The stability of metabolic syndrome in children and adolescents

Abstract

Context: Some studies suggest the presence of metabolic syndrome before adulthoodmayidentify those at high risk for later cardiovascular morbidity, but there arefewdata examining the reliability of pediatric metabolic syndrome. Objective: To examine the short- and long-term stability of pediatric metabolic syndrome. Design: Metabolic syndrome was defined as having at least three of the following: waist circumference, blood pressure, and fasting serum triglycerides in the 90th or higher percentile for age/sex; high-density lipoprotein- cholesterol 10th or lower percentile for age/sex; and fasting serum glucose of at least 100 mg/dl. Short-term metabolic syndrome stability (repeated measurements within 60 d) was assessedinobeseyouthages6-17yr.Long- termmetabolicsyndromestability(repeatedmeasurements more than 1.5 yr apart) was studied in 146 obese and nonobese children age 6-12 yr at baseline. Patients and Setting: Convenience samples of obese and nonobese youth ages 6-17 yr participating in research studies were collected at a clinical research hospital. Results: Short-term metabolic syndrome stability (repeat measurements performed 19.7 ± 13.1 d apart) was assessed in 220 children. The diagnosis of metabolic syndrome was unstable in 31.6% of cases. At their short-term follow-up visit, incidence of metabolic syndrome among participants whodid not have metabolic syndrome at baselinewas24%.In the long term (repeat measurements performed 5.6±1.9 yr apart), the diagnosis of metabolic syndrome was unstable in 45.5% of cases. Conclusions: Cutoff-point-based definitions for pediatric metabolic syndrome have substantial instability in the short and long term. The value of making a cutoff-point-based diagnosis of metabolic syndrome during childhood or adolescence remains in question. Copyright © 2009 by The Endocrine Society.