Metabolic syndrome prevalence in chilean children according to three different criteria and its agreement with insulin resistance
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Date
2013
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Abstract
Background and objectives: There is not a consensus in Metabolic Syndrome (MS) definition for children and adolescents, although its prevalence is increasing. The aim of the present study was tocompare the prevalence of MS according to three diagnostic criteria for children and adolescents and to study the agreement with insulin resistance (IR). Methods: Cross-sectional study (2009-2011) of 3325 students, 10-15 years old, from schools in Puente Alto County, Santiago, Chile. Anthropometry was performed, measuring blood pressure (BP) and in a fast blood sample: glicemia, insulin, blood lipids. We calculated HOMA-IR (Homeostasis Model Assessment index); values >90th percentile of a normal sub-sample were considered as IR. We compared three criteria of MS: International Diabetes Federation (IDF), Cook S. and De Ferranti S. They define different cut-offs for the five components of MS (waist circumference, triglycerides, HDLCholesterol, blood pressure and glicemia) having bnormal at least three of them. Results: Prevalence of MS was 3.82% for IDF, 7.25% for Cook and 20.48% for de Ferranti criterion (Cochran Q-test, p<0.001). In total 859 subjects were IR (25.8%). 73.2% and 69.7% of the children diagnosed with MS according the first two criteria had IR in but only 52.7% according to the third one (Predictive Positive Values: PPV). To predict IR, each criterion had ROC-AUC of 0.60, 0.62 and 0.67 respectively (adjusted for sex and puberty). IR predicted the presence of MS according the different criteria with PPV of 10.8%, 19.6% and 41.8% and ROC-AUC for HOMA-IR was: 0.84, 0.82 and 0.76 respectively (adjusted for sex and puberty). Conclusions: Prevalence of MS varies significantly according to different criteria. IDF and Cook´s criteria are similar predictors for IR (even the former has higher cutoffs for MS components), better than de Ferranti´s. HOMA-IR was a good predictor of the three MS criteria.
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Keywords
Metabolic syndrome, Children, Insulin resistance