Pediatric metabolic syndrome, which is a group of risk factors in one person including obesity, insulin resistance, hypertension and other metabolic abnormalities, is present in nearly half of all severely obese children and adolescents and increases with worsening obesity, researchers at Yale report.
Published today in the New England Journal of Medicine, the study examined the relationship between the degree of obesity and metabolic syndrome in 439 obese, 31 overweight and 20 lean children and adolescents between the ages of four and 20. Researchers gave participants a standard glucose-tolerance test and measured blood pressure, plasma lipid, C-reactive protein and adiponectin levels. The research team further evaluated future cardiovascular risk in these participants.
Levels of triglycerides, high-density lipoprotein cholesterol and blood pressure were adjusted for age and sex. The study included participants from different racial backgrounds, including 41 percent white, 31 percent black and 28 percent Hispanic.
"We found that the metabolic syndrome is highly prevalent among obese children and adolescents, reaching nearly 50 percent in severely obese youth," said first author Ram Weiss, M.D., clinical fellow in pediatrics at Yale School of Medicine. "We also found that worsening body mass index and insulin resistance, independently, increase the risk for the metabolic syndrome in obese youth. The main issue is that every amount of weight gain increases risk for type 2 diabetes and cardiovascular disease in these young people."
Weiss said signs of an increased risk of future cardiovascular disease are already present in these youngsters and worsen with increased body mass index and insulin resistance. "We found that insulin resistance serves as a 'driving force' for the majority of components of the metabolic syndrome, similar to adults," said Weiss.
The study was funded by a grant to principal investigator Sonia Caprio, M.D., from the National Institute of Child Health and Human Development.
Other Yale authors on the study included James Dziura, Tania S. Burgert, M.D., William V. Tamborlane, M.D., Sara E. Taksali, Catherine W. Yeckel, Karin Allen, Melinda Lopes, Mary Savoye and Robert S. Sherwin, M.D. John Morrison, M.D. is from Cincinnati Children's Hospital Medical Center.
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