Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria

Granjeiro, Paulo Afonso; Silva, Thaís Marques da; Dorim, Diego Dias Ramos; Vieira, Mariana Sousa; Borges Neto, Juscelino de Sousa; Santos, Maria Emília Soares Martins dos

AIMS:

To assess the frequency of metabolic syndrome in children and adolescents according to three international diagnostic criteria determining the level of agreement between these different criteria.

METHODS:

Waist circumference, blood pressure, blood glucose, high-density lipoprotein cholesterol, and serum triglycerides were evaluated in students from public schools of different regions of Divinópolis, MG, Brazil. Children and adolescents aged between 10 and 17 years were selected. Criteria adapted from the World Health Organization (WHO), National Cholesterol Education Program – Adult Treatment Panel III (NCEP/ATPIII), and International Diabetes Federation (IDF) were used for the diagnosis of metabolic syndrome. The kappa coefficient was used to evaluate the level of agreement among the three criteria.

RESULTS:

The study evaluated 202 students (86 boys and 116 girls). The frequency of metabolic syndrome was 1.16% for boys and none of the girls presented with metabolic syndrome, according to WHO criteria. According to the NCEP/ATPIII and IDF criteria, metabolic syndrome was not detected in the studied sample. Low blood levels of high-density lipoprotein cholesterol was the most frequent metabolic alteration in all teenagers according to the NCEP/ATPIII and IDF criteria, while body mass index was the most frequent one according to WHO criteria. The level of agreement for one altered parameter was poor when comparing WHO and NCEP/ATP/III, moderate when comparing WHO and IDF and high when comparing the NCEP/ATP/III and IDF criteria.

CONCLUSIONS:

Significant differences between the frequencies of individual metabolic syndrome parameters were found in the studied sample of children and adolescents, depending on the criteria used. According to WHO criteria, metabolic syndrome was found at a low frequency and only in boys, while the NCEP/ATPIII and IDF criteria did not diagnose metabolic syndrome. The present findings suggest the need to reach a consensus on the cut-off points for risk factors and a single diagnostic definition of metabolic syndrome in children and adolescents.