Is Metabolic Syndrome Useful for Identifying Youths with Obesity at Risk for NAFLD?
Procolo Di Bonito,
Anna Di Sessa,
Maria Rosaria Licenziati,
Domenico Corica,
Malgorzata Wasniewska,
Giuseppina Rosaria Umano,
Anita Morandi,
Claudio Maffeis,
Maria Felicia Faienza,
Enza Mozzillo,
Valeria Calcaterra,
Francesca Franco,
Giulio Maltoni,
Giuliana Valerio
Affiliations
Procolo Di Bonito
Department of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
Anna Di Sessa
Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
Maria Rosaria Licenziati
Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80122 Napoli, Italy
Domenico Corica
Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
Malgorzata Wasniewska
Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
Giuseppina Rosaria Umano
Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
Anita Morandi
Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
Claudio Maffeis
Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
Maria Felicia Faienza
Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, Italy
Enza Mozzillo
Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, Italy
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDFm) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6–17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIIIm) was performed. The prevalence of MetS-IDFm was 27.8% and 28.9% by MetS-ATPIIIm. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30–5.60) (p = 0.008) for high WC, 1.68 (1.25–2.26)(p = 0.001) for MetS, 1.54 (1.12–2.11)(p = 0.007) for low HDL-Cholesterol, 1.49 (1.04–2.13)(p = 0.032) for high triglycerides and 1.37 (1.03–1.82)(p = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDFm and frequency of NAFLD compared to Mets-ATPIIIm definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD.
