Endocrine Abstracts (2011) 26 P321

Prevalence of metabolic syndrome in 850 obese children from infancy to adolescence

S Bellone1, F Prodam1,2, R Ricotti1, A Petri1, V Agarla1, C Guidi1, G Genoni1 & G Bona1

1Division of Pediatrics, Department of Medical Sciences, University of Piemonte Orientale, Novara, Italy; 2Endocrinology, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Novara, Italy.

Introduction: Obesity and connected metabolic alterations are a growing problem in paediatric age, but few data are available in the youngest population. Poor evidences on metabolic syndrome (MS) definition are present in childhood and the most used definitions are those of the modified National Cholesterol Education Program and of the International Diabetes Federation (IDF). Aim of our study was to evaluate the presence of MS in obese children using these two definitions and the usefulness of clinical parameters.

Subjects and methods: We performed clinical and metabolic blood evaluations in 850 overweight and obese children ranging from 1.9 to 18.1 years of both sexes.

Results: Following NCEP criteria, some children showed glucose alterations: 4.9% showed IFG, 7.6% IGT and 0.9% type 2 diabetes mellitus. 49.6% showed low levels of HDL-cholesterol, 28.1% high levels of triglycerides; 81.7% high blood pressure and 16.1% acanthosis. Waist circumference (WC) was high in 96.7%. Waist/height ratio (W/Hr) was higher the cut-off of 0.5 in about all population.

Prevalence of metabolic syndrome was 36.9% following NCEP ATP III and 55.1% following IDF definition. 28.0% of subjects demonstrated MS using both definitions. Percentage of disagreement between definitions (59.1% in the group under age of 10 years, 9.1 over 16 years) is lower increasing age of population and presence of metabolic complications.

Conclusions: In this large population of obese children WC was high in about all population demonstrating the presence of visceral obesity. W/Hr could be a simple and useful parameter to identify children at risk of metabolic syndrome. They showed in early ages high percentage of metabolic alterations like hypertension, dislipidemia, disglycemia. IDF criteria could overestimate the presence of syndrome, above all in prepubertal children under 10 years of age. These data suggest that metabolic surveillance is needed in children with visceral obesity already in early age.

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