Objective: To assess the risk of metabolic syndrome (MS) in children and adolescents as per the recommendation based on the age and sex-specific reference curves for Waist Circumference (WC) for Indian children by Khadilkar et al.
Study Design: A total of 370 children (200 girls, 170 boys) aged 6 to 18years coming for regular checkups to our center from January 2016 to March 2019 with WC >70th percentile were enrolled. All children were assessed for metabolic syndrome risk factors with respect to BMI, BP measurements, and levels of fasting triglycerides, high- density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL), and fasting plasma glucose were recorded for all patients.
Prevalence rates of MS in the pediatric age group vary depending on the criteria used. The International Diabetes Federation's (IDF) definition of MS in children has been divided according to the following age groups (6-10 years, 10-16 years, and 16+ years). For those aged 6 to <10yr, though MS cannot be diagnosed but further measurements were made in children with a family history of metabolic syndrome (MS), type 2 diabetes mellitus (T2DM), dyslipidemia, cardiovascular disease, hypertension and/or obesity.
Results: As per IDF definition, 64 out of 240 (26.66%) children in the 10 to 18 year age group met the criteria for pediatric metabolic syndrome.
|Age group||10 to <16yr (n=217)||16-18yr (n=23)|
|Percentage meeting the IDF criteria||23.5%||56.52%|
Those aged 6 to <10years with a family history of MS, T2DM, dyslipidemia, cardiovascular disease, hypertension and/or obesity were also evaluated for metabolic syndrome. Eighteen out of 130 children (13.84%) met the criteria for metabolic syndrome as per IDF definition in this age group.
Children were also evaluated for MS as per the modified definition proposed by NCEP/ATPIII. As per this definition, 63 out of 158 (39.8%) children in the age group of 12-18yr met the criteria for pediatric metabolic syndrome.
|Gender||Males (n=78)||Females (n=80)|
|Percentage meeting the NECP criteria||34.61%||45%|
Conclusion: Overall, 39.8% and 26.66% children met the NCEP/ATPIII & IDF criteria respectively. The low incidence of MS with IDF definition may be due to the cut-off value used for blood pressure as systolic BP ≥130 or diastolic BP=85mmHg for all age groups.
The WC percentiles proposed for Indian children are useful in identifying children with metabolic syndrome. Early detection and management is vital in halting the progression of this syndrome pathway in children.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology