Construct validity of a continuous metabolic syndrome score in children

<p>Abstract</p> <p>Objective</p> <p>The primary purpose of this study was to examine the construct validity of a continuous metabolic syndrome score (cMetS) in children. The secondary purpose was to identify a cutpoint value(s) for an adverse cMetS based on receiver operating characteristic (ROC) curve analysis.</p> <p>Methods</p> <p>378 children aged 7 to 9 years were assessed for the metabolic syndrome which was determined by age-modified cutpoints. High-density-lipoprotein cholesterol, triglycerides, the homeostasis assessment model of insulin resistance, mean arterial pressure, and waist circumference were used to create a cMetS for each subject.</p> <p>Results</p> <p>About half of the subjects did not possess any risk factors while about 5% possessed the metabolic syndrome. There was a graded relationship between the cMetS and the number of adverse risk factors. The cMetS was lowest in the group with no adverse risk factors (-1.59 ± 1.76) and highest in those possessing the metabolic syndrome (≥3 risk factors) (7.05 ± 2.73). The cutoff level yielding the maximal sensitivity and specificity for predicting the presence of the metabolic syndrome was a cMetS of 3.72 (sensitivity = 100%, specificity = 93.9%, and the area of the curve = 0.978 (0.957-0.990, 95% confidence intervals).</p> <p>Conclusion</p> <p>The results demonstrate the construct validity for the cMetS in children. Since there are several drawbacks to identifying a single cut-point value for the cMetS based on this sample, we urge researchers to use the approach herein to validate and create a cMetS that is specific to their study population.</p

Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: A case control study

Background With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs. Methods A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome. Results Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds. Conclusions We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating

Metabolic syndrome in overweight children from the city of Botucatu - São Paulo State - Brazil: agreement among six diagnostic criteria

<p>Abstract</p> <p>Background</p> <p>The metabolic syndrome has been described in children; however, a standard criterion has not been established for its diagnosis. Also, few studies have been conducted to specifically observe the possible existence of agreement among the existing diagnostic criteria. The purpose of the study is to evaluate agreement concerning prevalence rates of the metabolic syndrome diagnosed by six different criteria in overweight schoolchildren in the city of Botucatu - SP -Brazil.</p> <p>Methods</p> <p>This is a cross-sectional study on 128 overweight schoolchildren. Clinical examination included anthropometry, pubertal staging evaluation, and blood pressure. Triacylglycerol, glycemia, HDL-cholesterol, insulin levels, and HOMA-IR were determined. The Kappa index, the Mann-Whitney test and the chi-square test were used for statistical analysis.</p> <p>Results</p> <p>The prevalence of the metabolic syndrome varied from 10 to 16.5% according to different diagnostic criteria. Results were similar for boys and girls and pubertal stage. Great agreement was observed among the six different diagnostic criteria for the metabolic syndrome.</p> <p>Conclusions</p> <p>Different diagnostic criteria, when adopted for subjects with similar demographic characteristics, generate similar and compatible prevalence. Results suggest that it is possible to adopt any of the analyzed criteria, and the choice should be according to the components available for each situation.</p

Aptidão física de escolares do sudoeste da Amazônia Ocidental em diferentes estágios de maturação sexual

Resumo O objetivo desta pesquisa foi comparar as variáveis antropométricas e de aptidão física de crianças e adolescentes de ambos os sexos em diferentes estágios de maturação sexual. Foram coletadas amostras de 436 escolares de Porto Velho, RO, 218 meninos e 218 meninas. Foi utilizado o protocolo de Tanner para dividir a amostra em relação aos estágios de 1 a 4 e na sequência foram coletados os dados de antropometria (peso, altura e IMC) e aptidão física (flexibilidade, força e corrida/caminhada). Este estudo caracterizou-se como "ex-post-facto", portanto, utilizou-se a média e desvio padrão, seguido de análise de variância (Anova "one-way") com "post-hoc" de Bonferroni, adotando um nível de significância de 5%. Não foram encontradas diferenças nas variáveis antropométricas para os dois sexos. Nos testes de aptidão física foram encontradas diferenças relativas à flexibilidade e corrida/caminhada no sexo feminino e nas variáveis força e corrida/caminhada no sexo masculino

Relationship between salivary androstenedione levels, body composition and physical activity levels in young girls

Background: High androgenic activity in adolescent girls and adult women is associated with adiposity and metabolic disturbances. This study examined the relationship between salivary androstenedione levels, body composition, and physical activity levels in young girls. Method: Twenty-three girls (8.4 &plusmn; 0.9 years), nine of normal weight, and 14, overweight or obese, according to Centers for Disease Control and Prevention body mass index (BMI) percentile ranking, wore an ActiGraph&reg; accelerometer for five days. Skin folds were measured for percentage body fat and fat-free mass calculation. Saliva samples were collected at home, three times in one day (upon waking, 30 minutes post-waking and in the evening). Previously published cut-points estimated the minutes of sedentary behaviour, light, moderate, moderate-to-vigorous, vigorous, and very vigorous physical activity. Meeting physical activity recommendations was defined as accumulating 60 minutes/day of moderate-to-vigorous physical activity. T-tests, correlation analysis, and analysis of variance, examined the relationships among the variables (alpha = p-value &le; 0.05). Results: Thirty-five per cent of the girls met current physical activity recommendations. There were no differences between the normal weight and overweight or obese categories in terms of meeting physical activity recommendations, or salivary androstenedione levels. Evening salivary androstenedione levels were higher among girls who did not meet the physical activity recommendations (116.9 &plusmn; 15.3 pg/ml vs. 80.45 &plusmn; 8.5 pg/ml, p-value = 0.04). Salivary androstenedione levels at 30 minutes post-waking were positively correlated with BMI (r = 0.45, p-value = 0.03) and percentage body fat (r = 0.40, p-value = 0.05). Conclusion: These research results were similar to those of circulating androgen research performed in adolescent girls and adult women, in that salivary androstenedione levels were positively correlated with BMI and percentage body fat in young girls. Meeting physical activity recommendations was associated with the maintenance of the normal diurnal rhythm of salivary androstenedione secretion.Keywords: androstenedione, obesity, physical activity, women, girl