METABOLIC SYNDROME IN SCHOOL CHILDREN OF DERA ISMAIL KHAN, PAKISTAN

Authors

  • Muhammad Ramzan
  • Irshad Ali
  • Faiqah Ramzan
  • Faiza Ramzan
  • Muhammad Haris Ramzan

Abstract

Background: Childhood obesity has increased considerably in many regions of the world includingPakistan. The recent phenomenon of ‘nutritional transition’ with a westernisation of food so prevalentin developing countries, has caused a significant rise in obesity among population that were unaware ofthis problem in the recent past. The aim of this study was to find out the frequency of metabolicsyndrome and cardiovascular risk factors in obese school children (6–11 years) in Dera Ismail Khan.Methods: Eighty-six children were included in this study with 61 (70.94%) obese and 25 (29.06%)normal weight children. Obese children comprised of 34 (39.53%) boys and 27 (31.40%) girls. Normalweight children included 15 (17.44%) boys and 10 (11.63%) girls. They were selected among 1,336children from 8 primary schools of Dera Ismail Khan city. Anthropometric parameters of each subjectwere recorded, BMI determined and body mass status calculated. Children were categorized by thepresence or absence of Obesity. Blood Pressure was also measured. Non-fasting venous blood sampleswere taken, analysed for lipids; Triglycerides (TG), Cholesterol (TC); Lipoproteins: High and LowDensity Lipoprotein-cholesterol (HDL-C, LDL-C) and Plasma Glucose Concentration (PGC).Metabolic syndrome was identified in the presence of ≥3 of the followings with cut-off values: TG>170mg/dl, HDL-C<35 mg/dl, WC>71 cm, BP >120/80 mm Hg, PGC>200 mg/dl. Results: Metabolicsyndrome was identified in 22.95% of the obese children. It was 19.67% and 3.27% in obese boys andgirls respectively. Metabolic syndrome was not found in normal weight children. Clustering ofcardiovascular factors was abundantly present in obese and rare in normal weight children.Keywords: Metabolic Syndrome, Cardiovascular Risk Factors, Obese School Children, Lipid Profile

References

Bhargava SK, Sachdev HS, Fall CHD, Osmond C, Lakshmy R,

Barker DJP, et al. Relation of Serial Changes in Childhood

Body-Mass Index to Impaired Glucose Tolerance in Young

Adulthood. N Engl J Med 2004;350:865–75.

Guo SS, Wu W, Chumlea WC, Roche AF. Predicting

overweight and obesity in adulthood from body mass index

values in childhood and adolescence. Am J Clin Nutr

;76:653–8.

Reaven GM. Role of insulin resistance in human disease.

Bunting lecture 1988. Diabetes 1988;37:1595–607.

Kahn CR. Insulin resistance, insulin insensitivity, and insulin

unresponsiveness: a necessary distinction. Metabolism

;27(12 Suppl 2):1893–902.

Matthael S, Stumvoli M, Kellerer M, Häring H.

Pathophysiology and pharmacological treatment of insulin

resistance. Endocrine Rev 2000;21:585–618.

Bajaj M, DeFronzo RA. Metabolic and molecular basis of

insulin resistance. J Nucl Cardiol 2003;10:311–23.

Biddinger SB, Kahn CR. From mice to men: Insights into the

Insulin Resistance Syndromes. Annual Review of Physiology

;68:123–58.

Liu L, Hironaka K, Pihoker C. Type 2 diabetes in youth.

Current Problems in Pediatric and Adolescent Health Care

; 34:254–72.

Weiss R, Kaufman FR. Metabolic complications of childhood

obesity: identifying and mitigating the risk. Diabetes Care

;31:S310–16.

Huang TT, Nansel TR, Belsheim AR, Morrison JA. Sensitivity,

specificity, and predictive values of pediatric metabolic syndrome

components in relation to adult metabolic syndrome: the

Princeton LRC follow-up study. J Pediatr 2008;152:185–190.

Lambert M, Paradis G, O’Loughlin J, Delvin EE, Hanley JA,

Levy E. Insulin resistance syndrome in a representative sample

of children and adolescents from Quebec, Canada. Int J Obes

Relat Metab Disord 2004;28:833–41.

Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH,

McCrindle B, et al. Progress and Challenges in Metabolic

Syndrome in Children and Adolescents: A Scientific Statement

From the American Heart Association Atherosclerosis,

Hypertension, and Obesity in the Young Committee of the

Council on Cardiovascular Disease in the Young; Council on

Cardiovascular Nursing; and Council on Nutrition, Physical

Activity, and Metabolism. Circulation 2009;119:628–47.

Balkau B, Charles MA. Comments on the provisional report

from the WHO consultation: European Group for the Study of

Insulin Resistance. Diabetic Med 1999;16:442–3.

Expert Panel on Detection, Evaluation, and Treatment of High

Blood Cholesterol in Adults. Executive Summary of the Third

Report of The National Cholesterol Education Program

(NCEP) Expert Panel on Detection, Evaluation, And Treatment

of High Blood Cholesterol In Adults (Adult Treatment Panel

III). JAMA 2001;285:2486–97.

Ford ES. Prevalence of the metabolic syndrome defined by the

International Diabetes Federation among adults in the US.

Diabetes Care 2005;28:2745–9.

World Health Organization. Physical Status: the use and

interpretation of anthropometry. Report of a WHO Expert

Committee (WHO Technical Report Series No. 854). Geneva,

Switzerland: World Health Organization, 1995.

Lapidus L, Bengtsson C. Regional obesity as a health hazard in

women-a prospective study. Acta Med Scand1988;723:53–9.

Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL,

Taubert K; American Heart Association. American Heart

Association guidelines for primary prevention of

atherosclerotic cardiovascular disease beginning in childhood.

Circulation 2003;107:1562–6.

Report of the Expert Committee on the diagnosis and

classification of diabetes mellitus. Diabetes

Care1997;20:1183–97.

Kelishadi R, Ardalan G, Gheiratmand R, Adeli K, Delavari

A, Majdzadeh R. Paediatric metabolic syndrome and

associated anthropometric indices: The CASPIAN Study. Acta

Paediatrica 2006;95:1625–34.

Esmaillzadeh A, Mirmiran P, Azadbakht L, Etemadi A, Azizi

F. High prevalence of the metabolic syndrome in Iranian

adolescents. Obesity (Silver Spring) 2006;14: 377–82.

Semiz Serap, Bican Mevlüt, Çakaloz Inanç, Semiz Ender.

Metabolic syndrome in Childhood Obesity. Indian Pediatrics

;44:657–62.

Agirbasli M, Cakir S, Ozme S, Ciliv G. Metabolic syndrome in

Turkish children and adolescents. Metabolism Clin Exp

;55:1002–6.

Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ,

Goran MI. The metabolic syndrome in overweight Hispanic

youth and the role of insulin sensitivity. J Clin Endocrinol

Metab 2004;89:108–13.

Weiss R, Dziura J, Burgert TF, Tamberlane WV, Takasali SE,

Yeckel Cw, et al. Obesity and the metabolic syndrome in

children and adolescents. N Engl J Med 2004;350:2362–74.

Yoshinaga M, Tanaka S, Shimago A, Sameshima K, Nishi J,

Nomura Y, et al. Metabolic Syndrome in Overweight and

Obese Japanese Children. Obesity Research 2005;13:1135–40.

Published

2010-09-01