Metabolic Syndrome in Adolescents: Time Differences and Component Analysis
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Background: Metabolic syndrome (MetS) describes a cluster of characteristics associated with insulin resistance and type 2 diabetes. Researchers adapted adult criteria to develop cutoffs for adolescents. Purposes of this descriptive study were to apply a uniform definition of MetS to adolescents over four time periods, to examine changes in MetS prevalence and its components over time, and to examine the sensitivity of the MetS component of fasting glucose. Methods: Data were drawn from the National Health and Nutrition Examination Survey (NHANES) 1999-2000, 2001-2002, 2003-2004, and 2005-2006. N=652, 970, 926, and 1,840 for the respective two-year samples. Exclusions were pregnancy, and use of insulin, medications regulating blood glucose or anti-hypertensives. Percents with elevated triglycerides, glucose, blood pressure, waist circumference and low HDL-C were calculated; percent with MetS (three of the five criteria above) was measured. Results: Prevalence of elevated triglycerides increased from 23% to 26.2%; elevated glucose remained stable for <110 mg/dL, but increased from 8.9% to 10.5% for <100 mg/dL; elevated blood pressure increased from 15.5% to 18.6%; elevated waist circumference increased from 15.5% to 18.6%; low levels of HDL-C decreased from 22.3% to 17.2%. Significance: MetS prevalence fell from 1999-2006 (from 8.4% to 6.9%), while several components identifying the syndrome worsened. Increases in blood pressure and waist circumference are particularly disturbing; they are associated with type 2 diabetes and cardiovascular disease. Conclusions: The components of MetS provide an epidemiological method for analyzing health of U.S. adolescents over time. Trends can inform health practitioners and researchers in addressing health concerns.