Metabolic syndrome in obese Thai children and adolescents.

BACKGROUND

The prevalence of childhood obesity in Thailand is increasing. Obese children are at risk of metabolic syndrome.

OBJECTIVE

To determine the prevalence of metabolic syndrome in obese Thai children with various degrees of obesity and its association with severity of obesity, insulin resistance and C-reactive protein.

MATERIAL AND METHOD

A cross-sectional study of 89 obese Thai children and adolescents was conducted at the Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University. Family histories of diabetes mellitus, hypertension, obesity and dyslipidemia were assessed. Anthropometry and cardiovascular risks including levels of fasting blood sugar, oral glucose tolerance test, insulin, C-reactive protein (CRP) and lipid profile were determined. Metabolic syndrome was defined using International Diabetes Federation criteria adjusted for age and sex. Univariate and logistic regression analysis were used for identification of the independent associated factors.

RESULTS

The overall prevalence of metabolic syndrome in the present study was 16.9%. The percentages of metabolic syndrome in subjects with moderate, severe and morbid obesity were 10.5, 23.1 and 22.2 respectively. Univariate analysis revealed that metabolic syndrome had a statistically significant association with insulin level over 25 microIU/mL, homeostasis model for assessment of insulin resistance (HOMA-IR) equal to 3.16 or more and CRP over 3 mg/L. Logistic regression analysis revealed that only insulin level over 25 microIU/mL was independently associated with metabolic syndrome (OR 7.24; 95% CI: 2.01-26.10).

CONCLUSION

The prevalence of metabolic syndrome is high among obese Thai children and adolescents. Prevention and proper management of metabolic syndrome including treatment of obesity should be considered in obese children.