Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
J Pediatr (Rio J). 2010 Jul-Aug;86(4):325-30. doi: 10.2223/JPED.2006.
To propose a new criterion for the diagnosis of metabolic syndrome (MS) in adolescents and to check its consistency with those proposed by Jolliffe and Janssen and by the International Diabetes Federation (IDF).
This is a cross-sectional study of 80 obese adolescents aged 14 to 19 years. Anthropometric (weight, height, and waist circumference) and laboratory (fasting triglycerides, HDLc, glucose, and insulin) parameters, as well as blood pressure were evaluated. The HOMA-IR index was used to characterize insulin resistance, and the presence of steatosis was assessed by hepatic ultrasound. Agreement analyses across the three criteria were made using the kappa coefficient.
The prevalence of MS was 13.5, 15, and 25% for IDF and Jolliffe and Janssen's criteria and the proposed method, respectively. A nearly perfect agreement between Jolliffe and Janssen's and IDF (kappa = 0.94) criteria and a moderate agreement between the new criteria and the previous two (kappa = 0.46 and 0.41, respectively) were observed.
The highest prevalence of MS was observed with the criterion proposed in this study, which included steatosis and insulin resistance as parameters, thus being able to diagnose a larger number of adolescents at metabolic risk.
提出一种新的青少年代谢综合征（MS）诊断标准，并检验其与 Jolliffe 和 Janssen 以及国际糖尿病联合会（IDF）提出的标准的一致性。
这是一项横断面研究，纳入了 80 名年龄在 14 至 19 岁的肥胖青少年。评估了人体测量学（体重、身高和腰围）和实验室（空腹甘油三酯、HDLc、血糖和胰岛素）参数以及血压。HOMA-IR 指数用于评估胰岛素抵抗，肝超声用于评估脂肪变性。使用 Kappa 系数对三种标准之间的一致性进行分析。
按照 IDF、Jolliffe 和 Janssen 的标准和本研究提出的方法，MS 的患病率分别为 13.5%、15%和 25%。Jolliffe 和 Janssen 的标准与 IDF（Kappa = 0.94）标准之间存在近乎完美的一致性，新提出的标准与前两者之间存在中度一致性（Kappa 值分别为 0.46 和 0.41）。
本研究提出的标准观察到 MS 的患病率最高，该标准将脂肪变性和胰岛素抵抗作为参数纳入其中，从而能够诊断出更多处于代谢风险中的青少年。
