Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Metabolic syndrome in children and adolescents

소아 및 청소년의 대사증후군

  • Hong, Young Mi (Department of Pediatrics, School of Medicine, Ewha Womans University Hospital)
  • 홍영미 (이화대학교 의학전문대학원 소아과학교실)
  • Received : 2009.06.05
  • Accepted : 2009.07.06
  • Published : 2009.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Metabolic syndrome (MS) in children and adolescents has become a global public health problem. MS among Korean children and adolescents has been increasing significantly over the past decade. This paper aims to provide the currently available information on the MS in children and adolescents. This review focuses on the definition, diagnostic criteria, epidemiology and pathophysiology which may be helpful for the pediatrician in early identification and management of the MS in children and adolescents.

Keywords

References

  1. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007;29: 62-76 https://doi.org/10.1093/epirev/mxm003
  2. Prevalence of metabolic syndrome among 20 years of age and over, by sex, age, race and ethnicity, and body mass index in United States, 2003-2006. National Health Statistic Reports. 2009, May, No 13
  3. Park MJ. Epidemiology of the metabolic syndrome among Korean children and adolescents. Korean J Pediatr 2008;51: 564-8 https://doi.org/10.3345/kjp.2008.51.6.564
  4. Alberti KGMM, Zimmet PZ, Shaw JE. The metabolic syndrome-a new world-wide definition from the International Diabetes Federation Consensus. Lancet 2005;366:1059-62 https://doi.org/10.1016/S0140-6736(05)67402-8
  5. Changes in leading causes of death (2006), Korean National Statistical Office. http://nso.go.kr/
  6. Chronic Disease Information,(2003-2007), Health Insurance Review & Assessment Service. http://hira.or.kr
  7. Reaven GM. Banting lecture 1988: role of insulin resistance in human disease. Diabetes 1988;37:1595-607 https://doi.org/10.2337/diabetes.37.12.1595
  8. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52 https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  9. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003;157:821-7 https://doi.org/10.1001/archpedi.157.8.821
  10. de Ferranti SD, Gauvreau K, Ludwig DS, Newfeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the third National Health and Nutrition Examination Survey. Circulation 2004;110:2494-7 https://doi.org/10.1161/01.CIR.0000145117.40114.C7
  11. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 2004;89:108-13 https://doi.org/10.1210/jc.2003-031188
  12. Ford ES, Ajani UA, Mokdad AH. The metabolic syndrome and concentrations of C-reactive protein among US youth. Diabetes Care 2005;28:878-81 https://doi.org/10.2337/diacare.28.4.878
  13. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet 2007;369:2059-61 https://doi.org/10.1016/S0140-6736(07)60958-1
  14. Brambilla P, Bedogni G, Moreno LA, Goran MI, Gutin B, Fox KR, et al. Cross validation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obs 2006; 30:23-30
  15. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006;148:188-94 https://doi.org/10.1016/j.jpeds.2005.10.001
  16. Matsushita Y, Tomita K, Yokoyama T, Mizoue T. Optimal waist circumference measurement site for assessing the metabolic syndrome. Diabetes Care 2009;32:e70 https://doi.org/10.2337/dc09-0190
  17. Reinehr T, de Souso G, Toschke AM, Andler W. Comparison of metabolic syndome prevalence using eight different definitions: a critical approach. Arch Dis Child 2007;92:1067-72 https://doi.org/10.1136/adc.2006.104588
  18. Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH. Prevalence of metabolic syndrome among U. S. adolescents using the International Diabetes Federation. Diabetes Care 2008;31: 587-9 https://doi.org/10.2337/dc07-1030
  19. Lambert M, Paradis G, O　Loughlin J, Delvin EE, Hanley JA, Levy E. Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int Obes Relat Metab Disord 2004;28:833-41 https://doi.org/10.1038/sj.ijo.0802694
  20. 20)Seo MJ, Song JW, Kang JH. Prevalence of the metabolic syndrome in Korean children and adolescents. Korea National Health and Nutrition Survey 2001. J Korean Acad Fam Med 2006;29:798-806
  21. Kim HM, Park J, Kim HS, Kim DH. Prevalence of the metabolic syndrome in Korean adolescents aged 12-19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Pract 2007;75:1114 https://doi.org/10.1016/j.diabres.2006.04.009
  22. Cho YG, Song HJ, Kang JH. Prevalence of the metabolic syndrome in Korean children and adolescents according to the International Diabetes Federation Definition in Children and Adolescents. Korean J Fam Med 2009;30:261-8 https://doi.org/10.4082/kjfm.2009.30.4.261
  23. Seo SJ, Lee HY, Lee SW. The prevalence of the metabolic syndrome in Korean children and adolescents: Comparisons of the criteria of Cook et al., Curz and Goran, and Ferranti et al. Yonsei Med J 2008;49:563-72 https://doi.org/10.3349/ymj.2008.49.4.563
  24. Goldman E, Daniels SR, Dolan LM. Instability in diagnosis of metabolic syndrome in adolescents. Circulation 2007;2316- 22
  25. Morrison JA, Friedman LA, Gray-McGuire C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinic Follow- up Study. Pediatrics 2007;120:340-5 https://doi.org/10.1542/peds.2006-1699
  26. iranda PH, DeFronzo RA, Robert M. Califf RM, Guyton JR, Tex SA, et al. Metabolic syndrome: Definition, pathophysiology, and mechanisms. Am Heart J 2005;149:33-45 https://doi.org/10.1016/j.ahj.2004.07.013
  27. Steinberger J, Daniels SR, Eckel RH, Hayman L, Robert H. Lustig RH, et al. Progress and challenges in metabolic syndrome in children and adolescents: A scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 2009;119;628-47 https://doi.org/10.1161/CIRCULATIONAHA.108.191394
  28. Bao W, Srinivasan SR, Berenson GS. Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults: the Bogalusa Heart Study. Circulation 1996;93:54-9
  29. Steinberger J, Moorehead C, Katch V, Rocchini AP. Relationship between insulin resistance and abnormal lipid profile in obese adolescents. J Pediatr 1995;126:690-5 https://doi.org/10.1016/S0022-3476(95)70394-2
  30. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Low-grade systemic inflammation in overweight children. Pediatrics 2001;107:e13
  31. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001;358:1400-4 https://doi.org/10.1016/S0140-6736(01)06525-4
  32. Després JP, Prud　homme D, Pouliot MC, Tremblay A, Bouchard C. Estimation of deep abdominal adipose-tissue accumulation from simple anthropometric measurements in men. Am J Clin Nutr 1991;54:471-7
  33. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006;148:188-94 https://doi.org/10.1016/j.jpeds.2005.10.001
  34. 34)Retnakaran R, Hanley AJ, Connelly PW, Harris SB, Zinman B. Elevated C-reactive protein in Native Canadian children: an ominous early complication of childhood obesity. Diabetes Obes Metab 2006;8:483-91 https://doi.org/10.1111/j.1463-1326.2005.00533.x
  35. Pittas AG, Joseph NA, Greenberg AS. Adipocytokines and insulin resistance. J Clin Endoclinol Met 2004;89:447-52 https://doi.org/10.1210/jc.2003-031005
  36. Korner A, Kratzsch J, Gausche R, Schaab M, Erbs S, Kiess W. New predictor of the metabolic syndrome in children-role of adipocytokines. Pediatr Res 2007;61:640-5 https://doi.org/10.1203/01.pdr.0000262638.48304.ef
  37. Ogawa Y, Kikuchi T, Nagasaki K, Hiura M, Tanaka Y, Uchiyama M. Usefulness of serum adiponectin level as a diagnostic marker of metabolic syndrome in obese Japanese children. Hypertens Res 2005;28:51-7 https://doi.org/10.1291/hypres.28.51
  38. Okamoto Y, Kihara S, Funahashi T, Matsuzawa Y, Libby P. Adiponectin: a key adipocytokine in metabolic syndrome. Clinical Science 2006;110:267-78 https://doi.org/10.1042/CS20050182
  39. Marette A. Mediators of cytokine-induced insulin resistance in obesity and other inflammatory settings. Curr Opin Clin Nutr Metab Care 2002;5:377-83 https://doi.org/10.1097/00075197-200207000-00005
  40. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon III RO, Criqui M, et al. Markers of inflammation and cardiovascular disease application to clinical and public health practice. A statement for healthcare professionals from the Centers of Disease Control and Prevention and American Heart Association. Circulation 2003;107:499-511 https://doi.org/10.1161/01.CIR.0000052939.59093.45
  41. Ford ES, Ajani UA, Mokadad AH. The metabolic syndrome and concentration of C-reactive protein among US youth. Diabetes Care 2005;28:878-81 https://doi.org/10.2337/diacare.28.4.878
  42. Galili O, Versari D, Sattler KJ, Olson ML, Mannheim D, McConnell JP, et al. Early experimental obesity is associated with coronary endothelial dysfunction and oxidative stress.Am J Physiol Heart Circ Physiol 2007;292:H904-H911 https://doi.org/10.1152/ajpheart.00628.2006
  43. Petrie JR, Ueda S, Webb DJ, Elliott HL, Connell JM. Endothelial nitric oxide production and insulin sensitivity: a physiological link with implications for pathogenesis of cardiovascular disease. Circulation 1996;93:1331-3
  44. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001;358:1400-4 https://doi.org/10.1016/S0140-6736(01)06525-4
  45. Kelly AS, Wetzsteon RJ, Kaiser DR, Steinberger J, Bank AJ, Dengel DR. Inflammation, insulin, and endothelial function in overweight children and adolescents: the role of exercise. J Pediatr 2004;145:731-6 https://doi.org/10.1016/j.jpeds.2004.08.004
  46. Reinehr T, Wunsch R, de Sausa G, Toschke AM. Relationship between metabolic syndrome definitions for children and adolescents and intima-media thickness. Atherosclerosis 2008; 199:193-200 https://doi.org/10.1016/j.atherosclerosis.2007.09.041
  47. Chinali M, de Simone G, Roman M, Best LG, Lee ET, Russel M, et al. Cardiac markers of pre-clinical disease in adolescents with metabolic syndrome. J Am Coll Cardiol 2008;52: 932-8 https://doi.org/10.1016/j.jacc.2008.04.013
  48. Haynes WG, Morgan DA, Walsh SA, Mark AL, Sivitz WI. Receptor-mediated regional sympathetic nerve activation by leptin. J Clin Invest 1997;100:270-8 https://doi.org/10.1172/JCI119532
  49. Taittonen L, Uhari M, Nuutinen M, Turtinen J, Pokka T, Åkerblom HK. Insulin and blood pressure among healthy children: Cardiovascular risk in young Finns. Am J Hypertens 1996;9:193-9 https://doi.org/10.1016/0895-7061(95)00345-2
  50. Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniels SR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics 2007;119:237-46 https://doi.org/10.1542/peds.2006-2543
  51. Esmaillzadeh A, Mirmiran P, Azizi F. Clustering of metabolic abnormalities in adolescents with the hypertriglyceridemic waist phenotype. Am J Clin Nutr 2006;83:36-46
  52. Olivieri O, Bassi A, Stranieri C, Trabetti E, Martinelli N, Pizzolo F, et al. Apolipoprotein C-III, metabolic syndrome, and risk of coronary artery disease. J Lipid Res 2003;44: 2374-81 https://doi.org/10.1194/jlr.M300253-JLR200
  53. Weiss R, Taksali SE, Tamborlane WV, Burgert TS, Savoye M, Capiro S. Predictors of changes in glucose tolerance status in obese youth. Diabetes Care 2005;28:902-9 https://doi.org/10.2337/diacare.28.4.902
  54. Bao W, Srinivasan SR, Valdez R, Greenlund KJ, Wattigney WA, Berenson GS. Longitudinal changes in cardiovascular risk from childhood to young adulthood in offspring of parents with coronary artery disease: the Bogalusa Heart Study. JAMA 1997;278:1749-54 https://doi.org/10.1001/jama.278.21.1749
  55. Pankow JS, Jacobs DR Jr, Steinberger J, Moran A, Sinaiko AR. Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance syndrome. Diabetes Care 2004;27:775-80 https://doi.org/10.2337/diacare.27.3.775
  56. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002;288:1728-32 https://doi.org/10.1001/jama.288.14.1728
  57. Arslanian S, Suprasongsin C. Differences in the in vivo insulin secretion and sensitivity of healthy black versus white adolescents. J Pediatr 1996;129:440-3 https://doi.org/10.1016/S0022-3476(96)70078-1
  58. Reiner T, Kleber M, Toschke AM. Small for gestationastatus is associated with metabolic syndrome in overweight children. Eur J Endocrinol 2009;160:579-84 https://doi.org/10.1530/EJE-08-0914
  59. HK Park, MJ Kim, YH Kim, JA Jung, S Yang, IT Hwang, et al. The prevalence of metabolic syndrome in children and adolescents born small for gestational age. J Korean Soc Pediatr Endocrinol 2007;12:55-62
  60. Cruz ML, Goran MI. The metabolic syndrome in children and adolescents. Current Diabetes Reports 2004;4:53-62 https://doi.org/10.1007/s11892-004-0012-x
  61. Goddomg SS, Dennison BA, Birch LL, Daniels SR, Gillman MW, Lichenstein AH, et al. American Heart Association; American Academy of Pediatrics. Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association. Circulation 2005;112:2061-75 https://doi.org/10.1161/CIRCULATIONAHA.105.169251
  62. Park MH, Kinra S, Ward KJ, Whire B, Viner RM. Metformin for obesity in children and adolescents: a systemic review. Diabetes Care 2009;June 5, (Online) https://doi.org/10.2337/dc09-0258

Cited by

  1. Clinical Nutrition Therapy of Metabolic Syndrome in Adolescents vol.14, pp.4, 2011, https://doi.org/10.5223/kjpgn.2011.14.4.350
  2. 한국 중고등학생의 비만과 신체활동과의 연관성 vol.8, pp.3, 2009, https://doi.org/10.13067/jkiecs.2013.8.3.505