A proposed simplified definition of metabolic syndrome in children and adolescents: a global perspective
Xin’nan Zong,
Roya Kelishadi,
Hae Soon Kim,
Peter Schwandt,
Tandi E. Matsha,
Jose G. Mill,
Carmelo Antonio Caserta,
Carla Campos Muniz Medeiros,
Anastasios Kollias,
Peter H. Whincup,
Lucia Pacifico,
Abel López-Bermejo,
Min Zhao,
Miaobing Zheng,
Bo Xi
Affiliations
Xin’nan Zong
Department of Growth and Development, Capital Institute of Pediatrics
Roya Kelishadi
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences
Hae Soon Kim
Department of Pediatrics, Ewha Womans University College of Medicine
Peter Schwandt
Atherosclerosis Prevention Institute
Tandi E. Matsha
Department of Biomedical Sciences, Faculty of Health & Wellness Sciences, Cape Peninsula University of Technology
Jose G. Mill
Department of Physiological Sciences, Center of Health Sciences, Federal University of Espírito Santo
Carmelo Antonio Caserta
Associazione Calabrese Di Epatologia - Medicina Solidale - A.C.E. ETS
Carla Campos Muniz Medeiros
Department of Public Health, State University of Paraiba
Anastasios Kollias
Hypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital
Peter H. Whincup
Population Health Research Institute, St George’s, University of London
Lucia Pacifico
Department of Maternal and Child Health, Sapienza University of Rome
Abel López-Bermejo
Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI)
Min Zhao
Department of Nutrition and Food Hygiene, School of Public Health, Shandong University
Miaobing Zheng
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University
Bo Xi
Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University
Abstract Metabolic syndrome (MetS) is becoming prevalent in the pediatric population. The existing pediatric MetS definitions (e.g., the International Diabetes Federation (IDF) definition and the modified National Cholesterol Education Program (NCEP) definition) involve complex cut-offs, precluding fast risk assessment in clinical practice. We proposed a simplified definition for assessing MetS risk in youths aged 6–17 years, and compared its performance with two existing widely used pediatric definitions (the IDF definition, and the NCEP definition) in 10 pediatric populations from 9 countries globally (n = 19,426) using the receiver operating characteristic (ROC) curve analyses. In general, the total MetS prevalence of 6.2% based on the simplified definition was roughly halfway between that of 4.2% and 7.7% estimated from the IDF and NCEP definitions, respectively. The ROC curve analyses showed a good agreement between the simplified definition and two existing definitions: the total area under the curve (95% confidence interval) of the proposed simplified definition for identifying MetS risk achieved 0.91 (0.89–0.92) and 0.79 (0.78–0.81) when using the IDF or NCEP definition as the gold standard, respectively. The proposed simplified definition may be useful for pediatricians to quickly identify MetS risk and cardiometabolic risk factors (CMRFs) clustering in clinical practice, and allow direct comparison of pediatric MetS prevalence across different populations, facilitating consistent pediatric MetS risk monitoring and the development of evidence-based pediatric MetS prevention strategies globally.
