Golley R K, Magarey A M, Steinbeck K S, Baur L A, Daniels L A
Department of Nutrition and Dietetics, Flinders University, Adelaide, SA, Australia.
Int J Obes (Lond). 2006 May;30(5):853-60. doi: 10.1038/sj.ijo.0803195.
To assess the implications of variation in Metabolic Syndrome (MS) definition (biochemical and anthropometric indicators) on MS prevalence estimates in a population of overweight and mildly obese children.
Cross-sectional study.
Ninety-nine (64 girls) overweight or mildly obese, but otherwise healthy, pre-pubertal 6-9-year olds recruited for a randomized controlled trial of weight management.
Height, weight and waist circumference were measured with BMI and waist z-scores calculated. Fasting cholesterol and fractions, glucose and insulin were measured, together with systolic and diastolic blood pressure (BP). Anthropometric and metabolic indicators were classified as normal or elevated using adult- or child-specific cut points with clustering of MS indicators also assessed using two adult and three child-specific definitions.
A total of 0-4% of subjects were classified with MS when adult definitions were applied. This increased to between 39 and 60% using child-specific definitions, varying according to whether hyperinsulinaemia was central to the MS classification. Systolic BP, triglycerides, total cholesterol, high-density lipoprotein cholesterol and waist z-score increased across insulin quartiles (P<0.05). The use of body mass index and waist circumference in the MS definition classified the same subjects.
The classification of MS in children depends strongly on the definition chosen, with MS prevalence estimates higher if insulin is part of the definition and child-specific cut points for metabolic indicators are used. Hyperinsulinaemia and MS are common consequences of childhood obesity but they are not commonly part of the assessment or management plan for weight management in children. There is a need for the establishment of normal insulin ranges and consistent definition of MS in childhood and adolescence.
评估代谢综合征（MS）定义（生化指标和人体测量指标）的差异对超重和轻度肥胖儿童人群中MS患病率估计值的影响。
横断面研究。
99名（64名女孩）超重或轻度肥胖但健康的青春期前6至9岁儿童，他们被招募参加一项体重管理随机对照试验。
测量身高、体重和腰围，计算BMI和腰围z评分。测量空腹胆固醇及其组分、血糖和胰岛素，同时测量收缩压和舒张压（BP）。使用成人或儿童特定切点将人体测量和代谢指标分类为正常或升高，还使用两种成人和三种儿童特定定义评估MS指标的聚类情况。
应用成人定义时，共有0 - 4%的受试者被归类为患有MS。使用儿童特定定义时，这一比例增至39%至60%之间，具体取决于高胰岛素血症是否为MS分类的核心。收缩压、甘油三酯、总胆固醇、高密度脂蛋白胆固醇和腰围z评分在胰岛素四分位数间升高（P<0.05）。在MS定义中使用体重指数和腰围对相同受试者进行了分类。
儿童MS的分类在很大程度上取决于所选择的定义，如果胰岛素是定义的一部分且使用代谢指标的儿童特定切点，则MS患病率估计值会更高。高胰岛素血症和MS是儿童肥胖的常见后果，但它们通常不是儿童体重管理评估或管理计划的一部分。需要建立儿童和青少年正常胰岛素范围以及MS的一致定义。
