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Prevalence of Metabolic Syndrome in Obese Children

Korean Journal of Pediatrics 2004;47(11):1149-1156.
Published online November 15, 2004.
Prevalence of Metabolic Syndrome in Obese Children
Jin Ha Chang1, Duk Hee Kim1, Ho-Seong Kim1, In Kyoung Choi1, My Young Cheong2, Dong Kee Kim2
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
소아 비만증에서 대사 증후군의 유병률
장진하1, 김덕희1, 김호성1, 최인경1, 정미영2, 김동기2
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 의학통계학과
Correspondence: 
Duk Hee Kim, Email: dhkim3@yumc.yonsei.ac.kr
Abstract
Purpose
: Obesity has been known to be a cause of insulin resistance and dyslipidemia, and along with coronary artery disease and diabetes, is associated with metabolic syndrome(MS). This study aimed to ascertain the cause and prevalence of MS in obese children and adolescents.
Methods
: Two hundred and seventy-seven school children, who showed more than a 95th percentile of body mass index(BMI) for age and sex, underwent oral glucose tolerance tests; fasting plasma lipid profiles, leptin, and CRP were measured; and ultrasonography was done.
Results
: Out of 277 obese children, the prevalence of MS was 37.5%, with 38.7% occurring in males and 35.2% in females. The prevalence was 20.8% in primary school children and 50.3% in middle school children. MS was present in 25.2% of mildly obese children, 43.9% of moderate and 71.4% of highly obese children, showing increased occurrence among the severer degrees of obese groups. Increased prevalence was observed in males with high blood pressure, and females with high triglyceride levels. The ratio of children satisfying more than one, more than two, more than three, more than four and all of the five criteria for diagnosis of MS were 90.6%, 63.5%, 37.5%, 8.3%, and 0.4%, respectively. Aside from diagnostic criteria for MS, a statistically significant difference was present between obese patients with or without the syndrome in such items as weight, BMI, degree of obesity, visceral fat thickness, ratio of body fat, leptin, and adiponectin, fasting and 2 hour postprandial insulin concentration.
Conclusion
: The prevalence of MS is currently on the rise among children, due to the rapidly increasing rate of obesity, westernized diet, higher calorie intake and reduced exercise. The prevalence of MS in obese children was 37.5% - higher than US results - after implementation of modified pediatric criteria established by ATP III Asia-Pacific standard in 2003. It would therefore be necessary to establish an acceptable universal standard for the diagnosis of MS, and extend the study to the general pediatric population in order to acquire more accurate data on the prevalence of the disease.
Key Words: Metabolic syndrome, Obesity, Children, Adolescent, Insulin resistance


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