Metabolic syndrome in Mexican children: Low effectiveness of diagnostic definitions
Metabolic syndrome in Mexican children: Low effectiveness of diagnostic definitions
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DOI：
10.1016/j.endinu.2017.04.004
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发表时间：
2017-08-01
影响因子：
1.9
通讯作者：
Menjivar, Marta
中科院分区：
文献类型：
--
作者：
Itzel Pena-Espinoza, Barbara;de los Angeles Granados-Silvestre, Maria;Menjivar, Marta
背景资料：早期识别患有代谢综合征（MS）的儿童对于降低成年后患糖尿病和心血管疾病的风险至关重要。然而，由于诊断定义不同，MS的检测具有挑战性;因此，在一些有风险的儿童中没有采取预防措施。因此，本研究的目的是比较MS的患病率在儿童根据IDF，NCEP-ATP-III，库克，德费兰蒂和韦斯的定义，考虑胰岛素抵抗（IR）标志物，如HOMA-IR和/或代谢指数（MI）。方法：共有508名墨西哥儿童（9至13岁）从7所学校参加了一项横断面研究。体测量，生化和激素测量evaluated.Results：MS的频率为2.4-45.9%，这取决于所使用的定义。使用HOMA-IR，未诊断为MS的儿童中IR的频率为12.4-25.2%，使用MI为4.0-16.3%。当HOMA-IR或MI被包括在每个定义中时，MS的频率分别为8.5-50.2%和7.7-46.9%。包括HOMA-IR和/或MI在内的Kappa值均大于0.8。这项研究表明，目前用于诊断墨西哥儿童MS的标准效果不佳，如定义的可变性和未诊断为MS的儿童中IR的存在所示。MS定义中包括HOMA-IR和/或MI（从而增加他们之间的一致性）减少了排除风险儿童的机会，并允许人群之间的MS患病率。(C)2017 SEEN y SED.由Elsevier Espana出版，S.L.U. All rights reserved.
Background: Early identification of children with metabolic syndrome (MS) is essential to decrease the risk of developing diabetes and cardiovascular disease in adulthood. Detection of MS is however challenging because of the different definitions for diagnosis; as a result, preventive actions are not taken in some children at risk. The study objective was therefore to compare prevalence of MS in children according to the IDF, NCEP-ATP-III, Cook, de Ferranti and Weiss definitions, considering insulin resistance (IR) markers such as HOMA-IR and/or metabolic index (MI).Methods: A total of 508 Mexican children (aged 9 to 13 years) from seven schools were enrolled in a cross-sectional study. Somatometric, biochemical, and hormonal measurements were evaluated.Results: Frequency of MS was 2.4-45.9% depending on the definition used. Frequency of IR in children not diagnosed with MS was 12.4-25.2% using HOMA-IR and 4.0-16.3% using MI. When HOMA-IR or MI was included in each of the definitions, frequency of MS was 8.5-50.2% and 7.7-46.9% respectively. The kappa value including HOMA-IR and/or MI was greater than 0.8.Conclusions: This study demonstrated the poor effectiveness of the current criteria used to diagnose MS in Mexican children, as shown by the variability in the definitions and by the presence of IR in children who not diagnosed with MS. Inclusion of HOMA-IR and/or MI in definitions of MS (thus increasing agreement between them) decreases the chance of excluding children at risk and allows for MS prevalence between populations. (C) 2017 SEEN y SED. Published by Elsevier Espana, S.L.U. All rights reserved.