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

Prevalência de síndrome metabólica em amostra ambulatorial de crianças e adolescentes com sobrepeso e obesidade: análise comparativa de diferentes definições clínicas Prevalencia de síndrome metabólica en muestra ambulatorial de niños y adolescentes con sobrepeso y obesidad: análisis comparativa de distintas definiciones clínicas Prevalence of metabolic syndrome in overweight and obese outpatient children and adolescents: comparative analysis using different clinical definitions

OBJETIVO: Descrever a prevalência de síndrome metabólica em amostra ambulatorial de crianças e adolescentes com sobrepeso e obesidade segundo critérios propostos pela literatura para sua definição. MÉTODOS: Estudo descritivo observacional transversal com 74 crianças e adolescentes, entre seis e 17 anos, selecionados para participarem de um estudo de intervenção, no qual foram coletados dados antropométricos (peso, estatura, índice de massa corporal e circunferência da cintura), laboratoriais (perfil lipídico e glicemia), além de pressão arterial. A prevalência de síndrome metabólica foi determinada pelas quatro propostas mais frequentemente adotadas em uma revisão sistemática sobre o tema (SM1 a SM4), sendo obtidas as diferenças de proporções, com nível de significância de 0,05. RESULTADOS: A prevalência de síndrome metabólica variou de 55,6% (IC95% 43,4-67,1%) a 74,0% (IC95% 62,2-83,2%) de acordo com as propostas escolhidas, sendo mais elevada quando os pontos de corte eram mais sensíveis. O uso do índice de massa corporal como critério antropométrico não comprometeu, de forma significativa, o diagnóstico de síndrome metabólica. Apesar da variação, a prevalência encontrada foi elevada, atingindo, simultaneamente, por todas as propostas, 52,7% da amostra. As anormalidades mais observadas foram obesidade abdominal e hipertrigliceridemia e, a menos observada, foi a hiperglicemia. CCONCLUSÕES: As alterações metabólicas investigadas foram prevalentes em toda a amostra e o excesso de peso parece ter sido fator determinante no quadro descrito. Esse fato denota a importância do diagnóstico precoce e do monitoramento dessa população com o intuito de reduzir o risco de desenvolvimento de comorbidades cardiovasculares na vida adulta jovem.<br>OBJETIVO: Describir la prevalencia del Síndrome Metabólica en muestra ambulatorial de niños y adolescentes con sobrepeso y obesidad según criterios propuestos por la literatura para su definición. MÉTODOS: Estudio descriptivo observacional transversal con 74 niños y adolescentes, entre 6-17 años, selecciona-dos para participar de un estudio de intervención, donde se recogieron datos antropométricos (peso, estatura, IMC, circunferencia de la cintura), laboratoriales (perfil lipídico y glucemia), además de presión arterial. La prevalencia del Síndrome Metabólica (SM) fue determinada mediante cuatro propuestas más frecuentemente adoptadas en una revisión sistemática sobre el tema (SM1 a SM4), siendo obtenidas las diferencias de proporciones, con nivel de significancia de 0,05. RESULTADOS: La prevalencia de SM varió de 55,6% (95% IC 43,4-67,1%) a 74,0% (95% IC 62,2-83,2%) conforme las propuestas escogidas, siendo más elevada cuando los puntos de corte eran más sensibles. El uso del IMC como criterio antropométrico no comprometió, de modo significativo, el diagnóstico de SM. A pesar de la variación, la prevalencia en-contrada fue elevada alcanzando, simultáneamente, por todas las propuestas, 52,7% de la muestra. Las anormalidades más observadas fueron obesidad abdominal e hipertrigliceridemia y la menos observada fue la hiperglucemia. CONCLUSIÓN: Las alteraciones metabólicas investigadas fueron prevalentes en toda la muestra y el exceso de peso parece haber sido factor determinante en el cuadro descrito. Ese hecho denota la importancia del diagnóstico precoz y del monitoreo de esta población con el objetivo de reducir el riesgo de desarrollo de comorbidades cardiovasculares en la vida adulta joven.<br>OBJETIVE: To describe the prevalence of metabolic syndrome among children and adolescents with overweight and obesity according to standards proposed by literature. METHODS: Cross-sectional study comprising a total of 74 children and adolescents aged six to 17 years old and recruited for an interventional study. Anthropometric data (weight, height, body mass index and waist circumference), laboratorial data (lipid profile and fasting glycemia) and blood pressure were obtained. The prevalence of metabolic syndrome was determined by four criteria usually adopted, as observed in a systematic review (MS1 to MS4). Differences between the proportions of children diagnosed with metabolic syndrome according to the different classifications were studied, being significant p<0.05. RESULTS: The prevalence of metabolic syndrome ranged between 55.6% (95%CI 43.4-67.1%) and 74.0% (95% CI 62.2-83.2%), according to the chosen clinical definitions, being higher when more sensitive cut-off points were applied. Body mass index adoption as an anthropometric criterion did not interfere on metabolic syndrome diagnosis, and the observed prevalence was high (52.7%), regardless of the clinical definition. Abdominal obesity and hipertriglyceridemia were the most common observed abnormalities, and hyperglycemia had the lower prevalence. CONCLUSIONS: The metabolic changes were prevalent in the studied population and overweight seems to be the determinant condition, highlighting the importance of early diagnosis and monitoring aiming to reduce cardiovascular diseases in early adult life