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Metabolic syndrome in young children : definitions and results of the IDEFICS study

(2014) INTERNATIONAL JOURNAL OF OBESITY. 38(suppl. 2). p.S4-S14
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Abstract
OBJECTIVE: To estimate the prevalence of the metabolic syndrome (MetS) using reference standards obtained in European children and to develop a quantitative MetS score and describe its distribution in children. DESIGN AND METHODS: Population-based survey in eight European countries, including 18 745 children 2.0 to 10.9 years, recruited during a second survey. Anthropometry (weight, height and waist circumference), blood pressure and serum-fasting triglycerides, HDL cholesterol, glucose and insulin were measured. We applied three widely accepted definitions of the pediatric MetS and we suggest a new definition, to guide pediatricians in decisions about close monitoring or even intervention (values of at least three of the MetS components exceeding the 90th or 95th percentile, respectively). We used a z-score standardisation to calculate a continuous score combining the MetS components. RESULTS: Among the various definitions of MetS, the highest prevalence (5.5%) was obtained with our new definition requiring close observation (monitoring level). Our more conservative definition, requiring pediatric intervention gives a prevalence of 1.8%. In general, prevalences were higher in girls than in boys. The prevalence of metabolic syndrome is highest among obese children. All definitions classify a small percentage of thin or normal weight children as being affected. The metabolic syndrome score shows a positive trend with age, particularly regarding the upper percentiles of the score. CONCLUSIONS: According to different definitions of pediatric MetS, a non-negligible proportion of mostly prepubertal children are classified as affected. We propose a new definition of MetS that should improve clinical guidance. The continuous score developed may also serve as a useful tool in pediatric obesity research. It has to be noted, however, that the proposed cutoffs are based on a statistical definition that does not yet allow to quantify the risk of subsequent disease.
Keywords
NUTRITION EXAMINATION SURVEY, CARDIOVASCULAR RISK-FACTORS, INSULIN-RESISTANCE SYNDROME, 3RD NATIONAL-HEALTH, BODY-MASS INDEX, OBESE CHILDREN, SYNDROME SCORE, ADOLESCENTS, PREVALENCE, DISEASE

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Chicago
Ahrens, W, LA Moreno, S Mårild, D Molnár, A. Siani, Stefaan De Henauw, J Böhmann, et al. 2014. “Metabolic Syndrome in Young Children : Definitions and Results of the IDEFICS Study.” International Journal of Obesity 38 (suppl. 2): S4–S14.
APA
Ahrens, W., Moreno, L., Mårild, S., Molnár, D., Siani, A., De Henauw, S., Böhmann, J., et al. (2014). Metabolic syndrome in young children : definitions and results of the IDEFICS study. INTERNATIONAL JOURNAL OF OBESITY, 38(suppl. 2), S4–S14.
Vancouver
1.
Ahrens W, Moreno L, Mårild S, Molnár D, Siani A, De Henauw S, et al. Metabolic syndrome in young children : definitions and results of the IDEFICS study. INTERNATIONAL JOURNAL OF OBESITY. 2014;38(suppl. 2):S4–S14.
MLA
Ahrens, W et al. “Metabolic Syndrome in Young Children : Definitions and Results of the IDEFICS Study.” INTERNATIONAL JOURNAL OF OBESITY 38.suppl. 2 (2014): S4–S14. Print.
@article{7030538,
  abstract     = {OBJECTIVE: To estimate the prevalence of the metabolic syndrome (MetS) using reference standards obtained in European children and to develop a quantitative MetS score and describe its distribution in children. 
DESIGN AND METHODS: Population-based survey in eight European countries, including 18 745 children 2.0 to 10.9 years, recruited during a second survey. Anthropometry (weight, height and waist circumference), blood pressure and serum-fasting triglycerides, HDL cholesterol, glucose and insulin were measured. We applied three widely accepted definitions of the pediatric MetS and we suggest a new definition, to guide pediatricians in decisions about close monitoring or even intervention (values of at least three of the MetS components exceeding the 90th or 95th percentile, respectively). We used a z-score standardisation to calculate a continuous score combining the MetS components. 
RESULTS: Among the various definitions of MetS, the highest prevalence (5.5%) was obtained with our new definition requiring close observation (monitoring level). Our more conservative definition, requiring pediatric intervention gives a prevalence of 1.8%. In general, prevalences were higher in girls than in boys. The prevalence of metabolic syndrome is highest among obese children. All definitions classify a small percentage of thin or normal weight children as being affected. The metabolic syndrome score shows a positive trend with age, particularly regarding the upper percentiles of the score. 
CONCLUSIONS: According to different definitions of pediatric MetS, a non-negligible proportion of mostly prepubertal children are classified as affected. We propose a new definition of MetS that should improve clinical guidance. The continuous score developed may also serve as a useful tool in pediatric obesity research. It has to be noted, however, that the proposed cutoffs are based on a statistical definition that does not yet allow to quantify the risk of subsequent disease.},
  author       = {Ahrens, W and Moreno, LA and Mårild, S and Molnár, D and Siani, A. and De Henauw, Stefaan and Böhmann, J and Günther, K and Hadjigeorgiou, C and Iacoviello, L and Lissner, L and Veidebaum, T and Pohlabeln, H and Pigeot, I},
  issn         = {0307-0565},
  journal      = {INTERNATIONAL JOURNAL OF OBESITY},
  keywords     = {NUTRITION EXAMINATION SURVEY,CARDIOVASCULAR RISK-FACTORS,INSULIN-RESISTANCE SYNDROME,3RD NATIONAL-HEALTH,BODY-MASS INDEX,OBESE CHILDREN,SYNDROME SCORE,ADOLESCENTS,PREVALENCE,DISEASE},
  language     = {eng},
  number       = {suppl. 2},
  pages        = {S4--S14},
  title        = {Metabolic syndrome in young children : definitions and results of the IDEFICS study},
  url          = {http://dx.doi.org/10.1038/ijo.2014.130},
  volume       = {38},
  year         = {2014},
}

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