Metabolic syndrome in the obese child

Abstract

Introduction: The increasing prevalence of pediatric obesity has led to the development of different cardiometabolic diseases, so better understanding the behavior of metabolic syndrome (MS) in the pediatric population is essential. Furthermore, the use of a diagnostic score for pediatric MS has been proposed to simplify its diagnosis and avoid the dichotomy of its definition.

Objectives: The objectives of the study were to determine the prevalence of MS in obese pediatric patients, their biochemical characteristics and to evaluate the ability of the pediatric siMS score (PsiMS) to predict MS in obese pediatric patients.

Subjects and Methods: The study was cross-sectional and prospective. 70 subjects (52.9% men) of 10.73 ± 2.9 years of age were studied. An anthropometric evaluation was performed, systolic (SBP) and diastolic (DBP) blood pressure control, biochemical evaluation (insulin, blood glucose, triglycerides, total and fractionated cholesterol, hsCRP, GPT and complete thyroid profile), the PsiMS was calculated with the formula: PsiMS= 2x Waist Circumference/Height+ Blood glucose (mmol/l)/5.6+ Triglycerides (mmol/l)/1.7+ PAS/130– HDLchol(mmol/l)/1.02. Non-parametric statistics were used, the Spearman test was used for the correlation between quantitative variables and the Mann-Whitney U test was used for the comparison of quantitative variables.

Results: The prevalence of metabolic syndrome in obese patients was 52.8% (n = 37), of which 20 were men (54%) and 17 were women (46%). The waist-to-height ratio was 0.68 ± 0.06, SBP 110.7 ± 10 mmHg, Blood glucose 86.6 ± 9.8 mg/dL, Triglycerides 145.4 ± 77.9 mg/dL, HDL Chol 37.8 ± 7.6 mg/dL, Insulin 22.3 ± 12.9 uU/ml and hsCRP 2.19 ± 2.1 mg/dl. The PsiMS score had a sensitivity of 97.3% and specificity of 69.7% for diagnosing MS with an area under the ROC Curve of 0.964. PsiMS was significantly correlated with: insulin, LDL, total cholesterol and hsCRP.

Conclusions: MS is a prevalent pathology in obese children in our region, with an epidemiological and laboratory profile similar to that observed in other regions. The PsiMS score was significantly associated with parameters of insulin resistance, cardiovascular risk and endothelial inflammation, with a good diagnostic capacity for MS in obese children. However, future studies are necessary to establish a cut-off point for PsiMS.