Elsevier

The Journal of Pediatrics

Volume 152, Issue 2, February 2008, Pages 165-170.e2
The Journal of Pediatrics

Original article
Metabolic Syndrome Rates in United States Adolescents, from the National Health and Nutrition Examination Survey, 1999–2002

https://doi.org/10.1016/j.jpeds.2007.06.004Get rights and content

Objective

To report the prevalence rates of the metabolic syndrome in a nationally representative sample of adolescents in the United States using 4 previously reported definitions of the syndrome.

Study design

Data from 12- to 19-year-old adolescents included in the National Health and Nutrition Examination Survey from 1999 to 2002 (NHANES 99-02) were analyzed by cross-sectional methods, by using 4 definitions of the metabolic syndrome previously applied to adolescents.

Results

In NHANES 99-02, the prevalence of the metabolic syndrome in all teens varied from 2.0% to 9.4% of teens in the United States, depending on the definition used. In obese teens, these prevalence rates varied from 12.4% to 44.2%. In the group of obese teens, application of the definition by Cruz produced a metabolic syndrome prevalence rate of 12.4%; that of Caprio produced a rate of 14.1%. However, none of the normal weight or overweight teens met either definition. Application of the definition by Cook produced a prevalence rate of 7.8% in overweight teens and 44% in obese teens. The adult definition of metabolic syndrome produced a prevalence rate of 16% in overweight teens and 26% in obese teens.

Conclusions

In the period between 1999 and 2002, the prevalence rate of metabolic syndrome varied from just >9% to as low as 2% of adolescents overall. Different definitions of metabolic syndrome generated prevalence rates in obese adolescents that varied widely from 12% to 44%. For this syndrome to be a useful construct, a more standardized set of criteria may be needed.

Section snippets

Methods

The study samples were derived from the most recent NHANES, 1999 to 2002. This was the only sample available that had released all data needed for the inclusion, exclusion criteria, and the outcome variables. These surveys, through a multistage stratified design, collect nationally representative samples of the non-institutionalized civilian US population. Trained interviewers, with the aid of a computer-assisted personal interview system, conducted home interviews. Participants then attended

Results

Table II shows the prevalence of each component of the metabolic syndrome when each definition was applied. The first column shows the overall percentage of adolescents who meet each criterion cutoff point as defined in Table I. The columns of data to the right show the percentage of teens who met each criterion when stratified by sex, racial group, and weight status. In general, rates were highest when the definition by Cook/Ford was applied, followed by the adult criteria. The criteria used

Discussion

The “metabolic syndrome” is a term used to describe the clustering of cardiovascular risk factors in children and adolescents, particularly those who are overweight or obese. This clustering of risk factors was described in children long before the term “metabolic syndrome” emerged.21, 22, 23, 24 With cross-sectional studies, a number of cardiovascular risk factors have been revealed to cluster at a higher rate than would be expected by chance, including measures of blood pressure, lipid

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