Skip to main content
Log in

Trends in metabolic syndrome risk factors among adolescents in rural Crete between 1989 and 2011

  • Research paper
  • Published:
Hormones Aims and scope Submit manuscript

Abstract

OBJECTIVE

To investigate all the important factors contributing to the development of metabolic syndrome (MetS) as well as to explore the changes of these factors, over time, by comparing adolescent populations of rural areas of Heraklion, Crete, for the years 2011 and 1989.

DESIGN

This study was carried out within two rural areas of the Heraklion region in Crete, Greece. The 1989 study was conducted in the village of Agia Varvara and the respective 2011 study within the municipality of Minoa Pediados. The study population consisted of 150 high school students (97 girls and 69 boys) in 1989 and 66 (30 girls and 36 boys) elementary (6th grade) and high school students in 2011, aged from 12 to 14 years old. Anthropometric, blood pressure and biochemical information was obtained.

RESULTS

Of the MetS risk factors studied, only obesity incidence was found higher in 2011 compared to 1989 (obese adolescents 1.3% in 1989 versus 21.2% in 2011, p< 0.001). On the other hand, hypertension levels were higher in 1989 compared to 2011 (46.7% versus 6.3%, respectively, p<0.001). In addition, glucose and LDL-C levels were lower in 2011.

CONCLUSIONS

The present study supports the fact that there are significant changes in metabolic risk factors through time in adolescent populations of Crete, mainly due to the rise in obesity levels as well as to the decrease in hypertension, total cholesterol and LDL-cholesterol, as observed from the comparison of the years 1989 and 2011.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cruz ML, Goran MI, 2004 The metabolic syndrome in children and adolescents. Curr Diab Rep 4: 53–62.

    Article  PubMed  Google Scholar 

  2. Reaven GM, 1988 Role of insulin resistance in human disease. Diabetes 37: 1595–1607.

    Article  PubMed  CAS  Google Scholar 

  3. Levitt NS, Lambert EV, 2002 The foetal origins of the metabolic syndrome-a South African perspective. Cardiovasc J S Afr 13: 179–180.

    PubMed  Google Scholar 

  4. International Diabetes Federation, 2007 The IDF consensus definition of the metabolic syndrome in children and adolescents. Citied April 8, 2012. Available from: https://doi.org/www.idf.org/metabolic-syndrome.

  5. Katzmarzyk PT, Pérusse L, Malina RM, Bergeron J, Després JP, Bouchard C, 2001 Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: the Québec Family Study. J Clin Epidemiol 54: 190–195.

    Article  PubMed  CAS  Google Scholar 

  6. Alberga AS, Sigal RJ, Goldfield G, Prud’homme D, Kenny GP, 2012 Overweight and obese teenagers: why is adolescence a critical period? Pediatr Obes 7: 261–273.

    Article  PubMed  CAS  Google Scholar 

  7. Alberti G, Zimmet PZ, Shaw JE, 2005 The metabolic syndrome-a new world-wide definition from the International Diabetes Federation Consensus. Lancet 366: 1059–1062.

    Article  PubMed  Google Scholar 

  8. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH, 2003 Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 157: 8217.

    Article  Google Scholar 

  9. De Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N, 2004 Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 110: 2494–2497.

    Article  PubMed  Google Scholar 

  10. Kim HM, Park J, Kim HS, Kim DH, 2007 Prevalence of the metabolic syndrome in Korean adolescents aged 12–19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Pract 75: 111–114.

    Article  PubMed  Google Scholar 

  11. Papoutsakis C, Yannakoulia M, Ntalla I, Dedoussis GV, 2012 Metabolic syndrome in a Mediterranean pediatric cohort: prevalence using International Diabetes Federation-derived criteria and associations with adiponectin and leptin. Metabolism 61: 140–145.

    Article  PubMed  CAS  Google Scholar 

  12. Silva V, Stanton KR, Grande AJ, 2013 Harmonizing the Diagnosis of Metabolic Syndrome-Focusing on Abdominal Obesity. Metab Syndr Relat Disord 1: 102–108.

    Article  Google Scholar 

  13. Wang Y, Lobstein T, 2006 Worldwide trends in childhood overweight and obesity. Int J Pediatr Obesity 1: 11–25.

    Article  Google Scholar 

  14. Burke V, Beilin LJ, Simmer K, et al, 2005 Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int J Obes 29: 15–23.

    Article  CAS  Google Scholar 

  15. Must A, Jacques PF, Dallai GE, Bajema CJ, Dietz WH, 1992 Long term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 327: 1350–135.

    Article  PubMed  CAS  Google Scholar 

  16. Yannakoulia M, Karayiannis D, Terzidou M, Kokkevi A, Sidossis LS, 2004 Nutrition-related habits of Greek adolescents. Eur J Clin Nutr 58: 580–586.

    Article  PubMed  CAS  Google Scholar 

  17. Laron Z, 2006 Increasing incidence of childhood obesity. Pediatr Endocrinol Rev 1: 443–447.

    Google Scholar 

  18. Karlen J, Lowert Y, Chatziarsenis M, Fälth-Magnusson K, Faresjö T, 2008 Are children from Crete abandoning a Mediterranean diet? Rural Remote Health 8: 1034.

    PubMed  CAS  Google Scholar 

  19. Keys A, Blackburn H, Menotti A, et al, 1970 Coronary heart disease in seven countries. Circulation 41: 1e211.

    Google Scholar 

  20. Manios Y, Magkos F, Christakis G, Kafatos AG, 2005 Twenty-year dynamics in adiposity and blood lipids of Greek children: regional differences in Crete persist. Acta Paediatr 94: 859–865.

    Article  PubMed  Google Scholar 

  21. Mirkopoulou D, Grammatikopoulou MG, Gerothanasi K, Tagka A, Stylianou C, Hassapidou M, 2010 Metabolic indices, energy and macronutrient intake according to weight status in a rural sample of 17-year-old adolescents. Rural Remote Health 10: 1513.

    PubMed  CAS  Google Scholar 

  22. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH, 2000 Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320: 1240.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. U.S. Department of Health and Human Services, 2005 The fourth report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Citied April 8, 2012. Available from: https://doi.org/www.nhlbi.nih.gov/health/prof/heart/hbp/hbp_ped.pdf.

  24. Friedewald, W, Levy, RF, Fredrikson, DS, 1972 Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultaracentrifuge. Clin Chem 18: 499–502.

    PubMed  CAS  Google Scholar 

  25. Trinder P, 1969 Determination of glucose in blood using glucose oxidase with an alternative oxygen acceptor. Ann Clin Biochem 6: 24–27.

    Article  CAS  Google Scholar 

  26. American academy of paediatrics, 1992 National cholesterol education program: report of the expert panel of blood cholesterol levels in children adolescents. Paediatrics 89: 525–584.

    Google Scholar 

  27. Ogden CL, Flegal KM, Carroll MD, Johnson CL, 2002 Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288: 1728–1732.

    Article  PubMed  Google Scholar 

  28. Ogden CU, Carroll MD, Curtin UR, Uamb MM, Flegal KM, 2010 Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA 303: 242–249.

    Article  PubMed  CAS  Google Scholar 

  29. Kotani K, Nishida M, Yamashita S, et al, 1997 Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults? Int J Obes Relat Metab Disord 21: 912–921.

    Article  PubMed  CAS  Google Scholar 

  30. Lobstein TJ, James WP, Cole TJ, 2003 Increasing levels of excess weight among children in England. Int J Obes Relat Metab Disord 27: 1136–1138.

    Article  PubMed  CAS  Google Scholar 

  31. Moreno LA, Sarria A, Popkin BM, 2002 The nutrition transition in Spain: a European Mediterranean country. Eur J Clin Nutr 56: 992–1003.

    Article  PubMed  CAS  Google Scholar 

  32. Krassas GE, Tzotzas T, Tsametis C, Konstantinidis T, 2001 Prevalence and trends in overweight and obesity among children and adolescents in Thessaloniki, Greece. J Pediatr Endocrinol Metab 14: 1319–1365.

    Article  PubMed  Google Scholar 

  33. Tambalis KD, Panagiotakos DB, Sidossis LS, 2011 Greek children living in rural areas are heavier but fitter compared to their urban counterparts: a comparative, time-series (1997–2008) analysis. J Rural Health 27: 270–227.

    Article  PubMed  Google Scholar 

  34. Smpokos EA, Linardakis M, Papadaki A, Kafatos A, 2011 Secular changes in anthropometric measurements and blood pressure in children of Crete, Greece, during 1992/93 and 2006/07 Preventive Medicine 52: 213–217.

    PubMed  Google Scholar 

  35. Daniels S, 2006 The consequences of childhood overweight and obesity. Future Child 16: 47–67.

    Article  PubMed  Google Scholar 

  36. Lee JM, Okumura MJ, Davis MM, Herman WH, Gurney JG, 2006 Prevalence and determinants of insulin resistance among U.S. adolescents. A population-based study. Diabetes Care 29: 2427–2432.

    Article  PubMed  Google Scholar 

  37. World Health Organization. World Health Statistics, 2011 Citied April 8, 2012. Availablefrom: https://doi.org/www.who.int/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf.

  38. Nguyen QM, Srinivasan SR, Xu JH, Chen W, Kieltyka L, Berenson GS, 2010 Utility of childhood glucose homeostasis variables in predicting adult diabetes and related cardiometabolic risk factors: The Bogalusa Heart Study. Diabetes Care 33: 670–675.

    Article  PubMed  Google Scholar 

  39. Toschke AM, Montgomery SM, Pfeiffer U, Von Kries R, 2003 Early Intrauterine Exposure to Tobacco-inhaled Products and Obesity. Am J Epidemiol 158: 1068–1074.

    Article  PubMed  CAS  Google Scholar 

  40. Toschke AM, Beyerlein A, Von Kries R, 2005 Children at high risk for overweight: A classification and regression trees analysis approach. Obes Res 13: 1270–1274.

    Article  PubMed  Google Scholar 

  41. Freedman DS, Goodman A, Contreras OA, DasMahapatra P, Srinivasan SR, Berenson GS, 2012 Secular trends in BMI and blood pressure among children and adolescents: the Bogalusa Heart Study. Pediatrics 130: e159–66.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Khang Y-H, Lynch JW, 2011 Exploring determinants of secular decreases in childhood blood pressure and hypertension. Circulation 124: 397–405.

    Article  PubMed  Google Scholar 

  43. Martinez Vizcaino V, Salcedo Aguilar F, Franquelo Gutiérrez R, et al, 2006 Prevalence of obesity and trends in cardiovascular risk factors among Spanish school children, 1992–2004: the Cuenca (Spain) study. Med Clin (Barc) 126: 681–685.

    Article  Google Scholar 

  44. Okosun IS, Seale JP, Boltri JM, Davis-Smith M, 2012 Trends and clustering of cardiometabolic risk factors in American adolescents from 1999 to 2008. J Adolesc Health 50: 132–139.

    Article  PubMed  Google Scholar 

  45. Genovesi S, Giussani M, Pieruzzi F, Vigorita F, Arcovio C, Cavuto S, 2005 Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight. J Hypertens 23: 493–497.

    Article  PubMed  CAS  Google Scholar 

  46. Gundogdu, Z, 2008 Relationship between BMI and blood pressure in girls and boys. Public Health Nutrit 11: 1085–1088.

    Google Scholar 

  47. Armstrong N, Simmons-Morton B, 1994 Physical activity and blood lipids in adolescents. Pediatr Exerc Sci 6: 381–405.

    Article  Google Scholar 

  48. He FJ, MacGregor GA, 2009 A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 23: 363–384.

    Article  PubMed  CAS  Google Scholar 

  49. Chiolero A, Bovet P, Paradis G, Paccaud F, 2007 Has blood pressure increased in children in response to the obesity epidemic? Pediatrics 119: 544–553.

    Article  PubMed  Google Scholar 

  50. US Department of Health and Human Services. Dietary Guidelines for Americans, 2005. Citied April 8, 2012. Available from: https://doi.org/www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf

  51. Chapman MJ, Ginsberg HN, Amarenco P, et al, 2011 Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 32: 1345–1361.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  52. Di Angelantonio E, Sarwar N, Perry P, et al, 2009 Major lipids, apolipoproteins, and risk of vascular disease. JAMA 302: 1993–2000.

    Article  PubMed  Google Scholar 

  53. Addo J, Smeeth L, Leon AD, 2007 Hypertension In Sub-Saharan Africa A Systematic Review. Hypertension 50: 1012–1018.

    Article  PubMed  CAS  Google Scholar 

  54. Gustafsson PE, Persson M, Hammarström A, 2011 Life course origins of the metabolic syndrome in middle-aged women and men: the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood. Ann Epidemiol 21: 103–110.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Charis Girvalaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Girvalaki, C., Vardavas, C., Papandreou, C. et al. Trends in metabolic syndrome risk factors among adolescents in rural Crete between 1989 and 2011. Hormones 13, 259–267 (2014). https://doi.org/10.1007/BF03401340

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03401340

Key words

Navigation