Washington, Jan 26 : It has been estimated that almost 9pct of teenagers may be suffering from metabolic syndrome, a clustering of risk factors that may cause disease and diabetes in adulthood.
However, not much effort has gone into developing methods to define and measure metabolic syndrome in children and adolescents. There's a lack of standard definition of risk factors making the measuring problem a lot more difficult.
Paediatricians, 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 having a bunch of risk factors, including increased waist circumference (central adiposity), hypertension (or elevated blood pressure), low HDL cholesterol, elevated triglycerides and an elevated fasting glucose.
Although same components can be found in children, but they have not been developed into a universal definition or diagnosis.
These factors have now come in light with a study led by Stephen Cook, M.D., M.P.H., assistant professor of Paediatrics at the University of Rochester Medical Center, in 2003, which was based on national data from 1988 to 1994.
Some national experts were convened by the National Institutes of Health with a task to define the metabolic syndrome for children and adolescents, in summer 2006. The Paediatric Metabolic Syndrome Working Group (PMSWG) opted to deal with this problem that affects overweight and obese youth and Cook also participated.
Being a part of the committee, Cook performed a study, analyzing the number of teens in the U.S. that could be considered to have the metabolic syndrome based on four different definitions of it.
The study, based on the most recently available data from the National Health and Nutrition Examination Survey from 1999 to 2002, showed that the definition Cook developed in Rochester , reveals that 2.9 million teens, i.e. 9.4 pct of teens overall, and over a third of obese teens, agree to the definition of the metabolic syndrome.
The 2003 original work by Cook and his team showed only 4 pct of teens meet this definition and that the increased prevalence is driven by the rise in obesity.
After using two other well-reported definitions with stricter cut points, the study reported rates as low as 2 pct (or 600,000 teens). When using analyses that apply the U.S. adult definitions, it reported rates of 1.8 million teens, i.e. 5.8 pct of all teens, and 25 percent of obese teens.
"Even if there is no consensus on a paediatric-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. 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 heart disease," said Cook, who is a paediatrician and adult-internist at Golisano Children's Hospital at Strong.
Though, one of the goals of the committee was to define the metabolic syndrome in paediatric populations, the main aim was to recognize the importance of obesity on cardiovascular risk for paediatric 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. 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," said Cook.
According to Cook there have been advances in technology, pharmaceuticals and tremendous public health victories seen with reductions in tobacco use and exposure, thus the increased rates in cardiovascular risk factors in young adults must be considered "the first wave of severe consequences of the modern obesity epidemic."
The study is published with a collection of reports from the working group in February's Journal of Paediatrics.