Abstract
Background
Metabolic syndrome (MetS) is not only a problem of adulthood but is already present in children and adolescents. The aim of this study was to estimate the prevalence of MetS in adolescents and to identify the associated factors.
Methods
This was a cross-sectional study with 354 overweight and obese school-aged adolescents (10–19 years). Sociodemographic, anthropometric, clinical, biochemical and lifestyle variables were collected. MetS was identified according to the criteria proposed by the International Diabetes Federation (IDF). Multivariate logistic regression models were used to examine the associations between risk variables and MetS.
Results
The prevalence of MetS was 9.6%. Among adolescents with MetS, all of them had low high-density lipoprotein cholesterol (HDL-c), while 76.5% had hyperglycemia and 38.2% had hypertriglyceridemia. Only 12.1% did not present any component of MetS, while 40% had at least two components. Multivariate analysis showed that being a girl was a protective factor (odds ratio [OR] = 0.29, confidence interval [CI] = 0.13–0.65) for the presence of MetS, while obesity (OR = 3.63, CI = 1.62–8.17) and being insufficiently active (OR = 4.60, CI = 1.01–20.96) were the risk factors for MetS.
Conclusions
Obese and insufficiently active male adolescents are more likely to have MetS. Early identification of MetS components, especially among obese adolescents, is an important tool for the prevention of cardiovascular complications in adult life.
Funding source: Research Foundation of the State of São Paulo (FAPESP)
Award Identifier / Grant number: 2012/01283-3
Funding statement: The work was supported by a research grant from the Research Foundation of the State of São Paulo (FAPESP), Funder Id: http://dx.doi.org/10.13039/501100001807, Grant Number: 2012/01283-3.
Acknowledgments
We acknowledge the scholarship by the Coordination of Improvement of Personnel of Superior Level (Capes) for the scholarship granted.
Author contributions: RASD contributed to the interpretation, discussion of the data and wrote the draft of the manuscript. CCE contributed to the conception, design, analysis, interpretation and discussion of the data, and wrote the final version of the manuscript. LBN contributed to the analysis, writing and having revised the manuscript. All authors approved the final version of the manuscript.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Conflict of interest: The authors declare that there is no conflict of interest.
References
1. Pietrobelli A, Malavolti M, Battistini NC, Fuiano N. Metabolic syndrome: a child is not a small adult. Int J Pediatr Obes 2008;3(Suppl 1):67–71.10.1080/17477160801897133Search in Google Scholar PubMed
2. Kuschnir MC, Bloch KV, Szklo M, Klein CH, Barufaldi LA, et al. ERICA: prevalence of metabolic syndrome in Brazilian adolescents. Rev Saúde Pública 2016;50(Suppl 1):11s.10.1590/s01518-8787.2016050006701Search in Google Scholar PubMed PubMed Central
3. Reuter CP, Burgos MS, Barbian CD, Renner JD, Franke SI, et al. Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil. Eur J Pediatr 2018;177:1471–7.10.1007/s00431-018-3202-2Search in Google Scholar PubMed
4. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, et al. The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatr Diabetes 2007;8:299–306.10.1111/j.1399-5448.2007.00271.xSearch in Google Scholar PubMed
5. 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;55:164–70.10.1590/S0004-27302011000200009Search in Google Scholar PubMed
6. Pitangueira JC, Silva LR, Santana ML, Silva MC, Costa PR, et al. Metabolic syndrome and associated factors in children and adolescents of a Brazilian municipality. Nutr Hosp 2014;29:865–72.Search in Google Scholar
7. National Institutes of Health/National Heart, Lung, and Blood Institute (2002) Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Final Report. Bethesda: National Institutes of Health.10.1001/jama.285.19.2486Search in Google Scholar PubMed
8. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003;157:821–7.10.1001/archpedi.157.8.821Search in Google Scholar PubMed
9. Ferranti S, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, et al. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494–7.10.1161/01.CIR.0000145117.40114.C7Search in Google Scholar PubMed
10. Vanlancker T, Schaubroeck E, Vyncke K, Cadena-Sanchez C,Breidenassel C, et al. Comparison of definitions for the metabolic syndrome in adolescents. Eur J Pediatr 2017;176:241–52.10.1007/s00431-016-2831-6Search in Google Scholar PubMed
11. International Diabetes Federation. The IDF consensus definition of the metabolic syndrome in children and adolescents [Internet]. Brussels: IDF Communications; 2007 [cited 2018 Sep 10]. Available from: http://www.idf.org/webdata/docs/Mets_definition_children.pdf.Search in Google Scholar
12. Poyrazoglu S, Bas F, Darendeliler F. Metabolic syndrome in young people. Curr Opin Endocrinol Diabetes Obes 2014;21:56–63.10.1097/01.med.0000436414.90240.2cSearch in Google Scholar PubMed
13. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640–5.10.1161/CIRCULATIONAHA.109.192644Search in Google Scholar PubMed
14. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign, IL, USA: Human Kinetics Books, 1988.Search in Google Scholar
15. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660–7.10.2471/BLT.07.043497Search in Google Scholar PubMed PubMed Central
16. Barros AJ, Victora CG. A nationwide wealth score based on the 2000 Brazilian demographic census. Rev Saúde Pública 2005;39:523–9.10.1590/S0034-89102005000400002Search in Google Scholar PubMed
17. Slater B, Philippi ST, Fisberg RM, Latorre MR. Validation of a semi-quantitative adolescent food frequency questionnaire applied at a public school in São Paulo, Brazil. Eur J Clin Nutr 2003;57:629–35.10.1038/sj.ejcn.1601588Search in Google Scholar PubMed
18. Andrade RG, Pereira RA, Sichieri R. Food intake in overweight and normal-weight adolescents in the city of Rio de Janeiro. Cad Saúde Pública 2003;19:1485–95.10.1590/S0102-311X2003000500027Search in Google Scholar PubMed
19. Monteiro CA. Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutr 2009;12:729–31.10.1017/S1368980009005291Search in Google Scholar PubMed
20. Florindo AA, Romero A, Peres SV, Silva MV, Slater B. Development and validation of a physical activity assessment questionnaire for adolescents. Rev Saúde Pública 2006;40:802–9.10.1590/S0034-89102006000600009Search in Google Scholar PubMed
21. WHO. Global recommendations on physical activity for health. Available from: https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf;jsessionid=F6E30E79DB3E6AC0F6805AFF8C5BFE83?sequence=1. [cited 2019 Oct 01].Search in Google Scholar
22. Rinaldi AE, Gabriel GF, Moreto F, Corrente JE, McLellan KC, et al. Dietary factors associated with metabolic syndrome and its components in overweight and obese Brazilian schoolchildren: a cross-sectional study. Diabetol Metab Syndr 2016;8:58.10.1186/s13098-016-0178-9Search in Google Scholar PubMed PubMed Central
23. Mehata S, Shrestha N, Mehta RK, Bista B, Pandey AR, et al. Prevalence of the metabolic syndrome and its determinants among Nepalese adults: findings from a nationally representative cross-sectional study. Sci Rep 2018;8:14995.10.1038/s41598-018-33177-5Search in Google Scholar PubMed PubMed Central
24. MacPherson M, de Groh M, Loukine L, Prud’homme D, Dubois L. Prevalence of metabolic syndrome and its risk factors in Canadian children and adolescents: Canadian Health Measures Survey Cycle 1 (2007–2009) and Cycle 2 (2009–2011). Saúde Promot Dis Crônico Prev Can 2016;36:32–40.10.24095/hpcdp.36.2.03Search in Google Scholar PubMed PubMed Central
25. Johnson WD, Kroon JJ, Greenway FL, Bouchard C, Ryan D, et al. Prevalence of risk factors for metabolic syndrome in adolescents: National Health and Nutrition Examination Survey (2001–2006). Arch Pediatr Adolesc Med 2009;163:371–7.10.1001/archpediatrics.2009.3Search in Google Scholar PubMed
26. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013;93:359–404.10.1152/physrev.00033.2011Search in Google Scholar PubMed
27. Moraes AC, Fulaz CS, Netto-Oliveira ER, Reichert FF. Prevalence of metabolic syndrome in adolescents: a systematic review. Cad Saúde Pública 2009;25:1195–202.10.1590/S0102-311X2009000600002Search in Google Scholar PubMed
28. Stabelini Neto A, Bozza R, Ulbrich A, Mascarenhas LP, Boguszewski MC, et al. Metabolic syndrome in adolescents of different nutritional status. Arq Bras Endocrinol Metab 2012;56:104–9.10.1590/S0004-27302012000200003Search in Google Scholar PubMed
29. Gnacińska M, Małgorzewicz S, Stojek M, Łysiak-Szydłowska W, Sworczak K. Role of adipokines in complications related to obesity: a review. Adv Med Sci 2009;54:150–7.10.2478/v10039-009-0035-2Search in Google Scholar PubMed
30. Díaz-Martínez X, Petermann F, Leiva AM, Garrido-Méndez A, Salas-Bravo C, et al. Association of physical inactivity with obesity, diabetes, hypertension and metabolic syndrome in the Chilean population. Rev Med Chil 2018;146:585–95.10.4067/s0034-98872018000500585Search in Google Scholar PubMed
31. Amirfaiz S, Shahril MR. Objectively measured physical activity, sedentary behavior, and metabolic syndrome in adults: systematic review of observational evidence. Metab Syndr Relat Disord 2019;17:1–21.10.1089/met.2018.0032Search in Google Scholar PubMed
32. Fernandes RA, Christofaro DG, Casonatto J, Codogno JS,Rodrigues EQ, et al. Prevalence of dyslipidemia in individuals physically active during childhood, adolescence and adult age. Arq Bras Cardiol 2011;97:317–23.10.1590/S0066-782X2011005000083Search in Google Scholar PubMed
33. Zaros PR, Pires CE, Bacci Jr M, Moraes C, Zanesco U. Effect of 6-months of physical exercise on the nitrate/nitrite levels in hypertensive postmenopausal women. BMC Women Health 2009;9:17.10.1186/1472-6874-9-17Search in Google Scholar PubMed PubMed Central
©2020 Walter de Gruyter GmbH, Berlin/Boston
