ORIGINAL ARTICLE

Overweight, family history of diabetes and attending schools of lower academic grading are independent predictors for metabolic syndrome in Hong Kong Chinese adolescents

Risa Ozaki¹, Qing Qiao⁶, Gary W K Wong², Michael H M Chan³, Wing-Yee So¹, Peter C Y Tong¹, C S Ho⁴, Gary Tin-Choi Ko⁵, Alice P S Kong¹, Christopher W K Lam⁴, Jaakko Tuomilehto⁶, Juliana C N Chan¹

¹ Departments of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
² Department of Paediatrics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
³ Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
⁴ Departments of Medicine and Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
⁵ Department of Medicine, AH Nethersole Hospital, Tai Po, Hong Kong
⁶ The National Institute of Public Health, Helsinki, Finland

Correspondence to:
Dr G T-C Ko
Department of Medicine, AH Nethersole Hospital, 11, Chuen On Road, Tai Po, Hong Kong;gtc_ko{at}yahoo.com.hk

Background: Overweight and metabolic syndrome (MES) are emerging in both adult and paediatric populations.

Aims: To study the prevalence of and associated risk factors for the MES, using the National Cholesterol Education Program definition, among Hong Kong Chinese adolescents studying in secondary schools.

Methods: This was a cross-sectional, population-based study. A sample of 2115 Chinese adolescents was randomly selected from 14 secondary schools throughout Hong Kong. Data on anthropometric parameters, fasting blood and urine samples were collected in the school setting. Information regarding the adolescent’s family history of diabetes, perinatal history, socioeconomic status and school grading was evaluated.

Results: The prevalence of MES was 2.4% (95% confidence interval (CI) 1.8 to 3.1), with no significant difference between boys (2.9%) and girls (2%). The prevalence of various components of MES was 32.2% (30.2 to 34.2) for hypertension, 10.9% (9.6 to 12.2) for increased triglyceride, 9.0% (7.8 to 10.2) for central adiposity, 2.4% (1.7 to 3) for low high-density lipoprotein cholesterol and 0.3% (0.1 to 0.6) for impaired fasting glucose. On multivariate analysis, overweight (odds ratio 32.2; 95% CI 13.2 to 78.4), positive family history of diabetes (4.3; 1.3 to 14.1) and studying at schools of lower academic grading (5.5; 2.2 to 13.7) were found to be independent risk factors for MES.

Conclusion: A comparable prevalence of MES (2%) is observed in our study group Chinese adolescent girls and in US girls (2.1%), but a lower prevalence in Chinese boys (2.9%) than in US boys (6.1%). In our study, 41.8% harbour at least one component of the syndrome. Both families and schools should be alerted to this growing epidemic.

Abbreviations: ACR, albumin–creatinine ratio; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; MES, metabolic syndrome; NCEP, National Cholesterol Education Program; NHANES, National health and Nutrition Examination Survey

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