Prevalence of metabolic syndrome in scholars from Bucaramanga, Colombia: a population-based study

Cristina Villa-Roel, Adriana Buitrago, Diana C Rodríguez, Diana J Cano, María P Martínez, Paul A Camacho, Alvaro J Ruiz, Alvaro E Durán, Cristina Villa-Roel, Adriana Buitrago, Diana C Rodríguez, Diana J Cano, María P Martínez, Paul A Camacho, Alvaro J Ruiz, Alvaro E Durán

Abstract

Background: Obesity and metabolic syndrome are strongly associated with type 2 diabetes mellitus and cardiovascular diseases, thus the increasing trend in their prevalence among children and adolescents from developing countries requires a further understanding of their epidemiology and determinants.

Methods and design: A cross-sectional study was designed to determine the prevalence of metabolic syndrome among 6-10 year-old children from Bucaramanga, Colombia. A two-stage random-cluster (neighborhoods, houses) sampling process was performed based on local city maps and local statistics. The study involves a domiciliary survey; including a comprehensive socio-demographic, nutritional and physical activity characterization of the children that participated in the study, followed by a complete clinical examination; including blood pressure, anthropometry, lipid profile determination, fasting glucose and insulin levels. The prevalence of metabolic syndrome will be determined using definitions and specific percentile cut-off points for this population. Finally, the association between components of metabolic syndrome and higher degrees of insulin resistance will be analyzed through a multivariable logistic regression model. This study protocol was designed in compliance with the Helsinki declaration and approved by the local ethics board. Consent was obtained from the children and their parents/guardians.

Discussion: A complete description of the environmental and non-environmental factors underlying the burden of metabolic syndrome in children from a developing country like Colombia will provide policy makers, health care providers and educators from similar settings with an opportunity to guide primary and secondary preventive initiatives at both individual and community levels. Moreover, this description may give an insight into the pathophysiological mechanisms mediating the development of cardio-metabolic diseases early in life.

Figures

Figure 1
Figure 1
Study flow.

References

    1. Rosamond WD, Chambless LE, Folsom AR, Cooper LS, Conwill DE, Clegg L, Wang CH, Heiss G. Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. N Engl J Med. 1998;339:861–867. doi: 10.1056/NEJM199809243391301.
    1. Reddy KS. Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action. Public Health Nutr. 2002;5:231–237. doi: 10.1079/PHN2001298.
    1. Grundy SM. Inflammation, hypertension, and the metabolic syndrome. JAMA. 2003;290:3000–3002. doi: 10.1001/jama.290.22.3000.
    1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–3421.
    1. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17:961–969. doi: 10.2337/diacare.17.9.961.
    1. Mensah GA, Mokdad AH, Ford E, Narayan KM, Giles WH, Vinicor F, Deedwania PC. Obesity, metabolic syndrome, and type 2 diabetes: emerging epidemics and their cardiovascular implications. Cardiol Clin. 2004;22:485–504. doi: 10.1016/j.ccl.2004.06.005.
    1. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE. Abdominal adiposity and coronary heart disease in women. JAMA. 1998;280:1843–1848. doi: 10.1001/jama.280.21.1843.
    1. Wang Y, Monteiro C, Popkin BM. Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr. 2002;75:971–977.
    1. Uscategui Peñuela RM, Alvarez Uribe MC, Laguado Salinas I, Soler Terranova W, Martinez Maluendas L, Arias Arteaga R, Duque Jaramillo B, Perez Giraldo J, Camacho Perez JA. Cardiovascular risk factors in children and teenagers aged 6–18 years old from Medellín (Colombia) An Pediatr (Barc) 2003;58:411–417. doi: 10.1157/13046518.
    1. Martorell R, Kettel KL, Hughes ML, Grummer-Strawn LM. Overweight and obesity in preschool children from developing countries. Int J Obes Relat Metab Disord. 2000;24:959–967. doi: 10.1038/sj.ijo.0801264.
    1. de Onis M, Blossner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr. 2000;72:1032–1039.
    1. Vikram NK, Misra A, Pandey RM, Luthra K, Wasir JS, Dhingra V. Heterogeneous phenotypes of insulin resistance and its implications for defining metabolic syndrome in Asian Indian adolescents. Atherosclerosis. 2006;186:193–199. doi: 10.1016/j.atherosclerosis.2005.07.015.
    1. Steinberger J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism) Circulation. 2003;107:1448–1453. doi: 10.1161/01.CIR.0000060923.07573.F2.
    1. Smoak CG, Burke GL, Webber LS, Harsha DW, Srinivasan SR, Berenson GS. Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study. Am J Epidemiol. 1987;125:364–372.
    1. Li Y, Yang X, Zhai F, Piao J, Zhao W, Zhang J, Ma G. Childhood obesity and its health consequence in China. Obes Rev. 2008;9:82–86. doi: 10.1111/j.1467-789X.2007.00444.x.
    1. Li Y, Yang X, Zhai F, Kok FJ, Zhao W, Piao J, Zhang J, Cui Z, Ma G. Prevalence of the metabolic syndrome in Chinese adolescents. Br J Nutr. 2008;99:565–570. doi: 10.1017/S0007114507797064.
    1. Lee MS, Wahlqvist ML, Yu HL, Pan WH. Hyperuricemia and metabolic syndrome in Taiwanese children. Asia Pac J Clin Nutr. 2007;16:594–600.
    1. Chu NF, Rimm EB, Wang DJ, Liou HS, Shieh SM. Clustering of cardiovascular disease risk factors among obese schoolchildren: the Taipei Children Heart Study. Am J Clin Nutr. 1998;67:1141–1146.
    1. Bao W, Srinivasan SR, Wattigney WA, Berenson GS. Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. The Bogalusa Heart Study. Arch Intern Med. 1994;154:1842–1847. doi: 10.1001/archinte.154.16.1842.
    1. Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr. 2008;152:160–164. doi: 10.1016/j.jpeds.2007.07.056.
    1. Rodriguez-Moran M, Salazar-Vazquez B, Violante R, Guerrero-Romero F. Metabolic syndrome among children and adolescents aged 10–18 years. Diabetes Care. 2004;27:2516–2517. doi: 10.2337/diacare.27.10.2516.
    1. 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 J Obes Relat Metab Disord. 2004;28:833–841. doi: 10.1038/sj.ijo.0802694.
    1. 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;157:821–827. doi: 10.1001/archpedi.157.8.821.
    1. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR) Diabet Med. 1999;16:442–443. doi: 10.1046/j.1464-5491.1999.00059.x.
    1. International Diabetes Federation The IDF consensus worldwide definition of the metabolic syndrome. 2005.
    1. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatr Diabetes. 2007;8:299–306. doi: 10.1111/j.1399-5448.2007.00271.x.
    1. Razani B, Chakravarthy MV, Semenkovich CF. Insulin resistance and atherosclerosis. Endocrinol Metab Clin North Am. 2008;37:603–21. doi: 10.1016/j.ecl.2008.05.001.
    1. 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;89:108–113. doi: 10.1210/jc.2003-031188.
    1. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93:S9–30. doi: 10.1210/jc.2008-1595.
    1. DANE – Departamento Administrativo Nacional de Estadística Censo General 2005. Perfil Bucaramanga – Santander. 2005.
    1. Ministerio de la protección social Situación de salud de Colombia. Indicadores básicos 2005
    1. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555–576. doi: 10.1542/peds.114.2.S2.555.
    1. Blood Pressure Tables for Children and Adolescents from the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. 2004.
    1. Park MK. Blood pressure tables. Pediatrics. 2005;115:826–827. doi: 10.1542/peds.2004-2345.
    1. National health and nutrition examination survey Anthropometry procedure manual. 2000.
    1. Centers for disease control and prevention About BMI for Children and Teens. 2006.
    1. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–2374. doi: 10.1056/NEJMoa031049.
    1. Centro Nacional de Estadísticas de Salud en colaboración con el Centro Nacional para la Prevención de Enfermedades Crónicas y Promoción de Salud (2000) Percentiles del Índice de Masa Corporal por edad. Percentiles del Índice de Masa Corporal por edad
    1. De Fronzo RA, Tobin JD. Glucose clamp technique: a method for quantifying insulin secretion and resistance. American Journal of Physiol. 2009.

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