• Amina Zehra Iqbal
  • Sarah Basharat
  • Adeel Basharat
  • Shifa Basharat


Background: Concurrence of central adiposity, hypertension, hyperglycaemia, and atherogenic dyslipidaemia has been termed as the metabolic syndrome. High prevalence of the syndrome has been reported globally over the last decade. Methods: This cross-sectional study is based on a sample of eighty five children, ranging in age from six to twelve years. After parental consent, height, weight, waist circumference, and blood pressure were measured and investigation requests for fasting plasma glucose and fasting lipid profile were given. Children with known metabolic disorders, and those using metabolic-profile-altering medication were excluded. Results: The prevalence of metabolic syndrome, according to the various definitions, varied from as high as 16.5% (95% CI: 9.3–26.1%) to as low as 1.8% (95% CI: 0.03–6.4%). The most prevalent of the component abnormalities was blood pressure above 90th percentile, positive in 54% (95% CI: 43.0–65.0). HDL-c was low (≤1.3 mmol/L) in 36.5% (95% I: 26.3–47.6%), and waist circumference high (>75th percentile) in 30.6% (95% CI: 21.0–41.5%). Both systolic blood pressure and triglycerides to HDL-cholesterol ratio showed a linear trend of increasing with increasing quartiles of waist and body mass index (BMI). Conclusion: Depending on the cut-off values used for defining the component abnormalities, the metabolic syndrome may be quite prevalent in this population. Waist circumference above 75th percentile and even a single reading of blood pressure above 90th percentile should be considered a warning sign, indicating further investigation and lifestyle interventions.Keywords: Metabolic Syndrome, cardio-metabolic risk, central obesity, waist circumference, dyslipidaemia


Isomaa B. A major health hazard: The metabolic syndrome. Life Sci 2003;73:2395–411.

Vague J. The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. 1956. Nutrition 1999;15(1):89–90.

Crepaldi G, Tiengo A, Muggeo M, Trisotto A, Federspil G, Scandellari C. Primary and secondary hyperinsulinism. (Article in Italian). Minerva Med 1970;61:292–308.

Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595–607.

Reaven GM. The insulin resistance syndrome. Curr Atheroscler Rep 2003;5:364–71.

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus band its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539–53.

Expert Panel on Detection EaToHBCiA. 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.

Hjermann I. The metabolic cardiovascular syndrome: syndrome X, Reaven's syndrome, insulin resistance syndrome, atherothrombogenic syndrome. J Cardiovasc Pharmacol 1992;20 Suppl 8:S5-10.

Falkner B, Hassink S, Ross J, Gidding S. Dysmetabolic Syndrome: Multiple Risk Factors for Premature Adult Disease in an Adolescent Girl. Pediatrics 2002;110 (1 Pt 1):e14.

Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Alméras N, et al. Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation 2000;102:179–84.

Reaven GM. Insulin resistance/compensatory hyperinsulinemia, essential hypertension, and cardiovascular disease. J Clin Endocrinol Metab 2003;88:2399–403.

Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008;28:629–36.

Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem 2005;51:931–8.

Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a Metabolic SyndromePhenotype in Adolescents: Findings From the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003;157:821–7.

de Ferranti S, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494–7.

Cruz LM, 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 TS, Tamborlane WV, Taksali SE, Yeckel CW,, et al. Obesity and the Metabolic Syndrome in Children and Adolescents. N Engl J Med 2004;350:2362–74.

Ford ES, Ajani UA, Mokdad AH. The metabolic syndrome and concentrations of C-reactive protein among U.S. youth. Diabetes Care 2005;28:871–81.

Alberti G, Zimmet P, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The IDF consensus definition of metabolic syndrome in children and adolescents. 2007. Available at:

Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 2007;8:299–306.

Day C. Metabolic syndrome, or What you will: definitions and epidemiology. Diab Vasc Dis Res 2007;4(1):32–8.

Vasudevan AR, Ballantyne CM. Cardiometabolic risk assessment: an approach to the prevention of cardiovascular disease and diabetes mellitus. Clin Cornerstone 2005;7(2-3):7–16.

Salem Z, Vazirinejad R. Prevalence of obesity and metabolic syndrome in adolescent girls in South East of Iran. Pak J Med Sci 2009;25:196–200.

Lwanga SK, Lemeshow S, editors. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991. Available at:

EpiData Data Entry, Data Management and basic Statistical Analysis System [computer program]. Odense Denmark: EpiData Association; 2008.

R: A language and environment for statistical computing. R Foundation for Statistical Computing [computer program]. Version 2.13. Vienna, Austria: 2011. Available at: Stata Statistical Software: Release 8 [computer program]. StataCorp, College Station, Taxas, TX: StataCorp LP; 2008.

Ogden CL, Flegal KM. Changes in terminology for childhood overweight and obesity. Natl Health Stat Report 2010;25:1–5.

McCarthy HD, Jarrett KV, Crawley HF. The development of waist circumference percentiles in British children aged 5.0–16.9 y. Eur J Clin Nutr 2001;55:902–7.

Herman CR, Gill HK, Eng J, Fajardo LL. Screening for preclinical disease: test and disease characteristics. Am J Roentgenol 2002;179:825–31.

van Dieren S, Beulens JW, van der Schouw YT, Grobbee DE, Neal B. The global burden of diabetes and its complications: an emerging pandemic. Eur J Cardiovasc Prev Rehabil 2010;17(Suppl 1):S3–8.

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746–53.

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001;104:2855–64.

Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus--a systematic review of randomized controlled trials. Ann Behav Med 2010;40:49–64.

American Medical Association, Council on Scientific Affairs. Commercialized Medical Screening (Report A-03); 2011. Avaiable at: accessed April 25, 2011.

Daniels SR, Greer F, Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics 2008;122:198–208.

Haney EM, Huffman LH, Bougatsos C, Freeman M, Steiner RD, Nelson HD. Screening and treatment for lipid disorders in children and adolescents: systematic evidence review for the US Preventive Services Task Force. Pediatrics 2007;120:e189–214.

Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2006;114:2710–38.

National Cholesterol Education Program. 1992 Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992;89(3 Pt 1):524–84