Restricted accessResearch articleFirst published online 2023-11
Height-Corrected Definition of Metabolic Syndrome Is a Simple and Effective Method for Identifying Insulin Resistance and Low-Grade Inflammation in Adolescents: Metabolic Syndrome in Adolescents
The purpose of this study was to evaluate the feasibility of the height-corrected definition of metabolic syndrome(MetS) in adolescents. A retrospective study was conducted on US adolescents aged 12 to 17 years. Waist-to-height ratio and blood pressure-to-height ratio were substituted for waist circumference and blood pressure when defining MetS in adolescents. The proportions of insulin resistance of adolescents with 1 (30.1%), 2 (50.7%), and ≥3 components (77.8%) of MetS were 2.578 (P < .001), 6.882 (P < .001), and 23.992 (P < .001) times than the proportion of adolescents without the component of MetS (14.2%). The proportions of low-grade inflammation of adolescents with 1 (3.4%), 2 (5.3%), and ≥3 components (14.4%) of MetS were 2.050 (P = .106), 3.699 (P = .005), and 10.664 (P < .001) times than the proportion of adolescents without the component of MetS (1.7%). This study demonstrates that height-corrected definition of MetS is a simple and accurate method for identifying insulin resistance and low-grade inflammation in adolescents.
FriendACraigLTurnerS. The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord. 2013;11(2):71-80.
2.
DeBoerMDFilippSLGurkaMJ. Geographical variation in the prevalence of obesity and metabolic syndrome among US adolescents. Pediatr Obes. 2019;14(4):e12483.
3.
BerensonGSSrinivasanSRBaoWNewmanWPIIITracyREWattigneyWA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338(23):1650-1656.
4.
KoskinenJMagnussenCGSinaikoA, et al. Childhood age and associations between childhood metabolic syndrome and adult risk for metabolic syndrome, type 2 diabetes mellitus and carotid intima media thickness: the International Childhood Cardiovascular Cohort Consortium. J Am Heart Assoc. 2017;6(8):e005632.
5.
BassiNKaragodinIWangS, et al. Lifestyle modification for metabolic syndrome: a systematic review. Am J Med. 2014;127(12):1242.e1-1242.e10.
6.
MaCLuQWangRYinF. Using height-corrected definition of metabolic syndrome in children and adolescents. J Pediatr Endocrinol Metab. 2019;32(5):429-438.
7.
WeiliYHeBYaoH, et al. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity. 2007;15(3):748-752.
8.
MokhaJSSrinivasanSRDasmahapatraP, et al. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: the Bogalusa Heart Study. BMC Pediatr. 2010;10:73.
9.
LuQMaCMYinFZLiuBWLouDHLiuXL. How to simplify the diagnostic criteria of hypertension in adolescents. J Hum Hypertens. 2011;25(3):159-163.
10.
MaCLiuYLuQ, et al. The performance of blood pressure-to-height ratio as a screening measure for identifying children and adolescents with hypertension: a meta-analysis. Blood Press Monit. 2016;21(1):43-48.
11.
MaCMYinFZLiuXLWangRLouDHLuQ. How to simplify the diagnostic criteria of metabolic syndrome in adolescents. Pediatr Neonatol. 2017;58(2):178-184.
12.
FordESLiCCookSChoiHK. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007;115(19):2526-2532.
13.
LiCFordESMokdadAHCookS. Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics. 2006;118(5):e1390-e1398.
14.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2)(suppl 4th Report):555-576.
15.
LoKWongMKhalechelvamPTamW. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev. 2016;17(12):1258-1275.
16.
XiBZhangMZhangTLiSSteffenLM. Simplification of childhood hypertension definition using blood pressure to height ratio among US youths aged 8-17 years, NHANES 1999-2012. Int J Cardiol. 2015;180:210-213.
17.
MatthewsDRHoskerJPRudenskiASNaylorBATreacherDFTurnerRC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-419.
18.
Pina-AgueroMIZaldivar-DelgadoASalas-FernandezAMartinez-BasilaABernabe-GarciaMMaldonado-HernandezJ. Optimal cut-off points of fasting and post-glucose stimulus surrogates of insulin resistance as predictors of metabolic syndrome in adolescents according to several definitions. J Clin Res Pediatr Endocrinol. 2018;10(2):139-146.
19.
Gomez-ArbelaezDCamachoPACohenDDSaavedra-CortesSLopez-LopezCLopez-JaramilloP. Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: the ACFIES study. BMC Pediatr. 2016;16:31.
20.
VukovicRMitrovicKMilenkovicT, et al. Insulin-sensitive obese children display a favorable metabolic profile. Eur J Pediatr. 2013;172(2):201-206.
21.
SebekovaKGureckaRCsongovaMKoborovaIRepiskaGPodrackaL. Lean insulin-resistant young adults display increased cardiometabolic risk: a retrospective cross-sectional study. Diabetes Res Clin Pract. 2022;185:109217.
22.
LundMAVThostrupAHFrithioff-BojsoeC, et al. Low-grade inflammation independently associates with cardiometabolic risk in children with overweight/obesity. Nutr Metab Cardiovasc Dis. 2020;30(9):1544-1553.
23.
ChenFWangWTengY, et al. [Relationship between high-sensitivity C-reactive protein and obesity/metabolic syndrome in children]. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(6):621-625.
24.
SuhettLGHermsdorffHHMRochaNP, et al. Increased C-reactive protein in Brazilian children: association with cardiometabolic risk and metabolic syndrome components (PASE study). Cardiol Res Pract. 2019;2019:3904568.
25.
ThomasNERoweDAMurtaghEMStephensJWWilliamsR. Associations between metabolic syndrome components and markers of inflammation in Welsh school children. Eur J Pediatr. 2018;177(3):409-417.
26.
LandisJRKochGG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-174.
27.
ZhangHZhangTLiS, et al. Long-term impact of childhood adiposity on adult metabolic syndrome is modified by insulin resistance: the Bogalusa Heart Study. Sci Rep. 2015;5:17885.
28.
XueQYangXHuangY, et al. Association between baseline and changes in high-sensitive C-reactive protein and metabolic syndrome: a nationwide cohort study and meta-analysis. Nutr Metab. 2022;19(1):2.
29.
JuonalaMSinghGRDavisonB, et al. Childhood metabolic syndrome, inflammation and carotid intima-media thickness. The Aboriginal Birth Cohort Study. Int J Cardiol. 2016;203:32-36.
30.
VinciguerraFTumminiaABarattaR, et al. Prevalence and clinical characteristics of children and adolescents with metabolically healthy obesity: role of insulin sensitivity. Life. 2020;10(8):127.
31.
ReisingerCNkeh-ChungagBNFredriksenPMGoswamiN. The prevalence of pediatric metabolic syndrome-a critical look on the discrepancies between definitions and its clinical importance. Int J Obes. 2021;45(1):12-24.
32.
FordESLiC. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up?J Pediatr. 2008;152(2):160-164.
