Citation:

Gaston, S., N. Tulve, AND T. Ferguson. A comparison of standard definitions and sagittal abdominal diameter as a measure of excess adiposity when defining metabolic syndrome in adolescents. EPI Lifestyle 2017, Portland, OR, March 07 - 10, 2017.

Impact/Purpose:

To be presented at the EPI Lifestyle 2017

Description:

Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of components varied greatly by definition (e.g., boys’ prevalence of high fasting blood glucose: IDF-27.2% vs. Cook and deFerranti-both 2.7%). MeTS prevalence in boys using standard and SAD-modified definitions were 4.5% and 5.0%; 10.6% and 9.4%; and 4.6% and 3.3% for the Cook, deFerranti, and IDF definitions, respectively. Among girls, the standard-defined and SAD-modified MeTS prevalence were 2.4% and 2.4%; 8.5% and 8.2%; and 4.3% and 2.8% for the Cook, deFerranti, and IDF definitions, respectively. Conclusions: Though the most prevalent MeTS components were similar, the estimated prevalence values of individual components varied greatly across MeTS definitions. With the risk of false positives, the deFerranti definition of MeTS may identify the greatest number of adolescents at potential risk for MeTS. Cook and deFerranti definitions may miss the identification of adolescents who could benefit from additional health promotion programs. Compared to WC, use of SAD resulted in similar yet slightly attenuated estimated MeTS prevalence.

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