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Epidemiology of the Metabolic Syndrome and Related Disorders in Children and Adolescents

  • Chapter
Insulin Resistance

Part of the book series: Contemporary Endocrinology ((COE))

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The cluster of hypertension, hyperglycemia, and hyperuricemia was first described in 1923 and studies have since confirmed the clustering of cardio-metabolic factors that has come to be known by many names (1–3). In 1988, Reaven was the first to link type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) to the cluster he called Syndrome X: insulin resistance, hyperglycemia, hypertension, low HDL cholesterol, and raised very low-density lipoproteins VLDL-triglycerides (TG). The concept that cardiovascular risk was increased for individuals prior to the onset of type 2 diabetes gained further support from many studies during the 1990s (4–6). These studies indicated that a “pre-diabetic” state could be identified by the presence of borderline abnormal values of risk factors, such as blood pressure (BP), TG, and HDL cholesterol, that is associated with increased risk for CVD later in life. Dr Paul Zimmet suggested that type 2 diabetes and glucose intolerance were “the tip of the iceberg”, arguing that derangements in lipids, BP, and excess weight represent a much larger and unidentified entity lying below the water level (7).

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Abbreviations

NHANES:

National Health and Nutrition Examination Survey

CVD:

cardiovascular disease

T2DM:

type 2 diabetes mellitus

HDL:

high density lipoprotein

LDL:

low density lipoprotein

TLC:

therapeutic lifestyle change

VLDL:

very low density lipoprotein

References

  1. Kylin E. Studien uber das Hypertonie-Hyperglykamie-Hyperurikamiesyndrome. Zentralblattfur innere Medizin 1923; 44:105-27.

    Google Scholar 

  2. Guo S, Beckett L, Chumlea WC, Roche AF, Siervogel RM. Serial analysis of plasma lipidsand lipoproteins from individuals 9-21 y of age. American Journal of Clinical Nutrition 1993; 58(1):61-7.

    PubMed  CAS  Google Scholar 

  3. Raitakari OT, Porkka KV, Rasanen L, Ronnemaa T, Viikari JS. Clustering and six year clustertrackingof serum total cholesterol, HDL-cholesterol and diastolic blood pressure in childrenand young adults, The Cardiovascular Risk in Young Finns Study. Journal of ClinicalEpidemiology 1994; 47(10):1085-93.

    CAS  Google Scholar 

  4. Haffner SM, S tern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk f actors inconfirmed prediabetic individuals, Does the clock for coronary heart disease start tickingbefore the onset of clinical diabetes. JAMA: The Journal of the American Medical Association 1990; 263(21):2893-8.

    Article  CAS  Google Scholar 

  5. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysisof the insulin-resistance syndrome(syndrome X). Diabetes 1992; 41(6):715-22.

    Article  PubMed  CAS  Google Scholar 

  6. Isomaa B, Almgren P, Tuomi T et-al. Cardiovascular morbidity and mortality associated withthe metabolic syndrome. Diabetes Care 2001; 24(4):683-9.

    Article  PubMed  CAS  Google Scholar 

  7. Zimmet P, Boyko EJ, Collier GR, de Courten M. Etiology of the metabolic syndrome: potentialrole of insulin resistance, leptin resistance, and other players. Annals of the New YorkAcademy of Sciences 1999; 892: 25-44.

    Article  CAS  Google Scholar 

  8. 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 inadults(Adult Treatment Panel III). JAMA: The Journal of the American Medical Association 2001; 285(19):2486-97.

    Article  Google Scholar 

  9. Lorenzo C, Williams K, H unt KJ, Haffner SM. Trend in the prevalence of the metabolic syndromeand its impact on cardiovascular disease incidence: The San Antonio Heart Study.Diabetes Care 2006; 29(3):625-30.

    Article  PubMed  Google Scholar 

  10. Lakka HM, Laaksonen DE, L akka TA et-al. The metabolic syndrome and total andcardiovascular disease mortality in middle-aged men. JAMA: The Journal of the AmericanMedical Association 2002; 288(21):2709-16.

    Article  Google Scholar 

  11. Grundy SM. Does the metabolic syndrome exist. Diabetes Care 2006; 29(7):1689-92.

    Article  PubMed  Google Scholar 

  12. Grundy SM. Point: the metabolic syndrome still lives. Clinical Chemistry 2005; 51(8):1352-4.

    Article  PubMed  CAS  Google Scholar 

  13. Kahn R. The metabolic syndrome(emperor) wears no clothes. Diabetes Care 2006; 29(7):1693-6.

    Article  Google Scholar 

  14. Reaven G. Counterpoint: just being alive is not good enough. C linical Chemistry 2005; 51(8):1354-7.

    CAS  Google Scholar 

  15. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. The Lancet 2005; 365(9468):1415-28.

    Article  CAS  Google Scholar 

  16. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. TheLancet 2005; 366(9491):1059-62.

    Article  Google Scholar 

  17. Chen W, Bao W, Begum S, Elkasabany A, Srinivasan SR, Berenson GS. Age-related patternsof the clustering of cardiovascular risk variables of syndrome X from childhood to youngadulthood in a population made up of black and white subjects: the Bogalusa Heart Study. Diabetes 2000; 49(6):1042-8.

    Article  PubMed  CAS  Google Scholar 

  18. Csabi G, Torok K, Jeges S, Molnar D. Presence of metabolic cardiovascular syndrome inobese children. European Journal of Pediatrics 2000; 159(1-2):91-4.

    Article  PubMed  CAS  Google Scholar 

  19. Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhoodobesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 2001; 108(3):712-8.

    Article  PubMed  CAS  Google Scholar 

  20. Mahoney LT, Burns TL, Stanford W et-al. Coronary risk factors measured in childhood andyoung adult life are associated with coronary artery calcification in young adults: The muscatinestudy. Journal of the American College of Cardiology 1996; 27(2):277-84.

    Article  PubMed  CAS  Google Scholar 

  21. Burns TL, Moll PP, Lauer RM. Increased familial cardiovascular mortality in obese schoolchildren:The Muscatine Ponderosity Family Study. Pediatrics 1992; 89(2):262-8.

    PubMed  CAS  Google Scholar 

  22. Laskarzewski P, Morrison JA, Mellies MJ et-al. Relationships of measurement of body massto plasma lipoproteins in school children and adults. American Journal of Epidemiology 1980; 111(4):395-406.

    PubMed  CAS  Google Scholar 

  23. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Associationbetween multiple cardiovascular risk factors and atherosclerosis in children and youngadults. The Bogalusa Heart Study. New England Journal of Medicine 1998; 338(23):1650-6.

    Article  PubMed  CAS  Google Scholar 

  24. McGill HC, McMahan CA, Herderick EE et-al. Obesity accelerates the progression of coronaryatherosclerosis in young men. Circulation 2002; 105(23):2712-8.

    Article  PubMed  Google Scholar 

  25. McGill HC, McMahan CA, Zieske AW, Malcom GT, Tracy RE, Strong JP. Effects of nonlipidrisk factors on atherosclerosis in youth with a favorable lipoprotein profile. Circulation 2001; 103(11):1546-50.

    PubMed  CAS  Google Scholar 

  26. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence ofoverweight and obesity in the United States, 1999-2004. JAMA: The Journal of the AmericanMedical Association 2006; 295(13):1549-55.

    Article  CAS  Google Scholar 

  27. Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-heightratio among US children and adolescents. Pediatrics 2006; 118(5):e1390-8.

    Article  PubMed  Google Scholar 

  28. Ford ES, Mokdad AH, Ajani UA. Trends in risk factors for cardiovascular disease amongchildren and adolescents in the United States. Pediatrics 2004; 114(6):1534-44.

    Article  PubMed  Google Scholar 

  29. Cook S, Auinger P, Li C, Ford E. Metabolic syndrome rates in United States adolescents, fromthe National Health and Nutrition Examination Survey, 1999-2002. The Journal of Pediatrics 2008; 152(2):165-70.

    Article  PubMed  Google Scholar 

  30. 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 ExaminationSurvey, 1988-1994. Archives of Pediatrics & Adolescent Medicine 2003; 157(8):821-7.

    Article  Google Scholar 

  31. Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotypeamong U.S. adolescents, 1999-2000. Diabetes Care 2004; 27(10):2438-43.

    Article  PubMed  Google Scholar 

  32. McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK childrenand adolescents over two decades supports the simple message. International Journal ofObesity 2006; 30(6):988-92.

    Article  CAS  Google Scholar 

  33. Moreno LA, Sarria A, Fleta J, Marcos A, Bueno M. Secular trends in waist circumference inSpanish adolescents, 1995 to 2000-02. Archives of Disease in Childhood 2005; 90(8):818-9.

    Article  PubMed  CAS  Google Scholar 

  34. Goran MI. Measurement issues related to studies of childhood obesity: assessment of bodycomposition, body fat distribution, physical activity, and food intake. Pediatrics 1998; 101(Suppl 3):505-18.

    PubMed  CAS  Google Scholar 

  35. Bedogni G, Iughetti L, Ferrari M et-al. Sensitivity and specificity of body mass index andskinfold thicknesses in detecting excess adiposity in children aged 8-12 years 4. Annals ofHuman Biology 2003; 30(2):132-9.

    Article  CAS  Google Scholar 

  36. Gutin B, Litaker M, Islam S, Manos T, Smith C, Treiber F. Body-composition measurementin 9-11-y-old children by dual-energy X-ray absorptiometry, skinfold-thickness measurements,and bioimpedance analysis. The American Journal of Clinical Nutrition 1996; 63(3):287-92.

    PubMed  CAS  Google Scholar 

  37. Neovius M, Linne Y, Barkeling B, Rossner S. Sensitivity and specificity of classification systemsfor fatness in adolescents. The American Journal of Clinical Nutrition 2004; 80(3):597-603.

    PubMed  CAS  Google Scholar 

  38. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L. Waist circumference and cardiovascularrisk factors in prepubertal children. Obesity Research 2001; 9(3):179-87.

    Article  PubMed  CAS  Google Scholar 

  39. Savva SC, Tornaritis M, Savva ME et-al. Waist circumference and waist-to-height ratio arebetter predictors of cardiovascular disease risk factors in children than body mass index. International Journal of Obesity & Related Metabolic Disorders: Journal of the InternationalAssociation for the Study of Obesity 2000; 24(11):1453-8.

    Article  CAS  Google Scholar 

  40. Brambilla P, Bedogni G, Moreno LA et-al. Crossvalidation of anthropometry against magneticresonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. International Journal of Obesity 2006; 30(1):23-30.

    Article  PubMed  CAS  Google Scholar 

  41. Lee SJ, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictorof insulin resistance in black and white youths 31. The Journal of Pediatrics 2006; 148(2):188-94.

    Article  PubMed  CAS  Google Scholar 

  42. Taylor RW, Jones IE, Williams SM, Goulding A. Evaluation of waist circumference, waist-tohipratio, and the conicity index as screening tools for high trunk fat mass, as measured bydual-energy X-ray absorptiometry, in children aged 3-19 y. The American Journal of ClinicalNutrition 2000; 72(2):490-5.

    CAS  Google Scholar 

  43. Zhu SK, Wang ZM, Heshka S, Heo M, Faith MS, Heymsfield SB. Waist circumference andobesity-associated risk factors among whites in the third National Health and NutritionExamination Survey: clinical action thresholds. The American Journal of Clinical Nutrition 2002; 76(4):743.

    PubMed  Google Scholar 

  44. McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK childrenand adolescents over two decades supports the simple message-" keep your waist circumferenceto less than half your height ". International Journal of Obesity 2006; 30(6):988-92.

    Article  PubMed  CAS  Google Scholar 

  45. Maffeis C, Banzato C, Talamini G. Waist-to-height ratio, a useful index to identify high metabolicrisk in overweight children. The Journal of Pediatrics 2008; 152:(2)207-13.

    Article  PubMed  Google Scholar 

  46. Kahn HS, Imperatore G, Cheng YJ. Apopulation-based comparison of BMI percentiles andwaist-to-height ratio for identifying cardiovascular risk in youth. The Journal of Pediatrics 2005; 146(4):482-8.

    Article  PubMed  Google Scholar 

  47. Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among childrenand adolescents. JAMA: The Journal of the American Medical Association 2005; 291(17):2107-13.

    Article  Google Scholar 

  48. Srinivasan SR, Myers L, Berenson GS. Changes in metabolic syndrome variables since childhoodin prehypertensive and hypertensive subjects: The Bogalusa Heart Study. Hypertension 2006; 48(1):33-9.

    Article  PubMed  CAS  Google Scholar 

  49. Stan S, Levy E, Delvin EE et-al. Distribution of LDL particle size in a population-based sampleof children and adolescents and relationship with other cardiovascular risk factors. Clinical Chemistry 2005; 51(7):1192-200.

    Article  PubMed  CAS  Google Scholar 

  50. McCrindle BW, Urbina EM, Dennison BA et-al. Drug therapy of high-risk lipid abnormalitiesin children and adolescents: a scientific statement from the American Heart Association. Circulation 2007; 115(14):1948-67.

    Article  PubMed  Google Scholar 

  51. Sinha R, Fisch G, Teague B et-al. Prevalence of impaired glucose tolerance among childrenand adolescents with marked obesity. The New England Journal of Medicine 2002; 346(11):802-10.

    Article  PubMed  CAS  Google Scholar 

  52. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increasedincidence of non-insulin-dependent diabetes mellitus among adolescents. Journal of Pediatrics 1996; 128(5 Pt 1):608-15.

    PubMed  CAS  Google Scholar 

  53. Williams DE, Cadwell BL, Cheng YJ et-al. Prevalence of impaired fasting glucose and itsrelationship with cardiovascular disease risk factors in US adolescents, 1999-2000. Pediatrics 2005; 116(5):1122-6.

    Article  PubMed  Google Scholar 

  54. Duncan GE. Prevalence of diabetes and impaired fasting glucose levels among US adolescents:National Health and Nutrition Examination Survey, 1999-2002. Archives of Pediatrics& Adolescent Medicine 2006; 160(5):523-8.

    Article  Google Scholar 

  55. Dolan LM, Bean J, D'Alessio D et-al. Frequency of abnormal carbohydrate metabolism anddiabetes in a population-based screening of adolescents. Journal of Pediatrics 2005; 146(6):751-8.

    Article  PubMed  CAS  Google Scholar 

  56. Love-Osborne K, Butler N, Gao D, Zeitler P. Elevated fasting triglycerides predict impairedglucose tolerance in adolescents at risk for type 2 diabetes 20. Pediatric Diabetes 2006; 7(4):205-10.

    Article  PubMed  Google Scholar 

  57. The STOPP-Type Prevention Study Group. Presence of diabetes risk factors in a large U.S.eighth-grade cohort. Diabetes Care 2006; 29(2):212-7.

    Article  Google Scholar 

  58. Weiss R, Dziura J, Burgert T et-al. Obesity and the metabolic syndrome in children and adolescents. The New England Journal of Medicine 2004; 350(23):2362-74.

    Article  PubMed  CAS  Google Scholar 

  59. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndromein overweight Hispanic youth and the role of insulin sensitivity. Journal of ClinicalEndocrinology & Metabolism 2004; 89(1):108-13.

    Article  CAS  Google Scholar 

  60. Goodman E, Daniels SR, Morrison J, Huang B, Dolan LM. Contrasting prevalence of anddemographic disparities in the World Health Organization and National Cholesterol EducationProgram Adult Treatment Panel III definitions of metabolic syndrome among adolescents. The Journal of Pediatrics 2004; 145(4):445-51.

    Article  PubMed  Google Scholar 

  61. Chi CH, Wang Y, Wilson DM, Robinson TN. Definition of metabolic syndrome inpreadolescent girls. The Journal of Pediatrics 2006; 148(6):788-92.

    Article  PubMed  Google Scholar 

  62. Toward a Working Definition of the Metabolic Syndrome in Children and Adolescents. National Institute of Health, Office of Rare Diseases 2006; Available at URL: http://rarediseases.info.nih.gov/html/workshops/workshops/adolescents20060717.html .

    Google Scholar 

  63. Morrison JA, Friedman LA, Harlan WR et-al. Development of the metabolic syndrome inblack and white adolescent girls: a longitudinal assessment. Pediatrics 2005; 116(5):1178-82.

    Article  PubMed  Google Scholar 

  64. Jolliffe C, Janssen I. Development of age-specific adolescent metabolic syndrome c riteria thatare linked to the Adult Treatment Panel III and International Diabetes Federation criteria. Journal of the American College of Cardiology 2007; 49(8):891-8.

    Article  PubMed  Google Scholar 

  65. Jolliffe C, Janssen I. Distribution of lipoproteins by age and gender in adolescents. Circulation 2006; 114(10):1056-62.

    Article  PubMed  CAS  Google Scholar 

  66. Ogden CL, Kuczmarski RJ, Flegal KM et-al. Centers for Disease Control and Prevention 2000growth charts for the United States: improvements to the 1977 National Center for HealthStatistics version. Pediatrics 2002; 109(1):45-60.

    Article  PubMed  Google Scholar 

  67. Weitzman M, Cook S, Auinger P et-al. Tobacco smoke exposure is associated with the metabolicsyndrome in adolescents. Circulation 2005; 112(6):862-9.

    Article  PubMed  CAS  Google Scholar 

  68. Grundy SM, Brewer HB, Jr. Cleeman JI, Smith SC, Jr. Lenfant C. Definition of metabolic syndrome:Report of the National Heart, Lung, and Blood Institute/American Heart Associationconference on scientific issues related to definition. Circulation 2004; 109(3):433-8.

    Article  PubMed  Google Scholar 

  69. Grundy SM, Hansen B, Smith SC, Jr Cleeman JI, Kahn RA. Clinical management of metabolicsyndrome: Report of the American Heart Association/National Heart, Lung, and BloodInstitute/American Diabetes Association conference on scientific issues related to management. Circulation 2004; 109(4):551-6.

    Article  PubMed  Google Scholar 

  70. Rodriguez BL, Fujimoto WY, Mayer-Davis EJ et-al. Prevalence of cardiovascular disease riskfactors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youthstudy. Diabetes Care 2006; 29(8):1891-6.

    Article  PubMed  Google Scholar 

  71. Kershnar AK, Daniels SR, Imperatore G et-al. Lipid abnormalities are prevalent in youth withtype 1 and type 2 diabetes: the search for diabetes in youth study. The Journal of Pediatrics 2006; 149(3):314-9.

    Article  PubMed  CAS  Google Scholar 

  72. American Diabetes Association. Management of dyslipidemia in children and adolescentswith diabetes. Diabetes Care 2003; 26(7):2194-7.

    Article  Google Scholar 

  73. Ford ES, Giles WH, Myers GL, Rifai N, Ridker PM, Mannino DM. C-Reactive protein concentrationdistribution among US children and young adults: findings from the NationalHealth and Nutrition Examination Survey, 1999-2000. Clinical Chemistry 2003; 49(8):1353-7.

    Article  PubMed  CAS  Google Scholar 

  74. Iannuzzi A, Licenziati MR, Acampora C et-al. Carotid artery stiffness in obese children withthe metabolic syndrome. The American Journal of Cardiology 2006; 97(4):528-31.

    Article  PubMed  Google Scholar 

  75. Thompson DR, Obarzanek E, Franko DL et-al. Childhood overweight and cardiovascular diseaserisk factors: the National Heart, Lung, and Blood Institute Growth and Health Study. TheJournal of Pediatrics 2007; 150(1):18-25.

    Google Scholar 

  76. Quattrin T, Liu E, Shaw N, Shine B, Chiang E. Obese children who are referred to the pediatricendocrinologist: characteristics and outcome. Pediatrics 2005; 115(2):348-51.

    Article  PubMed  Google Scholar 

  77. Miller LA, Grunwald GK, Johnson SL, Krebs NF. Disease severity at time of referral forpediatric failure to thrive and obesity: time for a paradigm shiftJournal of Pediatrics 2002; 141(1):121-4.

    Article  PubMed  Google Scholar 

  78. Drobac S, Brickman W, Smith T, Binns HJ. Evaluation of a type 2 diabetes screening protocolin an urban pediatric clinic. Pediatrics 2004; 114(1):141-8.

    Article  PubMed  Google Scholar 

  79. Riley MR, Bass NM, Rosenthal P, Merriman RB. Underdiagnosis of pediatric obesity andunderscreening for fatty liver disease and metabolic syndrome by pediatricians and pediatricsubspecialists. The Journal of Pediatrics 2005; 147(6):839-42.

    Article  PubMed  Google Scholar 

  80. Eckel RH, Kahn R, Robertson RM, Rizza RA. Preventing cardiovascular disease and diabetes:a call to action from the American Diabetes Association and the American Heart Association. Circulation 2006; 113(25):2943-6.

    Article  PubMed  Google Scholar 

  81. Eckel RH, Kahn R, Robertson RM, Rizza RA. Preventing cardiovascular disease and diabetes:a call to action from the American Diabetes Association and the American Heart Association. Diabetes Care 2006; 29(7):1697-9.

    Article  PubMed  Google Scholar 

  82. Monzavi R, Dreimane D, Geffner ME et-al. Improvement in risk factors for metabolic syndromeand insulin resistance in overweight youth who are treated with lifestyle intervention. Pediatrics 2006; 117(6):e1111-8.

    Article  PubMed  Google Scholar 

  83. Krebs NF, Jacobson MS. AAP Committee on Nutrition. Prevention of pediatric overweightand obesity. Pediatrics 2003; 112(2):424-30.

    Article  PubMed  Google Scholar 

  84. National High Blood Pressure Education Program Working Group on High Blood Pressure inChildren and Adolescents. The fourth report on the diagnosis, evaluation, and treatment ofhigh blood pressure in children and adolescents. Pediatrics 2004; 114(2):555-76.

    Article  Google Scholar 

  85. American Diabetes Association. Type 2 diabetes in children and adolescents. Pediatrics 2000; 105(3):671-80.

    Article  Google Scholar 

  86. Kavey RE, Daniels SR, Lauer RM et-al. American Heart Association guidelines for primaryprevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003; 107(11):1562-6.

    Article  PubMed  Google Scholar 

  87. Steinberger J, Daniels SR. Obesity, insulin resistance, diabetes, and cardiovascular risk inchildren: an American Heart Association scientific statement. Circulation 2003; 107(10):1448-53.

    Article  PubMed  Google Scholar 

  88. Cook S, Gidding SS. Modifying cardiovascular risk in adolescent obesity. Circulation 2007; 115(17):2251-3.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, University of Rochester Medical Center, Rochester, New York

    Jennifer L. Foltz MD & Stephen R. Cook MD, MPH

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  1. Jennifer L. Foltz MD
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Editors and Affiliations

  1. Department of Pediatrics, University of Colorado Denver, Aurora, CO, 80045, USA

    Philip Scott Zeitler  & Kristen J. Nadeau  & 

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Foltz, J.L., Cook, S.R. (2008). Epidemiology of the Metabolic Syndrome and Related Disorders in Children and Adolescents. In: Zeitler, P.S., Nadeau, K.J. (eds) Insulin Resistance. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-192-5_2

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