Abstract
Prevalence of metabolic syndrome (MetS) in children is increasing and identifying the risk factors for MetS during childhood is an important first step to prevent chronic diseases later in life. The aim of the present study was to evaluate the prevalence of MetS and cardiometabolic risk factor (CMRF) clustering among Korean children and adolescents and to validate the associated anthropometric and laboratory surrogate markers. We used data from the 2011–2014 Korean National Health and Nutrition Examination Survey. In total, data for 2,935 subjects (1539 boys, 52.6%) aged 10–19 years were assessed. MetS was defined by central obesity plus any two or more of CMRFs such as abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and decreased high density lipoprotein cholesterol (HDL-C) using the International Diabetes Federation criteria for children and adolescents. The presence of two or more CMRFs was classified as CMRF clustering. The prevalence of MetS and CMRF clustering in this group was found to be 1.8% and 8.9%, respectively. The receiver operating characteristic analysis of MetS and CMRF clustering, and the area under the curve (95% confidence interval) of surrogate markers revealed that the waist circumference to height ratio [0.960 (95% CI 0.959–0.960), cut-off 0.491] showed the highest predictability for MetS whereas triglyceride to HDL-C ratio [0.891 (95% CI 0.891–0.892), cut-off 2.63] showed the highest predictability for CMRF clustering. Long-term follow-up is needed for further validation.
Highlights
The metabolic syndrome (MetS) is generally defined as a cluster of metabolically related cardiovascular risk factors
The aim of this study was to evaluate the prevalence of MetS and cardiometabolic risk factor (CMRF) clustering among Korean children aged 10–19 years, in addition to evaluating the validity of wellknown and emerging anthropometric and laboratory markers, such as body mass index (BMI), waist circumference (WC) to height ratio (WHtR), triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio, glycated hemoglobin (HbA1c) and elevated alanine transaminase (ALT)
After receiver operating characteristic (ROC) analysis of MetS and CMRF clustering, area under the curve (AUC) of surrogate markers revealed that BMI z-score [0.959] and WHtR [0.960] showed
Summary
The metabolic syndrome (MetS) is generally defined as a cluster of metabolically related cardiovascular risk factors. MetS is becoming a major public health issue globally, because individuals with MetS have higher risk of developing type 2 diabetes and cardiovascular diseases (CVD) than those without it [1]. Prevalence of MetS in children is less than that of in adults; as prevalence of childhood obesity increases so does MetS [2, 3]. Surrogate markers for metabolic syndrome and cardiometabolic risk factor clustering. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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