Di Bonito Procolo, Di Sessa Anna, Licenziati Maria Rosaria, Corica Domenico, Wasniewska Malgorzata, Umano Giuseppina Rosaria, Morandi Anita, Maffeis Claudio, Faienza Maria Felicia, Mozzillo Enza, Calcaterra Valeria, Franco Francesca, Maltoni Giulio, Valerio Giuliana
Department of Internal Medicine, "S. Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy.
Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Napoli, Italy.
Children (Basel). 2023 Jan 28;10(2):233. doi: 10.3390/children10020233.
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDF) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6-17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIII) was performed. The prevalence of MetS-IDF was 27.8% and 28.9% by MetS-ATPIII. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30-5.60) ( = 0.008) for high WC, 1.68 (1.25-2.26)( = 0.001) for MetS, 1.54 (1.12-2.11)( = 0.007) for low HDL-Cholesterol, 1.49 (1.04-2.13)( = 0.032) for high triglycerides and 1.37 (1.03-1.82)( = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDF and frequency of NAFLD compared to Mets-ATPIII definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD.
儿童代谢综合征（MetS）的定义存在争议。最近，国际糖尿病联盟（IDF）提出了一个修改版定义，该定义使用了来自国际人群的高腰围（WC）和血压（BP）参考数据，而脂质和血糖的固定临界值未改变。我们使用这个修改版定义（MetS-IDF）分析了1057名超重/肥胖（OW/OB）的青少年（6至17岁）中MetS的患病率及其与非酒精性脂肪性肝病（NAFLD）的关联。同时与根据成人治疗小组III（MetS-ATPIII）制定的另一个MetS修改版定义进行了比较。根据MetS-IDF，MetS的患病率为27.8%，根据MetS-ATPIII为28.9%。WC升高时，NAFLD的比值（95%置信区间）为2.70（1.30 - 5.60）（P = 0.008）；MetS时为1.68（1.25 - 2.26）（P = 0.001）；高密度脂蛋白胆固醇降低时为1.54（1.12 - 2.）（P = 0.007）；甘油三酯升高时为1.49（1.04 - 2.13）（P = 0.032）；血压升高时为1.37（1.03 - 1.82）（P = 0.033）。与MetS-ATPIII定义相比，MetS-IDF的患病率和NAFLD的发生率没有显著差异。我们的数据表明，无论采用哪种标准，三分之一的OW/OB青少年患有MetS。在识别有NAFLD风险的OW/OB青少年方面，这两种定义都不比其某些组成部分更具优势。
