Metabolic Risk Factor Prevalence in Children Participating in a Family‐Based Community Diabetes Prevention Program
Authors: Ussery Christopher , Going Scott , Roe Denise , Kutob Randa , Stump Craig , Merchant Nirav , Hingle Melanie 
Published: November 2023

Objective

Metabolic syndrome (MetS) is a cluster of conditions whose collective presence is used as a prognostic indicator for increased risk of type 2 diabetes (T2D) and cardiovascular disease (CVD). In children and adolescents, maturation and growth complicate interpretation of MetS risk factors and no consensus definition exists; however, common risk factors include central obesity, hyperglycemia, low HDL‐c, and high triglycerides (TG). Health professionals engaged in diabetes prevention must consider that, as in adults, T2D and CVD risk factors may cluster and children with one risk factor are likely to have others. Understanding who is at risk and diverting appropriate resources to screening is critical to preventing chronic disease later in life. The purpose of this study was to characterize the prevalence of metabolic risk factors in overweight and obese 9–12‐year‐old children, a developmental stage associated with increased metabolic risk.

Methods

Children, aged 9–12‐years‐old, were recruited to participate in a family‐based community diabetes prevention trial. Inclusion criteria were BMI ≥85th percentile for age‐ and sex, and ≥ 1 T2D risk factor (e.g., family history of T2D, ethnic minority). Height, weight, and waist circumference were measured by trained staff; BMI was calculated and children categorized as overweight/obese using CDC 2000 growth curves. Fasting blood glucose, insulin, TG, LDL‐c, and HDL‐c were assessed from each participant at J2 Laboratories (Tucson, AZ). Systolic and diastolic blood pressure (SBP, DBP) was measured on the non‐dominant arm using the Omron HBP‐1300‐PK Monitor. Demographic data (child age, gender, race/ethnicity, family history of T2D) was collected via questionnaire. MetS was defined using cut points for children established by Jessup and Harrell 2005; TG ≥ 110mg/dL, fasting glucose ≥ 110mg/dL, BP ≥ 90th percentile, HDL‐c ≤ 40mg/dL, with 3 out of the 4 criteria indicating MetS.

Results

Twenty‐eight children (age, 10.32 ± 1.19 years) were recruited to this study; 12 (43%) male, 16 (57%) female. Four (14%) were classified as overweight and 24 (86%) obese. Prevalence of MetS was 4 (14%) (2 male, 2 female). 7 (25%) had 2 risk factors, and 10 (36%) had one. 19 (68%) had a family member diagnosed with T2D. Prevalence of individual risk factors was as follows: 8 (29%) had high TG, 16 (57%) had high SBP, 4 (14%) had elevated fasting glucose, and 7 (25%) had low HDL.

Discussion

These findings are similar to previous studies in overweight and obese pediatric populations where prevalence of MetS was 7% and 29% in overweight and obese children, respectively. While only 4 (14%) of youth in our study met Jessup's definition of MetS, 7 (25%) had at least 2 risk factors. There are no guidelines for screening of children for MetS; however, the clustering of risk factors observed in this small study of high‐risk youth suggest screening for individual metabolic risk factors is indicated when overweight/obesity with family history of T2D is present.

Support or Funding Information

This study was supported by the National Institute of Digestive and Diabetes and Kidney Diseases of the National Institutes of Health, award number R21DK100805.