Cent Eur J Public Health 2024, 32(Suppl):S25-33 | DOI: 10.21101/cejph.a7889
Continuous metabolic syndrome score in cardiovascular risk assessment in adolescents
- 1 Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
- 2 Department of Public Health and Hygiene, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
Objectives: This study aimed to determine the metabolic syndrome (MS) prevalence in a sample of adolescents, to calculate their continuous metabolic syndrome scores, and to determine the associations of continuous metabolic syndrome score with overweight/obesity and selected cardiometabolic and lifestyle factors.
Methods: We enrolled a sample of 2,590 adolescents (1,180 males, mean age 17.1 ± 1.04 years) from 14 grammar schools and 48 secondary schools in the Bratislava Self-Governing Region, Slovakia. Data were collected from a standard anthropometric examination, biochemical analysis of fasting venous blood, blood pressure measurement, physical fitness assessment, and a comprehensive questionnaire focused on selected lifestyle characteristics. Continuous metabolic syndrome score and paediatric simple metabolic syndrome scores were calculated.
Results: The criteria for the MS diagnosis according to the International Diabetes Federation (IDF) guidelines for children and adolescents were fulfilled in the whole sample by 38 (1.4%) adolescents; all were classified as overweight/obese. In the obese subgroup (n = 270), the MS prevalence rose to 13.3%. The largest number of adolescents was in the group without any of the MS components (67.5%). In the groups with 1, 2 or 3 MS components, males predominated; 0.6% of males and no females had 4 components of MS. The increasing number of individual components of MS is accompanied by a continuous increase (in the case of HDL-cholesterol - a decrease) of mean values mostly of blood lipid levels. Mean values of blood pressure (BP) and anthropometric parameters were highest in the group with three MS components. Significant correlations with body fat content or with selected lifestyle factors were not found. Using the continuous MS score calculation we found 31 adolescents, of whom 14 (45.2%) had only 1 or at most 2 MS components, i.e., they did not meet the criteria for the MS diagnosis.
Conclusion: From the point of view of atherosclerosis prevention and early intervention, it is extremely important to monitor the MS prevalence in children and adolescents, especially in the current obesity pandemic. The paediatric MS score calculation is simple and accurate, allowing assessment of the severity of cardiometabolic risk in individuals even before the diagnosis of MS. The continuous MS score is useful in identifying individuals at increased risk and in the management of preventive health care for children and youth.
Keywords: adolescent, metabolic syndrome, continuous metabolic syndrome score, cardiometabolic risk, lifestyle factors
Received: May 24, 2023; Revised: June 10, 2024; Accepted: June 10, 2024; Published: December 31, 2024 Show citation
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References
- Kelishadi R, Heshmat R, Mansourian M, Motlagh ME, Ziaodini H, Taheri M, et al. Association of dietary patterns with continuous metabolic syndrome in children and adolescents; a nationwide propensity score-matched analysis: the CASPIAN-V study. Diabetol Metab Syndr. 2018;10:52. doi: 10.1186/s13098-018-0352-3.
Go to original source...
Go to PubMed...
- Soldatovic I, Vukovic R, Culafic D, Gajic M, Dimitrijevic-Sreckovic V. siMS Score: simple method for quantifying metabolic syndrome. PLoS One. 2016;11(1): e0146143. doi: 10.1371/journal.pone.0146143.
Go to original source...
Go to PubMed...
- Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53.
Go to original source...
- Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-5.
Go to original source...
Go to PubMed...
- Gurka MJ, Ice CL, Sun SS, Deboer MD. A confirmatory factor analysis of the metabolic syndrome in adolescents: an examination of sex and racial/ethnic differences. Cardiovasc Diabetol. 2012;11:128. doi: 10.1186/1475-2840-11-128.
Go to original source...
Go to PubMed...
- Guseman EH, Eisenmann JC, Laurson KR, Cook SR, Stratbucker W. Calculating a continuous metabolic syndrome score using nationally representative reference values. Acad Pediatr. 2018;18(5):589-92.
Go to original source...
Go to PubMed...
- Sebekova K, Sebek J. Continuous metabolic syndrome score (siMS) enables quantification of severity of cardiometabolic affliction in individuals not presenting with metabolic syndrome. Bratisl Lek Listy. 2018;119(11):675-8.
Go to original source...
Go to PubMed...
- Wijndaele K, Beunen G, Duvigneaud N, Matton L, Duquet W, Thomis M, et al. A continuous metabolic syndrome risk score: utility for epidemiological analyses. Diabetes Care. 2006;29(10):2329. doi: 10.2337/dc06-1341.
Go to original source...
Go to PubMed...
- Pandit D, Chiplonkar S, Khadilkar A, Kinare A, Khadilkar V. Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk. Int J Obes (Lond). 2011;35(10):1318-24.
Go to original source...
Go to PubMed...
- Heshmat R, Heidari M, Ejtahed HS, Motlagh ME, Mahdavi-Gorab A, Ziaodini H, et al. Validity of a continuous metabolic syndrome score as an index for modeling metabolic syndrome in children and adolescents: the CASPIAN-V study. Diabetol Metab Syndr. 2017;9:89. doi: 10.1186/s13098-017-0291-4.
Go to original source...
Go to PubMed...
- Lourenço LP, Viola PCAF, Franceschini SDCC, Rosa COB, Ribeiro SAV. Metabolic syndrome and risk factors in children: a risk score proposal. Eur J Clin Nutr. 2023 Feb;77(2):278-82.
Go to original source...
Go to PubMed...
- Eisenmann JC, Laurson KR, DuBose KD, Smith BK, Donnelly JE. Construct validity of a continuous metabolic syndrome score in children. Diabetol Metab Syndr. 2010;2:8. doi: 10.1186/1758-5996-2-8.
Go to original source...
Go to PubMed...
- Vukovic R, Milenkovic T, Stojan G, Vukovic A, Mitrovic K, Todorovic S, et al. Pediatric siMS score: A new, simple and accurate continuous metabolic syndrome score for everyday use in pediatrics. PLoS One. 2017;12(12):e0189232. doi: 10.1371/journal.pone.0189232.
Go to original source...
Go to PubMed...
- Saklaven MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018;20(2):12. doi: 10.1007/s11906-018-0812-z.
Go to original source...
Go to PubMed...
- 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(5):299-306.
Go to original source...
Go to PubMed...
- Friend A, Craig L, Turner S. The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord. 2013;11(2):71-80.
Go to original source...
Go to PubMed...
- Pirkola J, Tammelin T, Bloigu A, Pouta A, Laitinen J, Ruokonen A, et al. Prevalence of metabolic syndrome at age 16 using the International Diabetes Federation paediatric definition. Arch Dis Child. 2008;93(11):945-51.
Go to original source...
Go to PubMed...
- Lee YJ, Seo MY, Kim S-H, Park MJ. Validity of the pediatric simple metabolic syndrome score. Obesity Res Clin Pract. 2020;14(6):508-13.
Go to original source...
Go to PubMed...
- Jurkovičová J, Hirošová K, Vondrová D, Samohýl M, Štefániková Z, Filová A, et al. The prevalence of insulin resistance and the associated risk factors in a sample of 14-18-year-old Slovak adolescents. Int J Environ Res Public Health. 2021;18(3):909. doi: 10.3390/ijerph18030909.
Go to original source...
Go to PubMed...
- Dobiasova M. Atherogenic index of plasma [Log (triglycerides/HDL-cholesterol)]: theoretical and practical implications. Clin Chem. 2004;50(7):1113-5.
Go to original source...
Go to PubMed...
- Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: summary report. Pediatrics. 2011;128(Suppl 5):S213-56.
Go to original source...
Go to PubMed...
- Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005;115(4):e500-3.
Go to original source...
Go to PubMed...
- Morimoto A, Tatsumi Y, Soyano F, Miyamatsu N, Sonoda N, Godai K, et al. Increase in homeostasis model assessment of insulin resistance (HOMA-IR) had a strong impact on the development of type 2 diabetes in Japanese individuals with impaired insulin secretion: the Saku study. PLoS One. 2014;9(8):e105827. doi: 10.1371/journal.pone.0105827.
Go to original source...
Go to PubMed...
- Leunkeu AL, Shephard RJ, Ahmaidi S. Brief history of exercise clearance and prescription: 1. the era of heart rate recovery curves. Health Fitness J Can. 2014;7(1):26-35.
- Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821-7.
Go to original source...
Go to PubMed...
- Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotype among U.S. Adolescents, 1999-2000. Diabetes Care. 2004;27(10):2438-43.
Go to original source...
Go to PubMed...
- Lee AM, Gurka MJ, DeBoer MD. Trends in metabolic syndrome severity and lifestyle factors among adolescents. Pediatrics. 2016;137(3):e20153177. doi: 10.1542/peds.2015-3177.
Go to original source...
Go to PubMed...
- Rodríguez-Morán M, Salazar-Vázquez B, Violante R, Guerrero-Romero F. Metabolic syndrome among children and adolescents aged 10-18 years. Diabetes Care. 2004;27(10):2516-7.
Go to original source...
Go to PubMed...
- Kim HM, Park J, Kim HS, Kim DH. Prevalence of the metabolic syndrome in Korean adolescents aged 12-19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Pract. 2007;75(1):111-4.
Go to original source...
Go to PubMed...
- Agirbasli M, Cakir S, Ozme S, Ciliv G. Metabolic syndrome in Turkish children and adolescents. Metabolism. 2006;55(8):1002-6.
Go to original source...
Go to PubMed...
- 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(7):833-41.
Go to original source...
Go to PubMed...
- Dhuper S, Cohen HW, Daniel J, Gumidyala P, Agarwalla V, St Victor R, et al. Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study. Cardiovasc Diabetol. 2007;6:4. doi: 10.1186/1475-2840-6-4.
Go to original source...
Go to PubMed...
- Sen Y, Kandemir N, Alikasifoglu A, Gonc N, Ozon A. Prevalence and risk factors of metabolic syndrome in obese children and adolescents: the role of the severity of obesity. Eur J Pediatr. 2008;167(10):1183-9.
Go to original source...
Go to PubMed...
- Eisenmann JC. On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol. 2008;7:17. doi: 10.1186/1475-2840-7-17.
Go to original source...
Go to PubMed...
- Villa JKD, Silva AR, Santos TSS, Ribeiro AQ, Sant'Ana LFR. [Metabolic syndrome risk assessment in children: use of a single score]. Rev Paul Pediatr. 2015;33(2):187-93. Portuguese.
Go to original source...
- Sawant SP, Amin AS. Use of continuous metabolic syndrome score in overweight and obese children. Indian J Pediatr. 2019;86(10):909-14.
Go to original source...
Go to PubMed...
- DeBoer MD, Gurka MJ. Clinical utility of metabolic syndrome severity scores: considerations for practitioners. Diabetes Metab Syndr Obes. 2017;10:65-72.
Go to original source...
Go to PubMed...
- Steele RM, Brage S, Corder K, Wareham NJ, Ekelund U. Physical activity, cardiorespiratory fitness, and the metabolic syndrome in youth. J Appl Physiol. 2008; 105(1):342-51.
Go to original source...
Go to PubMed...
- Stabelini Neto A, de Campos W, Dos Santos GC, Mazzardo Junior O. Metabolic syndrome risk score and time expended in moderate to vigorous physical activity in adolescents. BMC Pediatr, 2014;14:42. doi: 10.1186/1471-2431-14-42.
Go to original source...
Go to PubMed...
- Sun Y, Magnussen CG, Dwyer T, Oddy WH, Venn AJ, Smith KJ. Cross-sectional associations between dietary fat-related behaviors and continuous metabolic syndrome score among young Australian adults. Nutrients. 2018;10(8):972. doi: 10.3390/nu10080972.
Go to original source...
Go to PubMed...
- Štefániková Z, Jurkovičová J, Ševčíková Ľ, Sobotová Ľ, Sekretár S, Ághová Ľ. [Contribution to monitoring the youth's nutritional habits]. In: Jurkovičová J, Štefániková Z, editors. [Living conditions and health]. Bratislava: Public Health Authority of the Slovak Republic SR; 2009. p. 143-9. Slovak.