), 2007 International Diabetes Federation criterion(IDF criterion), and Cook criterion based on the National Cholesterol Education Program - Adult Treatment Panel in 2003(Cook criterion). Statistic analysis was used to compare the prevalence of MetS diagnosed and the individual MetS components detected by the different diagnostic criteria, and to evaluate the differences and consistency between the three criteria. Results The prevalence of MetS diagnosed with the Cook criterion(16.2%)was significantly higher than that by the Chinese criterion(11.0%)and the IDF criterion. The most frequently detected components were low high-density with the Chinese criterion and IDF criterion, hypertension with the Cook criterion. The least frequently detected component was hyperglycemia with each criterion. The consistency was found stronger between the Chinese and IDF criteria(Kappa=0.798-0.829, P<0.01), but weak between the Cook and the other two criteria(Kappa=0.465-0.789, P<0.01). The adolescents solely diagnosed as MetS patients by the Cook criterion but not the other two criteria had more central obesity, higher plasma glucose and lipid levels and HOMA insulin resistance index(all P<0.05). Conclusion The prevalence of MetS and components diagnosed with the three criteria was evidently different. The Cook criterion may diagnose more adolescents with higher cardiovascular risks and insulin resistance. (Chin J Endocrinol Metab, 2017, 33: 93-97) Key words: Metabolic syndrome; Cardiovascular risk factors; Insulin resistance; Adolescents; Prevalence