Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria
DOI:
https://doi.org/10.15448/1980-6108.2016.3.22854Keywords:
metabolic syndrome X, child, adolescent.Abstract
Aims: To assess the frequency of metabolic syndrome in children and adolescents according to three international diagnostic criteria determining the level of agreement between these different criteria.
Methods: Waist circumference, blood pressure, blood glucose, high-density lipoprotein cholesterol, and serum triglycerides were evaluated in students from public schools of different regions of Divinópolis, MG, Brazil. Children and adolescents aged between 10 and 17 years were selected. Criteria adapted from the World Health Organization (WHO), National Cholesterol Education Program – Adult Treatment Panel III (NCEP/ATPIII), and International Diabetes Federation (IDF) were used for the diagnosis of metabolic syndrome. The kappa coefficient was used to evaluate the level of agreement among the three criteria.
Results: The study evaluated 202 students (86 boys and 116 girls). The frequency of metabolic syndrome was 1.16% for boys and none of the girls presented with metabolic syndrome, according to WHO criteria. According to the NCEP/ATPIII and IDF criteria, metabolic syndrome was not detected in the studied sample. Low blood levels of high-density lipoprotein cholesterol was the most frequent metabolic alteration in all teenagers according to the NCEP/ATPIII and IDF criteria, while body mass index was the most frequent one according to WHO criteria. The level of agreement for one altered parameter was poor when comparing WHO and NCEP/ATP/III, moderate when comparing WHO and IDF and high when comparing the NCEP/ATP/III and IDF criteria.
Conclusions: Significant differences between the frequencies of individual metabolic syndrome parameters were found in the studied sample of children and adolescents, depending on the criteria used. According to WHO criteria, metabolic syndrome was found at a low frequency and only in boys, while the NCEP/ATPIII and IDF criteria did not diagnose metabolic syndrome. The present findings suggest the need to reach a consensus on the cut-off points for risk factors and a single diagnostic definition of metabolic syndrome in children and adolescents.
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References
Kylin E. Studien ueber das Hypertonie-Hyperglyka "mie-Hyperurika" miesyndrom. Zentalblatt Fuer Innere Med. 1923;44:105-27.
Cameron AJ, Zimmet PZ, Shaw JE, Alberti GMM. The metabolic syndrome: in need of a global mission statement. Diabet Med. 2009 Mar;26(3):306-9. http://dx.doi.org/10.1111/j.1464-5491.2009.02681.x
Sociedade Brasileira de Hipertensão. I Diretriz brasileira de diagnóstico e tratamento da síndrome metabólica. Rev Soc Bras Hipertens. 2004;7(4):130.
Damiani D, Kuba VM, Cominato L, Damiani D, Dichtchekenian V, Menezes Filho, HC. Síndrome metabólica em crianças e adolescentes: dúvidas na terminologia, mas não nos riscos cardiometabólicos. Arq Bras Endocrinol Metab. 2011;55(8):576-82. http://dx.doi.org/10.1590/S0004-27302011000800011
Ford ES, Ajani UA, Mokdad AH. The metabolic syndrome and concentrations of C-reactive protein among U.S.Youth. Diabetes Care. 2005 Apr;28(4):878-81. http://dx.doi.org/10.2337/diacare.28.4.878
Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S; IDF Consensus Group. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007 Oct;8(5):299-306. http://dx.doi.org/10.1111/j.1399-5448.2007.00271.x
Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P. Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child. 2005 Jan;90(1):10-4. http://dx.doi.org/10.1136/adc.2003.036467
Marcovecchio ML, Chiarelli F. Metabolic syndrome in youth: chimera or useful concept? Curr Diab Rep. 2013 Feb;13(1):56-62. http://dx.doi.org/10.1007/s11892-012-0331-2
Pazin J, Frainer DES. Obesity and motor development: a cross-sectional study with brazilians school children. FIEP Bulletin 2007;77:453-6.
Lottenberg AS, Glezer A, Turatti LA. Metabolic syndrome: identifying the risk factors. J Pediatr (Rio J). 2007 Nov;83(5 Suppl):S204-8. http://dx.doi.org/10.1590/S0021-75572007000700012
Moraes AC, Fulaz CS, Netto-Oliveira ER, Reichert FF. Prevalence of metabolic syndrome in adolescents: a systematic review. Cad Saude Publica. 2009 Jun;25(6):1195-202. http://dx.doi.org/10.1590/S0102-311X2009000600002
Cuevas A, Alvarez V, Carrasco F. Epidemic of metabolic syndrome in Latin America. Curr Opin Endocrinol Diabetes Obes. 2011 Apr;18(2):134-8. http://dx.doi.org/10.1097/MED.0b013e3283449167
Tavares LF, Yokoo EM, Rosa MLG, Fonseca SC. Metabolic syndrome in Brazilian children and adolescents: systematic review. Cad Saúde Colet. 2010;18(4):469-76.
Seki M, Matsuo T, Carrilo AJ. Prevalence of metabolic syndrome and associated risk factors in Brazilian schoolchildren. Public Health Nutr. 2009 Jul;12(7):947-52. http://dx.doi.org/10.1017/S1368980008003030
Alvarez MM, Vieira AC, Sichieri R, Veiga GV. Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil. Arq Bras Endocrinol Metabol. 2011 Mar;55(2):164-70. http://dx.doi.org/10.1590/S0004-27302011000200009
Boodai SA, Cherry LM, Sattar NA, Reilly JJ. Prevalence of cardiometabolic risk factors and metabolic syndrome in obese Kuwaiti adolescents. Diabetes Metab Syndr Obes. 2014 Oct 24;7:505-11. http://dx.doi.org/10.2147/DMSO.S66156
Rinaldi AE, Pimentel GD, Pereira AF, Gabriel GF, Moreto F, Burini RC. Metabolic syndrome in overweight children from the city of Botucatu - São Paulo State - Brazil: agreement among six diagnostic criteria. Diabetol Metab Syndr. 2010 Jun 9;2(1):39. http://dx.doi.org/10.1186/1758-5996-2-39
Tavares Giannini D, Caetano Kuschnir MC, Szklo M. Metabolic syndrome in overweight and obese adolescents: a comparison of two different diagnostic criteria. Ann Nutr Metab. 2014;64(1):71-9.
Huang TT, Ball GD, Franks PW. Metabolic syndrome in youth: current issues and challenges. Appl Physiol Nutr Metab. 2007 Feb;32(1):13-22. http://dx.doi.org/10.1139/h06-094
Stabelini Neto A, Sasaki JE, Mascarenhas LP, Boguszewski MC, Bozza R, Ulbrich AZ, Silva SG, de Campos W. Physical activity, cardiorespiratory fitness, and metabolic síndrome in adolescents: a cross-sectional study. BMC Public Health. 2011 Aug 30;11:674. http://dx.doi.org/10.1186/1471-2458-11-674
Lwanga SK, Lemeshow S. Sample size determination in health studies: a pratical manual. Geneva: World Health Organization; 1991.
Instituto Brasileiro de Geografia e Estatística. Instrumento de Coleta Censo 2009 [Internet]. Rio de Janeiro; 2009 [cited 2015 Nov 15]. Available from: http://biblioteca.ibge.gov.br/visualizacao/instrumentos_de_coleta/doc1995.pdf
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Saúde da criança: crescimento e desenvolvimento. Brasília: Ministério da Saúde; 2012. 272 p. (Cadernos de Atenção Básica; vol. 33).
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159-74. http://dx.doi.org/10.2307/2529310
López-Jaramillo P, Sánchez RA, Diaz M, Cobos L, Bryce A, Parra-Carrillo JZ, Lizcano F, Lanas F, Sinay I, Sierra ID, Pe-aherrera E, Bendersky M, Schmid H, Botero R, Urina M, Lara J, Foss MC, Márquez G, Harrap S, Ramírez AJ, Zanchetti A. Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome. Arq Bras Endocrinol Metabol. 2014 Apr;58(3):205-25. http://dx.doi.org/10.1590/0004-2730000003019
Burns TL, Letuchy EM, Paulos R, Witt J. Childhood predictors of the metabolic syndrome in middle-aged adults: the Muscatine study. J Pediatr. 2009 Sep;155(3):S5.e17-26.
Wee BS, Poh BK, Bulgiba A, Ismail MN, Ruzita AT, Hills AP. Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: a case control study. BMC Public Health. 2011 May 18;11:333. http://dx.doi.org/10.1186/1471-2458-11-333
Agirbasli M, Cakir S, Ozme S, Ciliv G. Metabolic syndrome in Turkish children and adolescents. Metabolism. 2006 Aug;55(8):1002-6. http://dx.doi.org/10.1016/j.metabol.2006.03.009
Reyes MV, Mederico M, Valeri MP, Briceno Y, Zerpa Y, Gómez-Pérez R, Camacho R, Martínez JL, Valeri L, Arata-Bellabarba G. Síndrome metabólico en escolares y adolescentes de la ciudad de Mérida-Venezuela: comparación de resultados utilizando valores de referencia locales e internacionales (estudio CREDEFAR). Endocrinol Nutr. 2014;61(9):474-85. http://dx.doi.org/10.1016/j.endonu.2014.03.009
Mbowe O, Diaz A, Wallace J, Mazariegos M, Jolly P. Prevalence of Metabolic Syndrome and Associated Cardiovascular Risk Factors in Guatemalan School Children. Matern Child Health J. 2014 Sep;18(7):1619-27. http://dx.doi.org/10.1007/s10995-013-1402-y
Pitangueira JCD, Silva LR, Santana MLP, Silva MCM, Costa PRF, D'Almeida V, Assis AMO. Metabolic syndrome and associated factors in children and adolescents of a Brazilian municipality. Nutr Hosp. 2014 Apr 1;29(4):865-72.
Henry CJ, Lightowler HJ, Al-Hourani HM. Physical activity and levels of inactivity in adolescent females ages 11-16 years in the United Arab Emirates. Am J Hum Biol. 2004 May-Jun;16(3):346-53. http://dx.doi.org/10.1002/ajhb.20022
Rashidi H, Payami SP, Latifi SM, Karandish M, Aleali AM, Aminzadeh M, Riahi K, Ghasemi M. Prevalence of metabolic syndrome and its correlated factors among children and cess adolescents of Ahvaz aged 10-19. J Diabetes Metab Disord. 2014 Apr 28;13:53. http://dx.doi.org/10.1186/2251-6581-13-53
Hallal PC, Dumith SC, Bastos JP, Reichert FF, Siqueira FV, Azevedo MR. Evolução da pesquisa epidemiológica em atividade física no Brasil: revisão sistemática. Rev Saude Publica. 2007;41(3):453-60. http://dx.doi.org/10.1590/S0034-89102007000300018
Lee S, Bacha F, Arslanian SA. Waist circunference, blood pressure, and lipid components of the metabolic syndrome. J Pediatr. 2006 Dec;149(6):809-16. http://dx.doi.org/10.1016/j.jpeds.2006.08.075
Poyrazoglu S, Bas F, Darendeliler F. Metabolic syndrome in young people. Curr Opin Endocrinol Diabetes Obes. 2014 Feb;21(1):56-63. http://dx.doi.org/10.1097/01.med.0000436414.90240.2c
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