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      Prevalence of metabolic syndrome in adolescents living in Mthatha, South Africa

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          Metabolic syndrome (MetS), defined as the clustering of three of five risk factors (hypertension, obesity, triglyceridemia, dyslipidemia and hyperglycemia), is being increasingly mentioned among children and adolescents despite there being no consensus on how it should be defined in this set of population. Furthermore, very few studies have focused on MetS in children and adolescents in sub-Saharan populations. This study, therefore, aimed at determining the prevalence of the MetS and contributing risk in adolescents living in Mthatha, South Africa.

          Research design and methods

          Four hundred and ten adolescents (age range: 13–18 years, both sexes) were recruited into this cross-sectional study. In addition to a lifestyle questionnaire being administered, anthropometric measurements (weight, height and waist circumferences) were carried out for each participant. Fasting venous blood was collected for lipid profile and blood glucose assessments. Blood pressure was also measured. MetS was assessed using appropriate diagnostic criteria for children and adolescents.


          Complete data sets were collected from 371 participants. Females showed an elevation in the risk factors for MetS. Of the 371 participants, 40.2% were overweight/obese (47.5% females; 22.5% males). MetS was diagnosed in 3.1% female participants compared with 6.0% in male participants.


          More risk factors for the MetS are seen among the overweight/obese as compared to lean adolescents. Given the fact that childhood overweight/obesity often continues into adulthood, it is important to address the causes of increased risk for MetS earlier in life to prevent the development of disease in adult life.

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          Most cited references 27

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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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            Type 2 diabetes in children and adolescents. American Diabetes Association.

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              The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children

              Background Low- to middle-income countries are undergoing a health transition with non-communicable diseases contributing substantially to disease burden, despite persistence of undernutrition and infectious diseases. This study aimed to investigate the prevalence and patterns of stunting and overweight/obesity, and hence risk for metabolic disease, in a group of children and adolescents in rural South Africa. Methods A cross-sectional growth survey was conducted involving 3511 children and adolescents 1-20 years, selected through stratified random sampling from a previously enumerated population living in Agincourt sub-district, Mpumalanga Province, South Africa. Anthropometric measurements including height, weight and waist circumference were taken using standard procedures. Tanner pubertal assessment was conducted among adolescents 9-20 years. Growth z-scores were generated using 2006 WHO standards for children up to five years and 1977 NCHS/WHO reference for older children. Overweight and obesity for those <18 years were determined using International Obesity Task Force BMI cut-offs, while adult cut-offs of BMI ≥ 25 and ≥ 30 kg/m2 for overweight and obesity respectively were used for those ≥ 18 years. Waist circumference cut-offs of ≥ 94 cm for males and ≥ 80 cm for females and waist-to-height ratio of 0.5 for both sexes were used to determine metabolic disease risk in adolescents. Results About one in five children aged 1-4 years was stunted; one in three of those aged one year. Concurrently, the prevalence of combined overweight and obesity, almost non-existent in boys, was substantial among adolescent girls, increasing with age and reaching approximately 20-25% in late adolescence. Central obesity was prevalent among adolescent girls, increasing with sexual maturation and reaching a peak of 35% at Tanner Stage 5, indicating increased risk for metabolic disease. Conclusions The study highlights that in transitional societies, early stunting and adolescent obesity may co-exist in the same socio-geographic population. It is likely that this profile relates to changes in nutrition and diet, but variation in factors such as infectious disease burden and physical activity patterns, as well as social influences, need to be investigated. As obesity and adult short stature are risk factors for metabolic syndrome and Type 2 diabetes, this combination of early stunting and adolescent obesity may be an explosive combination.

                Author and article information

                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                07 February 2017
                : 13
                : 131-137
                [1 ]Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
                [2 ]Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
                [3 ]Department of Medical Education, Faculty of Health Sciences, Walter Sisulu University
                [4 ]Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa
                Author notes
                Correspondence: Benedicta Ngwenchi Nkeh-Chungag, Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, J113, 1 Nelson Mandela Drive, New Science Building, Mthatha 5117, South Africa, Tel +27 47 502 1989, Email bnkehchungag@ 123456wsu.ac.za
                Nandu Goswami, Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Harrachgasse 21/V, Graz, Austria, Tel +43 316 380 4278, Email nandu.goswami@ 123456medunigraz.at
                © 2017 Sekokotla et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research


                metabolic syndrome, adolescent health, overweight, obesity


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