June 2, 2004New England Journal of Medicine
Obesity and the Metabolic Syndrome in Children and Adolescents
Why the study?
Does increasing severity of obesity increase the prevalence of the metabolic syndrome and adverse cardiovascular biomarkers in children and adolescents?
Population
490 children and adolescents (439 obese, 31 overweight, 20 nonobese) from a multiethnic, multiracial cohort
Comparison
Varying degrees of obesity (exposure) vs Nonobese children and adolescents (n=20)
Design
Cross-sectional
Authors
Discussion
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Overview
Supports monitoring for metabolic syndrome as obesity severity rises in youth; leaves open optimal intervention thresholds.
Key Points
- To evaluate the impact of increasing obesity severity on metabolic syndrome prevalence and assess its association with insulin resistance, C-reactive protein, and adiponectin in youth.
- Assessed 439 obese, 31 overweight, and 20 nonobese children and adolescents using a standard glucose-tolerance test alongside lipid, C-reactive protein, and adiponectin panels.
- Calculated age- and sex-standardized body-mass index z scores and adjusted blood pressure, high-density lipoprotein cholesterol, and triglyceride levels for age and sex.
- Metabolic syndrome prevalence reached 50 percent in severely obese youth, with each 0.5-unit increase in body-mass index z score increasing risk (odds ratio, 1.55; 95% CI, 1.16 to 2.08).
- Each 1-unit increase in homeostatic model insulin resistance significantly increased metabolic syndrome odds (odds ratio, 1.12; 95% CI, 1.07 to 1.18; P for trend < 0.001).
- Increasing obesity severity was directly associated with elevated C-reactive protein levels and reduced protective adiponectin concentrations.
Structured PICO
Does increasing severity of obesity increase the prevalence of the metabolic syndrome and adverse cardiovascular biomarkers in children and adolescents?
P
Population
490 children and adolescents (439 obese, 31 overweight, 20 nonobese) from a multiethnic, multiracial cohort
I
Intervention
Varying degrees of obesity (exposure)
C
Comparator
Nonobese children and adolescents (n=20)
O
Outcome
Prevalence of the metabolic syndrome and its relation to insulin resistance, C-reactive protein, and adiponectin levelssurrogate
The prevalence of metabolic syndrome and adverse cardiovascular biomarkers is high and increases with worsening obesity in children and adolescents.
Cite This Study
Weiss et al. (2004) studied this question.