Vanlancker Tine, Schaubroeck Emmily, Vyncke Krishna, Cadenas-Sanchez Cristina, Breidenassel Christina, González-Gross Marcela, Gottrand Frederic, Moreno Luis A, Beghin Laurent, Molnár Denes, Manios Yannis, Gunter Marc J, Widhalm Kurt, Leclercq Catherine, Dallongeville Jean, Ascensión Marcos, Kafatos Anthony, Castillo Manuel J, De Henauw Stefaan, Ortega Francisco B, Huybrechts Inge
Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Public Health, Ghent University, Ghent, Belgium.
Eur J Pediatr. 2017 Feb;176(2):241-252. doi: 10.1007/s00431-016-2831-6. Epub 2017 Jan 5.
Various definitions are used to define metabolic syndrome in adolescents. This study aimed to compare, in terms of prevalence and differences, five frequently used definitions for this population: International Diabetes Federation, National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP) modified by Cook, pediatric American Heart Association (AHA), World Health Organization, and Jolliffe and Janssen. A sample of 1004 adolescents (12.5-17.0 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study was considered. The components of the definitions (waist circumference/BMI, plasma lipids, glycemia, and blood pressure) were applied, and definitions were compared by using crosstabs, sensitivity, specificity, and kappa coefficient. The prevalence of metabolic syndrome varied from 1.6 to 3.8% depending on the used definitions. Crosstabs comparing the definitions showed the fewest cases being misclassified (having metabolic syndrome or not) between NCEP-ATP and AHA. Analyses for kappa coefficient, sensitivity, and specificity confirmed this finding.
The different definitions do not classify the same adolescents as having MS and prevalence varied between diagnostic methods. The modified NCEP-ATP and the AHA definitions were most analogous in defining subjects as having metabolic syndrome or not. What is known? • Metabolic syndrome is not only a problem of adulthood but is already present in children and adolescents. • Several diagnostic methods are used to define metabolic syndrome in adolescents. What is new? • Comparing the most frequently used definitions of metabolic syndrome in adolescents showed that they do not indicate the same adolescents as having metabolic syndrome. • The modified National Cholesterol Education Program Adult Treatment Panel III and the pediatric American Heart Association definitions were most analogous in defining subjects as having metabolic syndrome or not.
青少年代谢综合征有多种定义。本研究旨在比较国际糖尿病联盟、经库克修改的美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP-ATP）、美国儿科学会心脏协会（AHA）、世界卫生组织以及乔利菲和扬森这五种针对该人群常用的定义在患病率及差异方面的情况。研究采用了欧洲青少年营养健康生活方式（HELENA）研究中的1004名青少年（12.5 - 17.0岁）样本。应用了各定义的组成部分（腰围/体重指数、血脂、血糖和血压），并通过交叉制表、敏感性、特异性和kappa系数对各定义进行比较。根据所使用的定义，代谢综合征的患病率在1.6%至3.8%之间变化。比较各定义的交叉制表显示，NCEP-ATP和AHA之间将病例误分类（患有或未患有代谢综合征）的情况最少。kappa系数、敏感性和特异性分析证实了这一发现。
不同的定义对患有代谢综合征的青少年分类不同，且诊断方法之间的患病率存在差异。经修改的NCEP-ATP和AHA定义在将受试者定义为患有或未患有代谢综合征方面最为相似。已知信息有哪些？• 代谢综合征不仅是成年人的问题，在儿童和青少年中也已存在。• 有几种诊断方法用于定义青少年代谢综合征。新发现是什么？• 比较青少年代谢综合征最常用的定义表明，它们所指的患有代谢综合征的青少年并不相同。• 经修改的美国国家胆固醇教育计划成人治疗小组第三次报告和美国儿科学会心脏协会的定义在将受试者定义为患有或未患有代谢综合征方面最为相似。
