The prevalence of the metabolic syndrome among United States preadolescents and adolescents: Refinement of a working definition and implications for future health

Context. The Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) states the importance of identifying and treating patients with the metabolic syndrome to prevent cardiovascular disease and type 2 diabetes. Limited information is available about the prevalence of the metabolic syndrome among children and adolescents in the United States, however.Objective. To estimate the prevalence of the metabolic syndrome among 8--14 year olds in the United States.Design, setting, and subjects. Analysis of 3,455 males and females ages 8--14 from the combined 1999--2000 and 2001--2002 National Health and Nutrition Examination Survey, a cross-sectional health survey of a nationally representative sample of the noninstitutionalized civilian US population.Main outcome measure. The prevalence and distribution of the metabolic syndrome among 8--14 year olds in the United States, using the National Education Program (ATP III) definition modified for age.Results. The prevalence of the metabolic syndrome among 8--14 year olds was 3.16%, excluding abnormal fasting glucose (not measured among 8--11 year olds). Among 12--14 year olds, the prevalence of the metabolic syndrome was 8.69%. With the appropriate sample weights applied, it is estimated that 841,212 US 8--14 year olds (excluding abnormal fasting glucose) and 999,680 12--14 year olds (including abnormal fasting glucose) currently have the metabolic syndrome. Logistic regression analysis showed that among both 8--14 year olds and 12--14 year olds, an overweight child is over 11 times more likely than a normal weight child to have the metabolic syndrome (p \u3c 0.0001).Conclusion. This analysis indicates that a substantial percentage of US children and adolescents, and particularly those who are overweight, are at increased risk for type 2 diabetes and premature coronary artery disease as adults and will therefore significantly impact the healthcare system in the coming decade