Skip to main content
SpringerLink
Log in

Decreased high-density lipoprotein cholesterol and insulin resistance were the most common criteria in 12- to 19-year-old adolescents

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Background

Metabolic syndrome (MetS) is characterized by a group of metabolic risk factors leading to an increase in diabetes mellitus and cardiovascular diseases. It is known that the pathologic processes such as hyperinsulinemia and atherogenic risk profile associated with the development of MetS begin during childhood and adolescence.

Aim of the study

To determine the prevalence of MetS and assess the association between MetS and certain demographic and lifestyle factors in a representative adolescent population.

Methods

The study was carried out in central and ten districts located around Kayseri Province, Central Anatolia. A total of 790 adolescents aged from 12 to 19 years were selected systematically from the schools. Criteria of MetS were modified from Adult Treatment Panel III: (1) waist circumference > 90th percentile (aged between 12 and 17 years) and >102 cm in male, >88 cm in female (for aged 18 and 19 years), (2) serum triglycerides [≥136 mg/dl (aged between 12 and 16 years) and ≥150 mg/dl (for 17 and 19 years)], (3) high-density lipoprotein cholesterol [≤40 mg/dl (males) and ≤50 mg/dl (females)], (4) systolic blood pressure ≥ 95th percentile for gender, age and height, (5) insulin resistance HOMA index < 3.16. Multivariate regression model was performed to search for the association between MetS and demographic and lifestyle factors including gender, age, body mass index, settlement, socioeconomic class, smoking habit, physical activity and family history for diseases (cardiovascular diseases and diabetes mellitus).

Results

The overall prevalence of MetS was found as 10.8%. The prevalence was significantly higher in males than in females (13.5 and 8.6%, respectively). Low high-density lipoprotein cholesterol and insulin resistance were the most common criteria of the syndrome. According to the analysis, only gender and high socioeconomic class were weak-positive related factors with MetS.

Conclusions

High prevalence of MetS especially among overweight and obese adolescents is a serious health problem. Early identification of the syndrome would contribute greatly to the prevention of diabetes and cardiovascular diseases in youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agirbasli M, Cakir S, Ozme S, Ciliv G (2006) Metabolic syndrome in Turkish children and adolescents. Metabolism 55:1002–1006

    Article  CAS  Google Scholar 

  2. Alegria E, Cordero A, Laclaustra M, Grima A, Leon M (2005) Prevalence of metabolic syndrome in the Spanish Working Population: MESYAS Registry. Rev Esp Cardiol 58:797–806

    Article  Google Scholar 

  3. Atabek ME, Pirgon Ö, Kurtoglu S (2006) Prevalence of metabolic syndrome in obese Turkish children and adolescents. Diabetes Res Clin Pract 72:315–321

    Article  CAS  Google Scholar 

  4. Bayram F, Gündoğan K, Öztürk A, Yazıcı C (2006) Prevalence of metabolic syndrome in the world and Turkey. Turk Klin J Int Med Sci 2:18–24 (in Turkish)

    Google Scholar 

  5. Boney CM, Verma A, Tucker R, Vohr BR (2005) Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 115:e290–e296

    Article  Google Scholar 

  6. Braunschweig CL, Gomez S, Liang H, Tomey K, Doerfler B, Wang Y, Beebe C, Lipton R (2005) Obesity and risk factors for the metabolic syndrome among low-income, urban, African American schoolchildren: the rule rather than the exception. Am J Clin Nutr 81:970–975

    CAS  Google Scholar 

  7. Capabe ML, Alonso M, Colino E, Mustieles C, Corbaton J, Barrio R (2006) Frequency of the metabolic syndrome in obese Spanish pediatric population. Eur J Endocrinol 155:313–319

    Article  Google Scholar 

  8. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight an obesity worldwide: international survey. BMJ 320:1240–1243

    Article  CAS  Google Scholar 

  9. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH (2003) Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 157:821–827

    Article  Google Scholar 

  10. Cruz ML, Weigensberg J, Huang TT-K, Ball G, Shaibi GQ, Goran M (2004) The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 89:108–113

    Article  CAS  Google Scholar 

  11. Csabi G, Török K, Jeges S, Molnar D (2000) Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr 159:91–94

    Article  CAS  Google Scholar 

  12. Davis CL, Flickinger B, Moore D, Bassali R, Domel Baxter S, Yin Z (2005) Prevalence of cardiovascular risk factors in schoolchildren in a rural Georgia community. Am J Med Sci 330:53–59

    Article  Google Scholar 

  13. Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, Sardinha LB, Riddoch C, Andersen LB (2006) TV viewing and physical activity are independently associated with metabolic risk in children: The European Youth Heart Study. PLoS Med 3(12):e 488

    Article  Google Scholar 

  14. Esmaillzadeh A, Mirmiran P, Azadbakth L, Etemadi A, Azizi F (200) High prevalence of the metabolic syndrome in Iranian adolescents. Obesity 14:377–382

    Google Scholar 

  15. Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N (2004) Prevalence of the metabolic syndrome in American adolescents. Circulation 110:2494–2497

    Article  Google Scholar 

  16. Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359

    Article  Google Scholar 

  17. Gaillard TR, Schuster DP, Bossetti BM, Green A, Osei K (1997) The impact of socioeconomic status on cardiovascular risk factors in African-Americans at high risk for type II diabetes. Implications for syndrome X. Diabetes Care 20:745–752

    Article  CAS  Google Scholar 

  18. Garipagaoglu M, Budak N, Süt N, Akdikmen Ö, Oner N, Bundak R (2009) Obesity risk factors in Turkish children. J Ped Nurs 24:332–337

    Article  Google Scholar 

  19. Grundy SM, Cleeman JI, Merz CN, Brewer HB, Clark LT, Hunninghake DB (2004) Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 110:227–239

    Article  Google Scholar 

  20. Grundy SM, Cleemen JI, Daniels RS (2005) Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation 112:5–12

    Article  Google Scholar 

  21. International Diabetes Federation (2006) The IDF Consensus worldwide definition of the metabolic syndrome. What causes of the metabolic syndrome. IDF Communications, Belgium. Available at http://www.idf.org/metabolic-syndrome

  22. Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C (2005) 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 115:e500–e503

    Article  Google Scholar 

  23. Kim HM, Park J, Kim HS, Kim DH (2007) Prevalence of the metabolic syndrome in Korean adolescents ages 12–19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Prac 75:111–114

    Article  Google Scholar 

  24. Kraja AT, Rao DC, Weber AB (2005) An evaluation of the metabolic syndrome in a large multi-ethnic study: The Family Blood Pressure Program. Nutr Metab 2:17

    Article  Google Scholar 

  25. Lambert M, Paradis G, O’Loughlin J (2004) Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int J Obes Relat Metab Disord 28:829–832

    Article  Google Scholar 

  26. Mahley RW, Palaoglu KE, Atak Z, Dawson-Pepin J, Langlois AM, Cheung V, Onat A, Fulks P, Mahley LL, Vakar F (1995) Turkish Heart Study: lipids, lipoproteins, and apolipoproteins. J Lipid Res 36:839–859

    CAS  Google Scholar 

  27. McCarthy HD, Jarrett KV, Crawly HF (2001) The development of waist circumference percentiles in British children aged 5.0–16.9 y. Eur J Clin Nutr 55:902–907

    Article  CAS  Google Scholar 

  28. McMurrry RG, Bangdivale SI, Harrell JS, Amorim LD (2008) Adolescents with metabolic syndrome have a history of low aerobic fitness and physical activity levels. Dyn Med 7:5

    Article  Google Scholar 

  29. Miccoli R, Miachi C, Odoquardi L, Penno G, Caricato F, Giovannitti M, Pucci L, Del Prato S (2005) Prevalence of metabolic syndrome among Italian adults according to ATP III definition. Nutr Metab Cardiovasc Dis 15:250–254

    Article  Google Scholar 

  30. Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Soosd NK, Wander GS (2004) Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J 56:310–314

    Google Scholar 

  31. Monzavi R, Dreimane D, Geffner ME, Braun S, Conrad B, Klier M, Kaufman FR (2006) Improvement in risk factors for metabolic syndrome and insulin resistance in overweight youth who are treated with lifestyle intervention. Pediatrics 117:e1111–e1118

    Article  Google Scholar 

  32. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576 (supplement article)

    Article  Google Scholar 

  33. Oliveria AM, Oliveria AC, Almeida MS, Oliveria N, Adan L (2007) Influence of the family nucleus on obesity in children from northeastern Brasil: a cross-sectional study. BMC Pub Health 7:235–245

    Article  Google Scholar 

  34. Ozsahin AK, Gokcel A, Sezgin N, Akbaba M, Guvener N, Özısık L, Karademir BM (2004) Prevalence of the metabolic syndrome in a Turkish adult population. Diabetes Nutr Metab 17:230–234

    CAS  Google Scholar 

  35. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163:427–436

    Article  Google Scholar 

  36. Plourde G (2002) Impact of obesity on glucose and lipid profiles in adolescents at different age groups in relation to adulthood. BMC Fam Pract 3:18

    Article  Google Scholar 

  37. Raitikari OT, Porkka KV, Ronnemaa T, Knip M, Uhari M, Akerblom HK, Vilkari JS (1995) The role of insulin in clustering of serum lipids and blood pressure in children and adolescents. The Cardiovascular Risk in Young Finns Study. Diabetologia 38:1042–1050

    Article  Google Scholar 

  38. Salazar VB, Rodriguez MM, Guerrero RF (2005) Biochemical factors associated to cardiovascular risk among children and adolescents. Rev Med Inst Mex Seguro Soc 43:299–303

    Google Scholar 

  39. Santos AC, Ebrahim S, Barros H (2008) Gender, socio-economic status and metabolic syndrome in middle-aged and old adults. BMC Pub Health 8:62

    Article  Google Scholar 

  40. Schiel R, Beltschikow W, Kramer G, Stein G (2006) Overweight, obesity and elevated blood pressure in children and adolescents. Eur J Med Res 11:97–101

    CAS  Google Scholar 

  41. Shankuan Z, St-Onge MP, Heshka S, Heymsfield S (2004) Lifestyle, behaviours associated with lower risk of having the metabolic syndrome. Metabolism 53:1503–1511

    Article  Google Scholar 

  42. Sobal J, Stunkard AJ (1989) Socioeconomic status and obesity: a review of the literature. Psychol Bull 105:260

    Article  CAS  Google Scholar 

  43. Tresaco B, Bueno G, Moreno LA, Garagorri JM, Boeno M (2003) Insulin resistance and impaired glucose tolerance in obese children and adolescents. J Physiol Biochem 59:217–223

    Article  CAS  Google Scholar 

  44. Tumer N, Yalcinkaya F, İnce E, Ekim M, Kose K, Çakar N, Kara N, Ozkaya N, Ensari C, Önder S (1999) Blood pressure nomograms for children and adolescents in Turkey. Pediatr Nephrol 13:438–443

    Article  CAS  Google Scholar 

  45. Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P (2005) Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child 90:10–14

    Article  CAS  Google Scholar 

  46. Weiss R, Dufour S, Taksali SE, Tamborlane WV, Peterson KF, Bonadonna RC, Boselli L, Barbetto G, Allen K, Rife F, Savoye M, Dziura J, Sherwin R, Shulman GI, Caprio S (2003) Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet 362:951–957

    Article  CAS  Google Scholar 

  47. Weiss R, Dziura J, Burgert T, Tamborlane W, Taksali S, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin R, Caprio S (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374

    Article  CAS  Google Scholar 

  48. Yoshinaga M, TanakA S, Shimago A, Sameshima K, Nishi J, Nomura Y, Kawano Y, Hashiguchi J, Ichiki T, Shimizu S (2005) Metabolic syndrome in overweight and obese Japanese children. Obes Res 13:1135–1140

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutrition and Dietetics, Atatürk School of Health, Erciyes University, 38039, Kayseri, Turkey

    Nurten Budak

  2. Department of Biostatistics, Medical Faculty, Erciyes University, 38039, Kayseri, Turkey

    Ahmet Öztürk

  3. Department of Family Medicine, Medical Faculty, Erciyes University, 38039, Kayseri, Turkey

    Mümtaz Mazicioglu

  4. Department of Biochemistry and Clinical Biochemistry, Medical Faculty, Erciyes University, 38039, Kayseri, Turkey

    Cevad Yazici

  5. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical Faculty, Erciyes University, 38039, Kayseri, Turkey

    Fahri Bayram

  6. Division of Endocrinology and Metabolism, Department of Pediatrics, Medical Faculty, Erciyes University, 38039, Kayseri, Turkey

    Selim Kurtoglu

Authors
  1. Nurten Budak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmet Öztürk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mümtaz Mazicioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cevad Yazici
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fahri Bayram
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Selim Kurtoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nurten Budak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Budak, N., Öztürk, A., Mazicioglu, M. et al. Decreased high-density lipoprotein cholesterol and insulin resistance were the most common criteria in 12- to 19-year-old adolescents. Eur J Nutr 49, 219–225 (2010). https://doi.org/10.1007/s00394-009-0066-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-009-0066-2

Keywords

Search

Navigation