Comparison of metabolic syndrome prevalence using eight different definitions: A critical approach

¹ Vestische Kinderklinik, University Witten- Herdecke, Germany
² King’s College London, Division of Health and Social Care Research, United Kingdom

^* To whom correspondence should be addressed. E-mail: tireinehr{at}aol.com.

Accepted 8 February 2007

	Abstract

Objective: Multiple definitions of the Metabolic Syndrome (MS) were proposed for children, adolescents, and adults. The aim of this study was to analyse variations of MS prevalence by different definitions and which factors influence the frequency of MS in childhood and adolescence.

Methods and Design: The prevalence of the MS according to eight proposed definitions was studied in 1205 Caucasian overweight children and adolescents aged 4 to 16 years (mean BMI 27.3 kg/m²; mean age 11.8y, 46% males, 39% prepubertal). Blood pressure, waist circumference, and fasting triglycerides, HDL- and total cholesterol, insulin and glucose concentrations were determined. Overweight was defined according to the International Task Force of Obesity in Childhood. Degree of overweight was calculated as standard deviation score of BMI (SDS-BMI). Insulin resistance was estimated based on the HOMA- model.

Results: The prevalence of the MS varied significantly (p<0.001) between 6% and 39% depending on the different definitions. Only 2% of the children fulfilled the criteria of MS in all definitions. Insulin resistance and degree of overweight were associated to MS. In most definitions, pubertal stage did not influence the occurrence of the MS. In a principal component analysis, total cholesterol, triglycerides and waist circumference showed high final communality estimates.

Conclusions: Since the prevalence of the MS varied widely in overweight children and adolescents between the different proposed definitions, an internationally accepted uniform definition of MS is necessary to compare different populations and studies.

Keywords: childhood, definition, degree of overweight, metabolic syndrome, pubertal stage

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