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      Metabolic Syndrome and Related Factors in Chinese Children and Adolescents: Analysis from a Chinese National Study

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          Abstract

          Aims: Metabolic syndrome (MetS) has become a worldwide epidemic; however, few studies have described its status in Chinese children. This study aimed to estimate MetS status and its associations with geography, economic development, birth weight, and parental education of Chinese children and adolescents.

          Methods: Data were derived from 15,045 participants aged 7–18 years across seven Chinese provinces. Physical measurement and blood tests were conducted to assess the five classical MetS components described by the International Diabetes Federation, including abdominal obesity (the essential component), high blood pressure, low high-density cholesterol (HDL-C), high triglyceride, and elevated fasting glucose (FG). Logistic regression was adopted to explore possible associations between MetS and other factors.

          Results: Overall, MetS prevalence was 2.3%, higher in males (2.8% vs. 1.7% in females), northern regions (3.1%), more developed regions (2.9%), and older participants (aged 16–18 years) ( P < 0.05 for all). Among the five MetS components, abdominal obesity and low HDL-C level were most prevalent (21.8% and 14.4%), and 35.9% of the participants had at least one component. In logistic regression, MetS itself did not correlate with birth weight or parental education. High birth weight was positively correlated with abdominal obesity (odds ratio, 1.48) butnegatively associated with elevated FG (odds ratio, 0.49).

          Concusions: MetS itself was not common in Chinese children and adolescents, whereas its certain components were far more prevalent. Children from North China, more-developed areas, and at an older age were more likely to develop MetS. Strategies designed to prevent pediatric MetS in China should focus on prevalent components as well as its geographic and economic development predilections.

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          Most cited references26

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          Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship.

          The objective was to study the relationship between body mass index (BMI) and body fat per cent (BF%) in different population groups of Asians. The study design was a literature overview with special attention to recent Asian data. Specific information is provided on Indonesians (Malays and Chinese ancestry), Singaporean Chinese, Malays and Indians, and Hong Kong Chinese. The BMI was calculated from weight and height and the BF% was determined by deuterium oxide dilution, a chemical-for-compartment model, or dual-energy X-ray absorptiometry. All Asian populations studied had a higher BF% at a lower BMI compared to Caucasians. Generally, for the same BMI their BF% was 3-5% points higher compared to Caucasians. For the same BF% their BMI was 3-4 units lower compared to Caucasians. The high BF% at low BMI can be partly explained by differences in body build, i.e. differences in trunk-to-leg-length ratio and differences in slenderness. Differences in muscularity may also contribute to the different BF%/BMI relationship. Hence, the relationship between BF% and BMI is ethnic-specific. For comparisons of obesity prevalence between ethnic groups, universal BMI cut-off points are not appropriate.
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            Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey.

            Metabolic syndrome (MetS) is defined by the Third Report of the Adult Treatment Panel (ATP III) using criteria easily applied by clinicians and researchers. There is no standard pediatric definition. We defined pediatric MetS using criteria analogous to ATP III as > or =3 of the following: (1) fasting triglycerides > or =1.1 mmol/L (100 mg/dL); (2) HDL or =6.1 mmol/L (110 mg/dL); (4) waist circumference >75th percentile for age and gender; and (5) systolic blood pressure >90th percentile for gender, age, and height. MetS prevalence in US adolescents was estimated with the Third National Health and Nutritional Survey 1988 to 1994. Among 1960 children aged > or =12 years who fasted > or =8 hours, two thirds had at least 1 metabolic abnormality, and nearly 1 in 10 had MetS. The racial/ethnic distribution was similar to adults: Mexican-Americans, followed by non-Hispanic whites, had a greater prevalence of MetS compared with non-Hispanic blacks (12.9%, [95% CI 10.4% to 15.4%]; 10.9%, [95% CI 8.4% to 13.4%]; and 2.5%, [95% CI 1.3% to 3.7%], respectively). Nearly one third (31.2% [95% CI 28.3% to 34.1%]) of overweight/obese adolescents had MetS. Our definition of pediatric MetS, designed to be closely analogous to ATP III, found MetS is common in adolescents and has a similar racial/ethnic distribution to adults in this representative national sample. Because childhood MetS likely tracks into adulthood, early identification may help target interventions to improve future cardiovascular health.
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              Prevalence and trends of a metabolic syndrome phenotype among u.s. Adolescents, 1999-2000.

              To determine the prevalence of a metabolic syndrome phenotype among U.S. adolescents using the most recent national data and to examine trends in metabolic syndrome prevalence. Analysis of data on 991 adolescents (aged 12-19 years) who had fasted for at least 6 h, from the National Health and Nutrition Examination Survey (NHANES 1999-2000). The metabolic syndrome was determined using the National Cholesterol Education Program (Adult Treatment Panel III) definition modified for age. The overall prevalence of a metabolic syndrome phenotype among U.S. adolescents increased from 4.2% in NHANES III (1988-1992) to 6.4% in NHANES 1999-2000 (P or = 95th percentile for age and sex), compared with 7.1% of adolescents at risk for overweight (BMI between 85th and 95th percentiles) (P 2 million U.S. adolescents currently have a metabolic syndrome phenotype. The prevalence of a metabolic syndrome phenotype has increased significantly over the past decade among U.S. adolescents and is particularly prevalent (> 30%) in overweight adolescents. These findings have important implications for public health because of the well-known health risks associated with the metabolic syndrome in adults. Copyright 2004 American Diabetes Association
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                Author and article information

                Journal
                J Atheroscler Thromb
                J. Atheroscler. Thromb
                jat
                jat
                Journal of Atherosclerosis and Thrombosis
                Japan Atherosclerosis Society
                1340-3478
                1880-3873
                1 June 2020
                : 27
                : 6
                : 534-544
                Affiliations
                [1 ] Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
                [2 ] Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
                [3 ] Department of Maternal and Child Health, School of Public Health, Central South University, Changsha, China
                [4 ] School of Public Health, Tianjin Medical University, Tianjin, China
                [5 ] Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institute of Preventive Medicine, Shanghai, China
                [6 ] Chongqing Medical University, Chongqing, China
                [7 ] Ningxia Medical University, Yinchuan, China
                [8 ] Liaoning Health Supervision Bureau, Shenyang, China
                [9 ] Department of Nutrition and Sport, University of Copenhagen, Copenhagen, Denmark
                [10 ] Department of Community Medicine, Kathmandu University, Nepal. & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
                Author notes

                Yanna Zhu and Hao Zheng contributed equally to this work.

                Yajun Chen and Jun Ma are joint senior authors.

                Address for correspondence: Yajun Chen, Mailing address: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan Road II,Guangzhou, PR-China E-mail: chenyj68@ 123456sysu.edu.cn .
                Article
                10.5551/jat.50591
                7355101
                31827007
                054f89d6-d750-48c7-9840-a57598a8ecf3
                2020 Japan Atherosclerosis Society

                This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License. http://creativecommons.org/licenses/by-nc-sa/3.0/

                History
                : 28 April 2019
                : 5 September 2019
                Page count
                Figures: 1, Tables: 5, References: 37, Pages: 11
                Categories
                Original Article

                metabolic syndrome,abdominal obesity,children and adolescents

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