Prevalence and Trends of a Metabolic Syndrome Phenotype Among U.S. Adolescents, 1999–2000

Duncan GE, Li SM, Zhou XH. Diabetes Care. 2004;27:2438-2443.

The metabolic syndrome is characterized by a cluster of risk factors, including: abdominal obesity, dyslipidemia, increased blood pressure, glucose intolerance, and hypercoagulability. The prevalence of metabolic syndrome among US adults is estimated to be 24%; however, little is known about the prevalence among adolescents in the US. The purpose of this study was to determine the prevalence of the metabolic syndrome among US adolescents as well as examine recent trends.

Data from the 1999–2000 National Health and Nutrition Examination Survey (NHANES) were used to determine the prevalence of the metabolic syndrome among 991 adolescents 12 to 19 years of age, which was compared with data from NHANES III (1988–1992). Subjects were classified as having the metabolic syndrome if they met 3 of the 5 following criteria: waist circumference ≥90th percentile (for age and sex), blood pressure ≥90th percentile (for age, sex, and height), blood glucose ≥110 mg/dL, triglycerides ≥110 mg/dL, and high-density lipoprotein (HDL) cholesterol ≤40 mg/dL.

Among US adolescents, the prevalence of the metabolic syndrome was found to have increased 66% from 4.2% (1988–1992) to 6.4% (1999–2000) (P<.001). The metabolic syndrome was found to be more prevalent in adolscent males (9.1%) than females (3.7%) (P<.01) and was also found to be more prevalent in overweight adolescents (32.1%) compared with those at risk of becoming overweight (7.1%). In total, 43% of subjects had one or more risk factors for the metabolic syndrome. Of the 5 criteria assessed, high fasting triglycerides (23.2%) and low HDL cholesterol (23.4%) were the most common, followed by abdominal obesity (11.8%), increased blood pressure (8.0%), and high glucose level (1.1%).

The results indicate that the metabolic syndrome is an emerging public health issue among US adolescents. The prevalence of the metabolic syndrome in this group increased by 66% between 1988–1992 and 1999–2000. Currently, just over 2 million adolescents are estimated to have the metabolic syndrome. Weight loss and increased physical activity are 2 effective interventions, and the importance of a healthier, more active lifestyle in adolescents is highlighted by this study.