Metabolic syndrome in kids likely to persist

NEW YORK Fri Feb 15, 2008 3:22pm EST

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NEW YORK (Reuters Health) - Children with a clustering of cardiovascular risk factors that define the so-called metabolic syndrome are very likely to have the syndrome in mid-adulthood, or even overt heart disease or diabetes, according to a new study.

The metabolic syndrome is a grouping of risk factors that indicate a high risk of developing cardiovascular disease or diabetes. The risk factors include high triglyceride levels, high glucose levels, high blood pressure, low levels of "good" HDL cholesterol, and being overweight.

The current findings stem from a 30-year follow-up of 814 students who were between 5 and 19 years old when they enrolled in a National Heart, Lung, and Blood Institute study between 1973 and 1976.

"In the follow-up study, participants who had metabolic syndrome as children were about 13-times more likely to have cardiovascular disease and 6.5-times more likely to have type 2 diabetes than participants who did not have metabolic syndrome as children," Dr. John A. Morrison of Children's Hospital Medical Center, Cincinnati, noted in comments to Reuters Health.

Being able to identify children who are at increased risk of adult metabolic syndrome and type 2 diabetes would allow prevention efforts to start early, Morrison and his colleagues point out in the Journal of Pediatrics.

Despite the increased odds, most children with the metabolic syndrome did not have cardiovascular disease or diabetes when they were 30 to 48 years old, noted Morrison. That "reminds us that these outcomes are relatively rare in the late 30s and early 40s," he said. "However, it tells us that the people who had this cluster of factors were at much greater risk of having these outcomes."

The follow-up data also confirm that metabolic syndrome is strongly associated with overweight and obesity.

"Obesity is strongly associated with insulin resistance, low levels of HDL, high blood pressure, and high triglycerides. So it should not surprise us that people who were overweight as kids turn out to be overweight as adults -- and have high levels of all these factors and be at greater risk of the major outcomes associated with these factors," Morrison said.

He advised that overweight children should have their cholesterol, triglycerides, blood pressure and insulin levels checked. "If these are high, try to increase the child's physical activity level, aiming at holding the weight constant in younger children while height increases," Morrison recommended. "In adolescents who have attained full height, weight loss should be attempted."

J Pediatr 2008;152:201-206.

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