Diagnosis Of Metabolic Syndrome In Children Research Articles

Характер харчування та вміст окремих мікроелементів у крові підлітків з ознаками метаболічного синдрому

Purpose — to study the nature of nutrition and blood zinc and magnesium levels in adolescents with signs of metabolic syndrome (MS). Materials and methods. The 200 patients with obesity (aged 14–18: 100 boys and 100 girls) were examined at the clinic of the Institute of Children and Adolescent Health Care of the National Academy of Medical Sciences of Ukraine. All patients underwent a comprehensive clinical and laboratory examination. The study of eating behavior (EB) was conducted by questionnaire using the Dutch questionnaire (DEBQ, The Dutch Eating Behavior Questionnaire). The control group consisted of 30 healthy children of the same age category. The criteria for the diagnosis of MS in children, proposed by the International Diabetes Federation [IDF, 2007], were used, which allowed to divide patients into two groups: 1 — with signs of MS (50.0%) and 2 — without signs of MS (50.0%), each of which included 100 patients. Results and discussion. According to the anamnesis, adolescents had an unbalanced and irrational diet, as evidenced by complaints of pain and dyspepsia. Analysis of DEBQ data showed that in most adolescents there was a restrictive type of EB — (73.9±3.2%), also quite common variants were external (in 43.8±3.1%) and emotional type of EB (32.3±3.1%). The results showed significant zinc and magnesium deficiency in obese adolescents, in contrast to the surveyed control group (ϕ<0.05), in particular, the most pronounced (ϕ<0.05) deficiency of these trace elements was observed in the surveyed group with restrictive type of EB. Conclusions. Thus, an unbalanced diet naturally leads to disorders of both the digestive system and the formation of comorbid pathology, including obesity and MS. Analysis of the results of the DEBQ survey showed that patients with signs of MS were twice as likely to have EB disorders (71.8±3.7%) than patients without them (39.4±4.1%, ϕ<0.05). Among the violations of EB, the most common was the restrictive type (73.9%). Adolescents have a significant deficiency of zinc and magnesium in the blood (ϕ<0.05), in particular the most pronounced (ϕ<0.05) in the group of subjects with a restrictive type of EB. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: adolescents, microelements, nutrition, insulin resistance, metabolic syndrome.

Body Fat Mass is Better Indicator than Indirect Measurement Methods in Obese Children for Fatty Liver and Metabolic Syndrome

Introduction: To compare the bioelectric impedance analysis (BIA) with indirect measurement methods in the evaluation of obese children. To determine the diagnostic value of BIA in the fatty liver and metabolic syndrome (MS) in obese children. Population and methods: One hundred thirty-four obese children whom ≥10 years of age were prospectively assessment. All patients were evaluated by foot to foot BIA and indirect measurement methods. Blood biochemical parameters such as glucose, lipids and insulin levels were studied and oral glucose tolerance test was performed. Fatty liver was assessed by ultrasonography. Compared BIA records and indirect measurements findings according to fatty liver and MS. Results: The study included females/males: 77/57, mean age of 13.3 ± 2.2 years. Fatty liver was detected in 94 patients, MS was diagnosed in 58 cases. There were no gender difference in terms of fatty liver and MS. Fatty liver was seen more frequently in patients with metabolic syndrome than in those without metabolic syndrome (p < 0.001). Fat Mass (FM) of ≥ 97th percentile was observed in 63% of the 94 patients with fatty liver versus 37.5% of 40 patients without fatty liver. A FM of ≥97th percentile was observed in 72% (n=42) of the 58 patients with metabolic syndrome, 42% (n=33) of 76 patients without MS. Body mass index, upper mid-arm circumference, waist circumference (WC), and hip circumference values were significantly increased in patients with fatty liver. There was a better correlation was determined between FM and FM Index with fatty liver compared to indirect measurement methods. BIA records were found moderately correlated with indirect measurements. Conclusion: Our results revealed that FM and FMI have a better correlated in obese children with fatty liver and metabolic syndrome than indirect measurement methods. The measurement of body FM by BIA can be used together with the indirect measurement methods to detect the fatty liver. FMI may be an alternative diagnostic criterion instead of WC for diagnosis of MS in children.

Leptin-adiponectin imbalance as a marker of metabolic syndrome among Chinese children and adolescents: The BCAMS study.

PurposeLeptin and adiponectin have opposite effects on subclinical inflammation and insulin resistance, both involved in the development of metabolic syndrome (MS). We aimed to investigate whether leptin/adiponectin ratio (L/A), as a marker of these two adipokines imbalance, may improve diagnosis of MS in children and adolescents, and determined its cut-off value in the diagnosis of MS.MethodsA total of 3,428 subjects aged 6–18 years were selected from Beijing Child and Adolescent Metabolic Syndrome study. Adipokine leptin and adiponectin were measured using enzyme-linked immunosorbent assay. Odds ratio of MS per 1 z-score of adipokine was examined using logistic regression. Diagnosis accuracy was assessed using c-statistics (AUC) and net reclassification index.ResultsThe levels of leptin and L/A increased with number of positive MS components, while the levels of adiponectin declined in both boys and girls (all P <0.001). AUCs for diagnosis of MS in girls were 0.793, 0.773, and 0.689 using L/A, leptin and adiponectin, respectively; and AUCs in boys were 0.822, 0.798, and 0.697 for L/A, leptin and adiponectin, respectively. Notably, L/A outperformed individual leptin or adiponectin in discriminating a diagnosis of MS (all P < 0.02 in AUC comparisons). In addition, the optimal cut-offs of L/A by ROC curve differed by genders and pubertal stages, which were 1.63, 1.28, 1.95 and 1.53 ng/ug for total, pre-, mid- and postpubertal boys, respectively and 2.19, 0.87,1.48 and 2.27 ng/ug for total, pre-, mid- and postpubertal girls, respectively, yielding high sensitivity and moderate specificity for a screening test.ConclusionsIn this pediatric population, leptin-adiponectin imbalance, as reflected by an increase in L/A level, was found to be a better diagnostic biomarker for MS than leptin or adiponectin alone. Future longitudinal studies are needed to further validate the gender-specific cutoff values.