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Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study

International Journal of Obesity volume 30, pages 853–860 (2006)Cite this article

Abstract

Objectives:

To assess the implications of variation in Metabolic Syndrome (MS) definition (biochemical and anthropometric indicators) on MS prevalence estimates in a population of overweight and mildly obese children.

Design:

Cross-sectional study.

Subjects:

Ninety-nine (64 girls) overweight or mildly obese, but otherwise healthy, pre-pubertal 6–9-year olds recruited for a randomized controlled trial of weight management.

Measures:

Height, weight and waist circumference were measured with BMI and waist z-scores calculated. Fasting cholesterol and fractions, glucose and insulin were measured, together with systolic and diastolic blood pressure (BP). Anthropometric and metabolic indicators were classified as normal or elevated using adult- or child-specific cut points with clustering of MS indicators also assessed using two adult and three child-specific definitions.

Results:

A total of 0–4% of subjects were classified with MS when adult definitions were applied. This increased to between 39 and 60% using child-specific definitions, varying according to whether hyperinsulinaemia was central to the MS classification. Systolic BP, triglycerides, total cholesterol, high-density lipoprotein cholesterol and waist z-score increased across insulin quartiles (P<0.05). The use of body mass index and waist circumference in the MS definition classified the same subjects.

Conclusions:

The classification of MS in children depends strongly on the definition chosen, with MS prevalence estimates higher if insulin is part of the definition and child-specific cut points for metabolic indicators are used. Hyperinsulinaemia and MS are common consequences of childhood obesity but they are not commonly part of the assessment or management plan for weight management in children. There is a need for the establishment of normal insulin ranges and consistent definition of MS in childhood and adolescence.

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Acknowledgements

This research was carried out at the Department of Nutrition and Dietetics, Flinders University, Adelaide, Australia and was funded by the Australian Health Management Group Assistance to Health and Medical Research Fund. Rebecca Golley is supported by an Australian National Health and Medical Research Council Postgraduate Research Scholarship (No. 229978). We thank the children and their families for participating in the study including blood sample collection. We thank Ms Sarah Garnett, Institute of Endocrinology, The Children's Hospital at Westmead and Ms Margie Gruca, Lab Manager James Fairfax Institute Paediatric Nutrition, The Children's Hospital at Westmead for calculation of waist circumference z-scores; Division of Laboratory Medicine, Women's and Children's Hospital, Adelaide; and Diagnostic Laboratory, Department of Endocrinology Royal Prince Alfred Hospital (RPAH), Sydney for assistance.

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Authors and Affiliations

  1. Department of Nutrition and Dietetics, Flinders University, Adelaide, SA, Australia

    R K Golley, A M Magarey & L A Daniels

  2. Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW and the University of Sydney Discipline of Medicine, Sydney, Australia

    K S Steinbeck

  3. University of Sydney Discipline of Paediatrics & Child Health, The Children's Hospital at Westmead, Sydney, Australia

    L A Baur

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  1. R K Golley
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Correspondence to R K Golley.

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Golley, R., Magarey, A., Steinbeck, K. et al. Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study. Int J Obes 30, 853–860 (2006). https://doi.org/10.1038/sj.ijo.0803195

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