First report on the validity of a continuous Metabolic Syndrome score as an indicator for Metabolic Syndrome in a national sample of paediatric population - The CASPIAN-III study

Introduction: The aim of this study was to assess the validity of a continuous Metabolic Syndrome score (cMetS) in a nationally representative sample of Iranian children and to identify sex and age-specific optimal cut-off points of cMetS that are associated with MetS. Material and methods: This study was conducted among 3,254 schoolchildren aged 10-18 years. cMetS was derived by aggregating age and sex-standardised residuals of waist circumference (WC), mean arterial pressure (MAP), glucose, high density lipoprotein-cholesterol (HDL-C) and triglycerides (TG). To determine the optimal cut-off points of cMetS for predicting MetS, receiver operator characteristic (ROC) curve analysis was used with an estimation of the variables' sensitivity and specificity. Results: A graded relationship was documented between cMetS and the number of risk factors. Increasing mean values of cMetS with increasing numbers of components were apparent for both genders. The overall optimal cMetS cut-off point for predicting the presence of MetS was 2.93 sensitivity = 92%, specificity = 91%, area of the curve = 0.96 (0.95-0.97). The values for boys and girls were 2.97 and 3.26 respectively in the total study. Conclusion: This nationwide study confirmed the validity of the cMetS score in a population-based sample of Iranian children. cMetS appears to be an appropriate index for investigating the association between potential risk factors and MetS in epidemiological research in Iran

Association of dietary patterns with continuous metabolic syndrome in children and adolescents; A nationwide propensity score-matched analysis: The CASPIAN-V study

Objective: This study aims to determine the association of dietary patterns with metabolic syndrome (MetS) and its components in children and adolescents. Methods: This nationwide study was conducted in 2015 among 4200 students aged 7-18 years, who lived in 30 provinces in Iran. The analysis was conducted based on the propensity score using a matched case-control study design. Three dietary patterns were obtained conducting a principal component analysis with a varimax rotation on 16 dietary groups. Continuous MetS score was computed by standardizing the residuals (z-scores) of MetS components by regressing them according to age and sex. The gold standard diagnosis of MetS was considered based on the International Diabetes Federation criteria. Moreover, for the purpose of data analysis, matched logistics analysis was used. Results: The study participants consisted of 3843 children and adolescents (response rate 91.5) with mean (SD) age of 12.45 (3.04) years. Totally 49.4 of students were girls and 71.4 lived in urban areas. Three dietary patterns were obtained: Healthy, Western, and Sweet. Prevalence of MetS was 5 (boy 5.5 and girl 4.5). Results of multivariate analysis show that students with Sweet dietary patterns were at higher risk for abdominal obesity (OR 1.29; 95 CI 1.01-1.66), elevated blood pressure (OR 1.35; 95 CI 1.01-1.81) and MetS (OR 1.33; 95 CI 1.02-1.74). The two other dietary patterns were not associated with MetS and its components. Conclusion: Sweet dietary pattern increase the risk of MetS and some its components in Iranian children and adolescents. This finding provides valuable information for effective preventive strategies of MetS based on diet rather than medication to maintain healthy lifestyle habits. © 2018 The Author(s)

Association of anthropometric measures with cardiovascular risk factors and metabolic syndrome in normal-weight children and adolescents: The CASPIAN III study

Objective: This nationwide study was conducted to determine the association of anthropometric measures with cardiovascular risk factors and metabolic syndrome (MetS) in Iranian normal-weight children and adolescents. Methods: We analyzed the data of 3,565 children and adolescents (50.3 boys), aged 10-18 years, with a normal BMI (5th-84th percentile) obtained from the third survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN III) study. The diagnostic criteria for MetS were defined by the International Diabetes Federation consensus. Results: The prevalence of MetS for 10- to 13.9-year-old boys, 14- to 18-year-old boys, 10- to 13.9-year-old girls, and 14- to 18-year-old girls were 1.4, 2.8, 2.3, and 3.3, respectively. After adjustment for age and sex, each unit increase in BMI (within normal range) and waist circumference increased the odds of MetS from 6 to 72 and from 1 to 20, respectively. The dominant pattern of dyslipidemia among the participants was high triglycerides and low high-density lipoprotein cholesterol. Conclusion: This study complements recent research about the high frequency of metabolic risk factors among normal-weight individuals in the pediatric age group. © 2013 S. Karger GmbH, Freiburg