Prevalence of the metabolic syndrome using ATP-derived definitions and its relation to insulin-resistance in a cohort of Italian outpatient children.

Abstract

OBJECTIVE:

To analyze the prevalence of the metabolic syndrome (MetS) defined by three sets of Adult Treatment Panel III (ATPIII)-derived criteria, and the ability of each definition to identify insulin-resistance (IR) in a wide cohort of outpatient children.

SUBJECTS AND METHODS:

Seven hundred and twenty-four children consecutively observed in the Outpatient Pediatric Clinic of Pozzuoli Hospital during the period 2004-2009 were included in the study. Diagnosis of the MetS was made using three definitions: Cook, Jolliffe (which adopt age- and gender-specific cut-points) and de Ferranti. Insulin sensitivity was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). IR was defined by the 90th percentile of HOMA-IR in healthy non-obese Italian children grouped by gender and Tanner stage. The ability of each definition to identify IR was evaluated in terms of sensitivity and specificity.

RESULTS:

The prevalence of the MetS in the overall cohort was 11, 12 and 24% using Cook, Jolliffe and de Ferranti criteria, respectively. Sensitivity and specificity in relation to IR were 19 and 94% with Cook criteria, 21 and 92% with Jolliffe criteria, and 39 and 84% with de Ferranti criteria.

CONCLUSIONS:

The prevalence of the MetS in children increases with increasing body weight. Among the three definitions analyzed, de Ferranti identifies a larger number of children with the MetS. The prediction of IR is weak with all definitions; on the contrary, the absence of MetS identifies fairly well children with low degree of IR.

• Authors: P Di Bonito, C Forziato, E Sanguigno, T Di Fraia, F Saitta, M R Iardino, B Capaldo
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) Vol. 33 Issue 11 Pg. 806-9 (Dec 2010) ISSN: 1720-8386 [Electronic] Italy
• PMID: 20220295 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Female
• Humans
• Insulin Resistance
• Italy (epidemiology)
• Male
• Metabolic Syndrome (epidemiology)
• Obesity (complications, epidemiology)
• Overweight (complications, epidemiology)
• Prevalence
• Sensitivity and Specificity