Examining Metabolic Syndrome Definitions in Overweight Hispanic Youth: A Focus on Insulin Resistance
Objective
To examine the prevalence of the metabolic syndrome in overweight Hispanic youth according to 3 published pediatric definitions. Furthermore, the relationship of each definition to directly measured insulin resistance was examined.
Study design
We conducted a secondary data analysis of 218 overweight Hispanic youth with a family history of type 2 diabetes mellitus. The metabolic syndrome was defined as ≥3 of these criteria: elevated triglyceride level, low high-density lipoprotein cholesterol level, elevated blood pressure, abdominal obesity, and hyperglycemia. The cutoff points were derived from updated definitions of Cook et al,1 Cruz et al,2 and Weiss et al.3 Insulin sensitivity was determined with the insulin-modified frequently sampled intravenous glucose tolerance test.
Results
Prevalence of the metabolic syndrome ranged from 25.7% to 39%, with moderate to substantial agreement between definitions (kappa = 0.52-0.70). Regardless of definition, an inverse relationship between metabolic risk and insulin sensitivity was noted such that children with the metabolic syndrome had 51% to 60% lower insulin sensitivity compared with children without any risk factors (P ≤.001 for all definitions).
Conclusion
The metabolic syndrome is prevalent in overweight Hispanic youth and may provide pediatricians with additional clinical insight for identifying the most metabolically at-risk children. Working toward a uniform and practical definition of the metabolic syndrome may improve its clinical implementation.
Abbreviations: ATP III, National Cholesterol Education Panel Adult Treatment Panel III, HDL, High-density lipoprotein, IFG, Impaired fasting glucose, IGT, Impaired glucose tolerance, USC, University of Southern California
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Supported by grants from the National Institutes of Health (R01 DK 59211 to Dr Goran and M01 RR 00043 to the University of Southern California General Clinical Research Center). This manuscript was prepared for the Pediatric Metabolic Syndrome Working Group.
PII: S0022-3476(07)00773-1
doi:10.1016/j.jpeds.2007.08.010
© 2008 Mosby, Inc. All rights reserved.
Refers to article:
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- Comparison of Different Definitions of Pediatric Metabolic Syndrome: Relation to Abdominal Adiposity, Insulin Resistance, Adiponectin, and Inflammatory Biomarkers , 22 October 2007
- Sensitivity, Specificity, and Predictive Values of Pediatric Metabolic Syndrome Components in Relation to Adult Metabolic Syndrome: The Princeton LRC Follow-up Study , 18 October 2007
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- Metabolic Syndrome in Childhood Predicts Adult Metabolic Syndrome and Type 2 Diabetes Mellitus 25 to 30 Years Later , 05 November 2007
- Waist-to-Height Ratio, a Useful Index to Identify High Metabolic Risk in Overweight Children , 19 November 2007
