تعیین شیوع سندرم متابولیک بین کودکان9-3 ساله در مطالعه قند و لیپید تهران

Background: The metabolic syndrome is a constellation of risk factors that increase the incidence of cardiovascular disease and type 2 diabetes mellitus in adults. Some studies in recent years have found evidence of initiation of this disease in childhood and of the association of childhood obesity with adult cardiovascular disease and diabetes. The present study was carried out to determine the prevalence of risk factors for metabolic syndrome in children, in order to prevent, or at-least decrease the occurrence of fatal cardiovascular and diabetic complications. Materials and methods: In a cross-sectional study within the framework of the Tehran Lipid and Glucose Study (TLGS), 1067 children, 3-9 years of age, including 506 boys and 561 girls were investigated. Weight and height was measured and BMI calculated. Fasting blood samples for the measurements of glucose and lipid concentrations were drawn. A qualified physician measured blood pressure three times in a seated position using a standard mercury sphygmomanometer and the mean of three measurements was considered as the participant’s blood pressure. After gathering the results of basic measurements, all results, except blood pressure were matched with Iranian tables of percentiles of BMI and lipids for age and sex. For blood pressure we used the world wide accepted NCHS tables. ‘At risk of overweight’ was defined as ≥85th to <95th percentile of BMI for age and sex. Subjects with three or more characteristics of the following components of metabolic syndrome were categorized as having the syndrome (1) BMI≥95th percentile for age and sex (2) TG≥95th percentile for age and sex (3) HDL cholesterol 95th percentile for age, sex, and height. Results: Prevalence of metabolic syndrome was 0.9 percent, (95%CI:0.3-1.5) overall, 8.9 percent in overweight youngsters, 0.3 percent in at risk of overweight and only 0.1 percent in the normal weight group. Prevalence increased with increases of body-weight with a significant difference between overweight children and other BMI groups. Overall, 12 percent of children were at risk of overweight, 8.4 percent were overweight, with no significant difference between two sex groups. Most prevalent components of metabolic syndrome in overweight children were hypertension and high TGL, (14.4%) low HDL and impaired fasting glucose were next in order of frequency. In comparison with subjects with normal weights, the difference in hypertension was significant in overweight children, (P<0.01).TGL was significantly different from normal weight group (P<0.01) and also with at risk of overweight (P<0.05). Conclusion: This study showed a low prevalence of metabolic syndrome among Iranian children but the prevalence of this syndrome in overweight youngsters was significantly higher than other BMI groups. The prevalence of at risk of overweight of 12 percent on one hand, and the high rate of transition of overweight children into obese adults in subsequent years of life on the other hand, is alarming. Special attention to weight control through nutritional counseling and increased physical activity during childhood and adolescence is recommended.