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      Metabolic syndrome and associated factors in Iranian children and adolescents: the CASPIAN-V study

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          Abstract

          Introduction: Metabolic syndrome (MetS) is one of the common metabolic disorders seen in children and adolescents. This study aims to assess the rate of the MetS and its associated factors in a nationally-representative sample of Iranian pediatric age groups.

          Methods: This nationwide cross- sectional study was designed in 2015 in 30 provinces of Iran. Participants consisted of 4,200 school students, aged 7-18 years, studied in a national school-based surveillance program (CASPIAN-V). Physical examination and laboratory tests were performed using standard protocols. Blood samples were drawn from 3834 students for biochemical tests.

          Results: The participation rate for blood sampling was 91.5%. MetS was significantly more prevalent among students in urban than in rural areas (5.7% vs. 4.8%, P value < 0.01). MetS was more prevalent in students with obese parents than in those with non-obese parents (6.4% vs. 4.5%, P value < 0.05). Significant association existed between moderate level of healthy nutritional behaviors and MetS after controlling for potential confounders (odds ratio [OR]: 0.62, 95% CI: 0.40-0.98). Students with high unhealthy nutritional behaviors showed an increased risk of MetS in crude (OR: 1.6, 95% CI: 1.05-2.44) and adjusted model (OR: 1.65, 95% CI: 1.05-2.63).

          Conclusion: High rate of MetS and associated risk factors was observed in Iranian pediatric age groups, with higher rates among boys. These findings provide useful information for effective preventive strategies based on diet, exercise, and lifestyle modification rather than therapeutic modalities.

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          Most cited references35

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            The burden of non communicable diseases in developing countries

            Background By the dawn of the third millennium, non communicable diseases are sweeping the entire globe, with an increasing trend in developing countries where, the transition imposes more constraints to deal with the double burden of infective and non-infective diseases in a poor environment characterised by ill-health systems. By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. Many of the non communicable diseases can be prevented by tackling associated risk factors. Methods Data from national registries and international organisms are collected, compared and analyzed. The focus is made on the growing burden of non communicable diseases in developing countries. Results Among non communicable diseases, special attention is devoted to cardiovascular diseases, diabetes, cancer and chronic pulmonary diseases. Their burden is affecting countries worldwide but with a growing trend in developing countries. Preventive strategies must take into account the growing trend of risk factors correlated to these diseases. Conclusion Non communicable diseases are more and more prevalent in developing countries where they double the burden of infective diseases. If the present trend is maintained, the health systems in low-and middle-income countries will be unable to support the burden of disease. Prominent causes for heart disease, diabetes, cancer and pulmonary diseases can be prevented but urgent (preventive) actions are needed and efficient strategies should deal seriously with risk factors like smoking, alcohol, physical inactivity and western diet.
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              The prevalence of metabolic syndrome in children: a systematic review of the literature.

              Metabolic syndrome has been identified as a condition of childhood relatively recently. The aim in this study was to describe the prevalence of metabolic syndrome in children allowing for differences in metabolic syndrome definitions. This was a systematic review of the OVID, EMBASE, and CINAHL databases, capturing details of overall prevalence and prevalence within groups categorized by obesity, gender, age, and ethnicity. In all, 378 studies published since 2003 were identified, and of these 85 papers were included in the present review. When all studies were considered, the median prevalence of metabolic syndrome in whole populations was 3.3% (range 0%-19.2%), in overweight children was 11.9% (range 2.8%-29.3%), and in obese populations was 29.2% (range 10%-66%). Within-study analyses confirmed higher prevalence for obese compared to overweight (P=0.012) and obese compared to nonobese, nonoverweight children (P<0.001). Within-study analyses also revealed higher median metabolic syndrome prevalence for boys compared to girls (5.1% versus 3.0%, P<0.001) and also in older compared with younger children (5.6% versus 2.9%, P=0.001). Limited evidence was found to suggest differences between ethnic groups, and there were insufficient studies to determine whether metabolic syndrome prevalence was increasing over time. This is the first systematic review of all of the relevant literature. It describes the magnitude of associations between metabolic syndrome and obesity, age, and gender. We find evidence that ethnicity and geography may be important to metabolic syndrome prevalence in children and these associations require further study.
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                Author and article information

                Journal
                J Cardiovasc Thorac Res
                J Cardiovasc Thorac Res
                J Cardiovasc Thorac Res
                JCVTR
                TBZMED
                Journal of Cardiovascular and Thoracic Research
                Tabriz University of Medical Sciences
                2008-5117
                2008-6830
                2018
                05 December 2018
                : 10
                : 4
                : 214-220
                Affiliations
                1Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                2Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
                3Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
                4Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                5Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
                6Pediatrics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                7Bureau of Health and Fitness, Ministry of Education and Training, Tehran, Iran
                8Office of Adolescents and School Health, Ministry of Health and Medical Education, Tehran, Iran
                9Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
                Author notes
                [* ] Corresponding Authors: Mostafa Qorbani, Email: Mqorbani1379@ 123456yahoo.com ; Roya Kelishadi, Email: roya.kelishadi@ 123456gmail.com
                Article
                10.15171/jcvtr.2018.37
                6335982
                30680080
                dec7765f-3f1b-428f-b88e-3cc7368327b0
                © 2018 The Author(s)

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 August 2017
                : 16 November 2018
                Page count
                Tables: 3, References: 47, Pages: 7
                Categories
                Original Article

                metabolic syndrome,obesity,pediatric
                metabolic syndrome, obesity, pediatric

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