Diagnostic criteria patterns of U.S. children with Metabolic Syndrome: NHANES 1999-2002

BACKGROUND: As childhood obesity increases in the U.S., the Metabolic Syndrome (MS) can be assumed to be increasing in the pediatric population as well. To date, there is lack of information on the most prevalent risk factors of MS in children and the patterns of risk factors present in children met the criteria for MS.

METHODS: Anthropometric and medical data of children 2-18 years old of a nationally representative data set (NHANES 1999-2002) were obtained and the diagnostic criteria of Cook et al. employed to determine MS prevalence. Three samples were examined: a) Children 2-18 years old with non-missing data on at least three of the five diagnostic criteria but missing blood glucose data (n = 5,172), b) a subsample of 12-18 year olds also providing fasting glucose data but who were not overweight or obese using the International Obesity Task Force (IOTF) standards (n = 1,064), and c) 12-18 year olds with blood glucose data who were overweight or obese (n = 641).

RESULTS: Disease prevalence estimates were 2%, 0.7%, and 23% in the three populations. More than 10% of the children providing fasting blood levels had hyperglycemia. 2% of the overweight or obese 12-18 year olds with fasting blood glucose data met all five diagnostic criteria for MS. In all groups, elevated total triglycerides but low high density lipoprotein (HDL) level affected a large proportion of the population.

CONCLUSION: Results indicate a reason for concern, since the prevalence of MS risk factors in children was high. Dyslipidemia (concurrent high total triglyceride levels and low HDL levels) were prevalent in large portions of the population, even in the non-overweight. Thus, chronic disease prevention efforts in the pediatric population should not only encourage healthy body weight but also include dietary recommendations to consume diets moderately low in fat with emphasis on polyunsaturated and monounsaturated fats within recommended ratios of omega-6 and omega-3 fatty acids.