Prevalence of Metabolic Syndrome in Overweight and Obese Filipino Adolescents Based on the IDF Definition
Abstract
Objective. This study determined the prevalence of metabolic syndrome (MetS) in overweight and obese Filipino adolescents.
Methodology. A total of 350 overweight and obese Filipino adolescents (aged 10 to 18 years, 206 males and 144 females) referred to pediatric endocrine clinics in Metro Manila were included. Weight, height, waist and blood pressure were measured and fasting lipid profiles, blood glucose and insulin were determined. MetS is defined as presence of three out of five clinical features: central obesity, hyperglycemia, hypertriglyceridemia, low HDL-C level and hypertension. The prevalence of MetS was determined based on the International Diabetes Federation (IDF) definition.
Results. The overall prevalence of MetS in overweight and obese adolescents was 19%. Among participants, 98% had abdominal adiposity, 25% hypertension, 24% hypertriglyceridemia, 17% low HDL and 12% hyperglycemia; 67% had hyperinsulinemia (>15 uU/ml) and 70% had insulin resistance based on HOMA-IR (≥3). Among those with MetS, 14% had 3 components and 5% had 4 components; the prevalence of hyperinsulinemia and insulin resistance rose to 79% and 90%, respectively, with high mean levels of serum insulin (31.3 μU/ml) and HOMA-IR (7.7).
Conclusion. Overweight and obese adolescents are at risk to develop MetS. The prevalence of hyperinsulinemia and insulin resistance is high.
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References
Food and Nutrition Research Institute, Department of Science and Technology. Philippine Nutrition: Facts and Figures, 2005. Taguig City: FNRI-DOST, 2007.
. Food and Nutrition Research Institute, Department of Science and Technology. Seventh National Nutrition Survey 2008- Anthropometric survey component: Pre-school children, adolescents, adults, pregnant and lactating mothers. Available at: http://www.fnri.dost.gov.ph/images/stories/7thNNS/anthrop/anthrop_preschool_adoles.pdf. Accessed August 22, 2010.
. Chan-Cua, S, Amarillo MLE. Validity of body mass index based on self-reported weight and height in estimation of prevalence of overweight and obesity among adolescents. Phil J Pediatr. 2009; 57: 23-29.
. Chan-Cua, S, Cuayo-Juico C, Bugayong-Regidor P, Guerrero M. Prevalence of overweight among boys in a Metro Manila private grade school. JAFES. 1995; 16-20.
. Ley-Chua T, Cua S and Garcia RD. Correlation of body mass index with neck circumference, waist and hip circumference, waist-to-hip ratio and triceps skin fold thickness. Phil J Pediatr. 2003; 52: 117-125.
. Florentino, RF, Villavieja GM, Lana RD. Regional study of nutritional status of urban primary school children. 1. Manila, Philippines. Food Nutr Bull.2002; 23: 24-30.
. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005; 365: 1415-1428.
. Alberti KGMM, Zimmet PZ, Shaw JE. The metabolic syndrome - A new world-wide definition from the International Diabetes Federation Consensus. Lancet. 2005; 366: 1059-1062.
. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz W. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch of Pediatr Adolesc Med. 2003; 157:821-827.
. Zimmet P, Alberti KG, Kaufman F, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007;8:299-306.
. Csábi GY, Török K, Jeges S, et al. Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr. 2000; 159: 91-4.
. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev. 2007; 29: 62-76.
. Weiss R, Dziura J, Burgert T, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004; 350: 2362-2374.
. Dietz WH. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics. 1998; 101(3 Pt 2): 518-25.
. Sorof J, Daniels S. Obesity Hypertension in Children, A Problem of Epidemic Proportions. Hypertension. 2002; 40: 441-447.
. Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC. Childhood obesity, other cardiovascular risk factors, and premature death.N Engl J Med. 2010; 362: 485-93.
. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review.Int J Obes (Lond). 2011; 35:891-8.
. Chan-Cua, S; Regidor, P. Hyperlipidemia of obese Filipino children and adolescents (Abstract). Asia Pac J Clin Nutr. 2002; 11: S744.
. Chan-Cua S, Bugayong-Regidor P. Fasting Hyperinsulinemia in Obese Children and Adolescents (Abstract). J Pediatr Endocrinol Metab. 2000; 13: S1241.
. Florentino, Rodolfo. The burden of obesity in Asia: Challenges in assessment, prevention and management. Asia Pac J Clin Nutr. 2002; 11: S676-680.
. Cruz ML and Goran MI. The Metabolic Syndrome in Children and Adolescents. Curr Diab Rep. 2004; 4: 53–62.
. Singh R, Bhansali A, Sialy R, Aggarwal A. Prevalence of metabolic syndrome in adolescents from north Indian population. Diabet Med. 2007; 24:195-9.
. World Health Organization. Waist circumference and waist–hip ratio: report of a WHO expert consultation, Geneva, 8–11 December 2008. Geneva: WHO Document Production Services, 2011.
. de Onis M, Onyango AW, Borghi E, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007; 85: 660-7.
. McCarthy HD and Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message – 'Keep your waist circumference to less than half your height'. Int of Obes (Lond). 2006; 30: 988-992.
. Garnett SP, Baur LA, Cowell CT. Waist-to-height ratio: A simple option for determining excess central adiposity in young people. Int J Obes (Lond). 2008; 32: 1028-30.
. Yan W, He B, Yao H, et al. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity. 2007;15: 748–752.
. Sung RY, So HK, Choi KC, et al. Waist circumference and waist-to-height ratio of Hong Kong Chinese children. BMC Public Health. 2008; 8: 324.
. Ten S, Maclaren N. Insulin resistance syndrome in children. J Clin Endocrinol Metab. 2004; 89: 2526-2539.
. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia.1985; 28:412–419.
. Tresaco B, Bueno G, Pineda I, et al. Homeostatic model assessment (HOMA) index cut-off value to identify the metabolic syndrome in children. J Physiol Biochem. 2005; 61: 381-8.
. Braga-Tavares H, Fonseca H. Prevalence of metabolic syndrome in a Portuguese obese adolescent population according to three different definitions.Eur J Pediatr. 2010; 169: 935-40.
. Druet C, Ong K, Levy Marchal C. Metabolic syndrome in children: Comparison of the International Diabetes Federation 2007 consensus with an adapted National Cholesterol Education Program definition in 300 overweight and obese French children. Horm Res Paediatr. 2010; 73: 181-6.
. Iamopas O, Chongviriyaphan N, Suthutvoravut U. Metabolic syndrome in obese Thai children and adolescents. J Med Assoc Thai. 2011;94 Suppl 3:S126-32.
. van Vliet M, von Rosenstiel IA, Schindhelm RK, et al. Identifying the metabolic syndrome in obese children and adolescents: Do age and definition matter? Curr Clin Pharmacol. 2009; 4: 233-8.
. Lafortuna CL, Adorni F, Agosti F, et al. Prevalence of the metabolic syndrome among extremely obese adolescents in Italy and Germany.Diabetes Res Clin Pract. 2010; 88:14-21.
. Caceres M, Teran CG, Rodriguez S, et al. Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity. BMC Pediatrics. 2008; 8:31.
. Lopez-Capape M, Alonso M, Colino E, et al. Frequency of the metabolic syndrome in obese Spanish pediatric population. Eur J Endocrinol. 2006; 155:313–319.
. Atabek ME, Pirgon O, Kurtoglu S. Prevalence of metabolic syndrome in obese Turkish children and adolescents. Diabetes Res Clin Pract. 2006; 72:315-21.
. Moraes AC, Fulaz CS, Netto-Oliveira ER, et al. Prevalence of metabolic syndrome in adolescents: A systematic review.Cad Saude Publica. 2009; 25: 1195-202.
. William CL, Hayman LL, Daniels SR, et al: Cardiovascular health in childhood: A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation: 106:143-160.
. Zimmet PZ, Collins VR, Dowse GK, Knight LT: Hyperinsulinaemia in youth is a predictor of type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1992; 35: 534 -541.
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