[PHNUTR-L] Metabolic syndrome affects nearly 1 in 10 US teens
fivestar at nutritionucanlivewith.com
Sat Jan 26 11:29:41 PST 2008
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Public release date: 25-Jan-2008
Contact: Heather Hare
heather_hare at urmc.rochester.edu
University of Rochester Medical Center
Metabolic syndrome affects nearly 1 in 10 US teens
Lack of standard definition of risk factors makes measuring problem
About nine percent of teenagers may have metabolic syndrome, a
clustering of risk factors that put them on the path toward heart
disease and diabetes in adulthood. This shocking statistic represents
some of the first concentrated efforts to define and measure metabolic
syndrome in children and adolescents – a necessary starting point for
combating the problem, but one that has proven even trickier in youth
than it has been in adults.
With the number of obese children in the United States rising at an
alarming rate, pediatricians, family practitioners and researchers are
concerned about what it means to for children’s future health. The U.S.
cholesterol guidelines have defined the metabolic syndrome for adults
who have a cluster of risk factors, including increased waist
circumference (central adiposity), hypertension (or elevated blood
pressure), low HDL cholesterol, elevated triglycerides and an elevated
fasting glucose. Even though these same components can be found in
children, they have not been developed into a universal definition or
diagnosis. In fact, they have only recently gained attention with the
first publication on the syndrome by Stephen Cook, M.D., M.P.H.,
assistant professor of Pediatrics at the University of Rochester Medical
Center, in 2003, which was based on national data from 1988 to 1994.
In the summer of 2006, a handful of national experts were convened by
the National Institutes of Health with a task to define the metabolic
syndrome for children and adolescents. The Pediatric Metabolic Syndrome
Working Group (PMSWG) chose to tackle this problem affecting overweight
and obese youth, tapping Cook to participate. The National Institute of
Child Health and Human Development, National Heart, Lung, and Blood
Institute, National Institute of Diabetes and Digestive and Kidney
Diseases and the National Institutes of Health Office of Rare Diseases
sponsored the conference.
As part of the committee, Cook performed a study, published with a
collection of reports from the working group in February’s Journal of
Pediatrics, which analyzes how many teens in the U.S. could be
considered to have the metabolic syndrome based on four different
definitions of it.
Based on the most recently available data from the National Health and
Nutrition Examination Survey from 1999 to 2002, the study shows that the
definition Cook developed in Rochester (a waist circumference at or
above the 90th percentile for age and sex; blood pressure at or above
the 90th percentile; a high triglyceride level at or above 110 mg/dL; a
low HDL cholesterol level at or below 40 mg/dL; and an impaired glucose
metabolism at or above 100 mg/dL), reveals that 2.9 million teens – 9.4
percent of teens overall, and over a third of obese teens – meet the
definition of the metabolic syndrome.
The original work by Cook and colleagues published in 2003 showed only 4
percent of teens meet this definition and that the increased prevalence
is driven by the rise in obesity.
Using two other well-reported definitions with more stringent cut
points, the study also reports rates as low as 2 percent (or 600,000
teens); using analyses that apply the U.S. adult definitions, it
reported rates of 1.8 million teens –5.8 percent of all teens, and 25
percent of obese teens.
“Even if there is no consensus on a pediatric-specific definition, the
fact that 1 in 4 obese teens meet the adult definition for this
clustering of cardiovascular disease risk factors is enough of a
concern,” said Cook, who is a pediatrician and adult-internist at
Golisano Children’s Hospital at Strong. “Many longitudinal studies have
shown that adults with this definition are at increased risk for
developing type 2 diabetes, heart disease and dying prematurely from
While one goal of the committee was to define the metabolic syndrome in
pediatric populations, the bigger picture was to recognize the
importance of obesity on cardiovascular risk for pediatric populations.
“We are not saying that adolescents who meet a definition for metabolic
syndrome are going to develop diabetes or have a heart attack in the
next few years, but some of the longitudinal studies presented at this
meeting showed they were at very high risk for developing diabetes or
heart disease in their 30s,” Cook said. “When you consider all the
success we’ve had with lowering the death rate from heart disease for
middle aged and older adults, it’s really disheartening to see actual
data showing heart disease going up in young adults.”
Cook said there have been advances in technology, pharmaceuticals and
tremendous public health victories seen with reductions in tobacco use
and exposure, so the increased rates in cardiovascular risk factors in
young adults must be considered “the first wave of severe consequences
of the modern obesity epidemic.”
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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