Reina Samantha A, Llabre Maria M, Vidot Denise C, Isasi Carmen R, Perreira Krista, Carnethon Mercedes, Parrinello Christina M, Gallo Linda C, Ayala Guadalupe X, Delamater Alan
1 Department of Psychology, University of Miami , Coral Gables, Florida.
2 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.
Metab Syndr Relat Disord. 2017 Oct;15(8):400-406. doi: 10.1089/met.2017.0054. Epub 2017 Aug 22.
Metabolic syndrome (MetS), a cluster of cardiovascular risk factors, is being diagnosed in youth. Specific diagnostic criteria used to define MetS influence prevalence estimates and populations considered at risk for cardiovascular disease. The National Cholesterol Education Program's Adult Treatment Panel III (ATP), the World Health Organization (WHO), and the International Diabetes Federation (IDF) provide three MetS definitions used in medical research. This study examined concordance among these definitions in 1137 children 10-16 years of age, who participated in the Hispanic Community Children's Health Study/Study of Latino Youth.
Prevalence of MetS and of individual components was estimated using SAS. Mplus was used to test a single-factor model of MetS components (triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, waist circumference, and fasting glucose).
The ATP definition identified most MetS cases in 10-15 (N = 19, 4.7%) and 16-year-old girls (N = 3, 7.3%). The IDF definition identified most cases of MetS in 10-15 (N = 16, 3.1%) and 16-year-old boys (N = 2, 2.8%). Fewest cases of MetS were identified with the WHO definition across age and sex groups.
Only one participant was classified as having MetS across all three definitions. Confirmatory factor analysis indicated fasting glucose and systolic blood pressure did not reliably cluster with other risk factors that define MetS in Hispanic/Latino adolescents. We conclude that prevalence estimates of MetS in youth are unstable across current criteria, calling into question the accuracy of defining and diagnosing MetS in youth.
代谢综合征(MetS)是一组心血管危险因素,目前在青少年中也有诊断。用于定义MetS的特定诊断标准会影响患病率估计以及被视为有心血管疾病风险的人群。美国国家胆固醇教育计划成人治疗小组第三次报告(ATP)、世界卫生组织(WHO)和国际糖尿病联合会(IDF)提供了医学研究中使用的三种MetS定义。本研究调查了1137名10至16岁儿童(他们参与了西班牙裔社区儿童健康研究/拉丁裔青年研究)中这些定义之间的一致性。
使用SAS估计MetS及其各个组成部分的患病率。使用Mplus测试MetS各组成部分(甘油三酯、高密度脂蛋白胆固醇、收缩压和舒张压、腰围以及空腹血糖)的单因素模型。
ATP定义识别出的10至15岁(N = 19,4.7%)和16岁女孩(N = 3,7.3%)中的MetS病例最多。IDF定义识别出的10至15岁(N = 16,3.1%)和16岁男孩(N = 2,2.8%)中的MetS病例最多。在所有年龄和性别组中,WHO定义识别出的MetS病例最少。
在所有三种定义中,只有一名参与者被归类为患有MetS。验证性因素分析表明,空腹血糖和收缩压与定义西班牙裔/拉丁裔青少年MetS的其他危险因素不能可靠地聚类。我们得出结论,目前的标准下青少年MetS的患病率估计不稳定,这使得青少年MetS定义和诊断的准确性受到质疑。