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CLINICAL RESEARCH: METABOLIC SYNDROME IN ADOLESCENT

Development of Age-Specific Adolescent Metabolic Syndrome Criteria That Are Linked to the Adult Treatment Panel III and International Diabetes Federation Criteria

Courtney J. Jolliffe, MSc^_* and Ian Janssen, PhD^_*,,_*

^_* School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, Canada.

Manuscript received March 22, 2006; revised manuscript received August 10, 2006, accepted August 30, 2006.

^_* Reprint requests and correspondence: Dr. Ian Janssen, School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario K7L3N6, Canada. (Email: janssen{at}post.queensu.ca).

OBJECTIVES: The study objectives were to develop age-specific adolescent metabolic syndrome (MetS) criteria that were linked to the health-based Adult Treatment Panel III (ATP) and International Diabetes Federation (IDF) adult criteria.

BACKGROUND: There has been no consistency in the criteria used to diagnose the MetS in adolescents. Studies have either applied adult criteria or arbitrarily chosen adolescent high-risk cut-points.

METHODS: The adolescent (12 to 19 years old) MetS criteria developed in this study were linked to the ATP and IDF adult criteria with LMS growth curve modeling for each MetS component (waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose). Nationally representative data from the National Health and Nutrition Examination Surveys were used to develop the growth curves.

RESULTS: The growth curves for each MetS component passed through the ATP and IDF cut-points at 20 years of age such that adolescent cut-points were linked to the adult values. Age- and gender-specific cut-points for each MetS component were developed that can be used to define high-risk values in 12- to 19-year-olds. The prevalence of MetS in adolescents nearly doubled over the last decade and was 7.6% on the basis of the newly developed ATP adolescent criteria and 9.6% on the basis of the newly developed IDF adolescent criteria.

CONCLUSIONS: These new criteria should provide improved and age-appropriate approaches for diagnosing MetS among adolescents.

Abbreviations and Acronyms   ATP = Adult Treatment Panel   BMI = body mass index   CVD = cardiovascular disease   DBP = diastolic blood pressure   HDL-C = high-density lipoprotein cholesterol   IDF = International Diabetes Federation   MetS = metabolic syndrome   NHANES = National Health and Nutrition Examination Survey   NHLBI = National Heart, Lung, and Blood Institute   SBP = systolic blood pressure   TG = triglycerides   WC = waist circumference

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