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Which metabolic syndrome criteria best predict non-alcoholic fatty liver disease in children?

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Abstract

Objective

The aim of this study was to identify which metabolic syndrome criteria (WHO or IDF) better reflect the presence of non-alcoholic fatty liver disease (NAFLD) and to determine the prevalence of metabolic syndrome (MS) and NAFLD.

Methods

Two hundred and seventeen obese children and adolescents, 8–15 years of age (body mass index >95 p), were included in the study. Anthropometric measurements, blood pressure measurements, an oral glucose tolerance test and lipid profile were measured. MS was diagnosed according to WHO and IDF criteria. NAFLD risk ratio was assessed according to the two MS criteria.

Results

The prevalence of MS according to the IDF criteria was 43.3 %, and according to WHO criteria it was 55.2 %. NAFLD prevalence in the metabolic syndrome group according to IDF criteria was 25.5 % and this was statistically significant (p = 0.007). The prevalence of NAFLD was 20.8 % in the group with MS according to WHO criteria and this was not a statistically significant difference (p = 0.15). NAFLD hazard ratios were 7.06 (95 % CI 1.29–5.50) in the MS group according to IDF criteria and 2.02 (95 % CI 0.81–3.53) in the group with metabolic syndrome according to WHO criteria. IDF criteria were found to have a higher odds ratio.

Conclusion

The prevalence of MS depends on the diagnostic criteria used. IDF criteria give the best measure for the presence of NAFLD. NAFLD might be important as diagnostic criterion for MS.

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Abbreviations

MS:

Metabolic syndrome

IR:

Insulin resistance

NAFLD:

Non-alcoholic fatty liver disease

BMI:

Body mass index

WC:

Waist circumference

OGTT:

Oral glucose tolerance test

LDL:

Low-density lipoprotein

HDL:

High-density lipoprotein

HOMA-IR:

Homeostasis model assessment of insulin resistance

WHO:

World Health Organization criteria adapted for children

IDF:

International Diabetes Federation

References

  1. Atabek ME, Akyüz E, Selver Eklioğlu B et al (2011) The relationship between metabolic syndrome and left ventricular mass index in obese children. J Clin Res Pediatr Endocrinol 3:132–138

    Article  PubMed Central  PubMed  Google Scholar 

  2. Pacifico L, Nobili V, Anania C et al (2011) Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk. World J Gastroenterol 14(17):3082–3091

    Google Scholar 

  3. Alp H, Karaarslan S, Selver Eklioğlu B et al (2013) Association between nonalcoholic fatty liver disease and cardiovascular risk in obese children and adolescents. Can J Cardiol 29(9):1118–1125

  4. Seo HI, Cho YK, Lee WY et al (2012) Which metabolic syndrome criteria best predict the presence of non-alcoholic fatty liver disease? Diabetes Res Clin Pract 95:19–24

    Article  CAS  PubMed  Google Scholar 

  5. Kuczmarski RJ, Ogden CL, Guo SS et al (2002) 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11(246):1–190

    Google Scholar 

  6. Hatipoglu N, Ozturk A, Mazicioglu MM et al (2008) Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 167:383–389

    Article  PubMed  Google Scholar 

  7. Kurtoglu S, Akin L, Kendirci M et al (2012) The absence of insulin resistance in metabolic syndrome definition leads to underdiagnosing of metabolic risk in obese patients. Eur J Pediatr 171:1331–1337

    Article  CAS  PubMed  Google Scholar 

  8. Conwell LS, Trost SG, Brown WJ et al (2004) Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care 27:314–319

    Article  PubMed  Google Scholar 

  9. Keskin M, Kurtoglu S, Kendirci M et al (2005) Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 115:e500–e503

    Article  PubMed  Google Scholar 

  10. Goran MI, Gower BA (2001) Longitudinal study on pubertal insulin resistance. Diabetes 50:2444–2450

    Article  CAS  PubMed  Google Scholar 

  11. Katz A, Nambi SS, Mather K et al (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85:2402–2410

    Article  CAS  PubMed  Google Scholar 

  12. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  13. Zimmet P, Alberti KG, Kaufman F et al (2007) IDF Consensus Group. The metabolic syndrome in children and adolescents—an IDF consensus report. Pediatr Diabetes 8:299–306

    Article  PubMed  Google Scholar 

  14. Cook S, Auinger P, Li C et al (2008) Metabolic syndrome rates in United States adolescents, from the National Health and Nutrition Examination Survey, 1999–2002. J Pediatr 152:165–170

    Article  PubMed  Google Scholar 

  15. Love-Osborne KA, Nadeau KJ, Sheeder J et al (2008) Presence of the metabolic syndrome in obese adolescents predicts impaired glucose tolerance and nonalcoholic fatty liver disease. J Adolesc Health 42:543–548

    Article  PubMed Central  PubMed  Google Scholar 

  16. Caballería L, Pera G, Rodríguez L, Auladell MA, Bernad J, Canut S, Torán P (2012) Metabolic syndrome and nonalcoholic fatty liver disease in a Spanish population: influence of the diagnostic criteria used. Eur J Gastroenterol Hepatol 24(9):1007–1011

    Article  PubMed  Google Scholar 

  17. Strauss RS, Barlow SE, Dietz WH (2000) Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr 136:727–733

    CAS  PubMed  Google Scholar 

  18. Sartorio A, Del Col A, Agosti F et al (2007) Predictors of non-alcoholic fatty liver disease in obese children. Eur J Clin Nutr 61:877–883

    Article  CAS  PubMed  Google Scholar 

  19. Chan DF, Li AM, Chu WC et al (2004) Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord 28:1257–1263

    Article  CAS  PubMed  Google Scholar 

  20. Gökçe S, Atbinici Z, Aycan Z, Cınar HG, Zorlu P (2013) The relationship between pediatric nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children. Pediatr Cardiol 34:308–315

    Article  PubMed  Google Scholar 

  21. Uchil D, Pipalia D, Chawla M et al (2009) Non-alcoholic fatty liver disease (NAFLD)—the hepatic component of metabolic syndrome. J Assoc Physicians India 57:201–204

    PubMed  Google Scholar 

  22. Hamaguchi M, Takeda N, Kojima T et al (2012) Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome. World J Gastroenterol 7(18):1508–1516

    Article  Google Scholar 

  23. Chen SH, He F, Zhou HL et al (2011) Relationship between nonalcoholic fatty liver disease and metabolic syndrome. J Dig Dis 12:125–130

    Article  PubMed  Google Scholar 

  24. Weiss R, Dziura J, Burgert TS et al (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374

    Article  CAS  PubMed  Google Scholar 

  25. Cizmecioğlu FM, Hatun S, Kalaça S (2008) Metabolic syndrome in obese Turkish children and adolescents: comparison of two diagnostic models. Turk J Pediatr 50:359–365

    PubMed  Google Scholar 

  26. Isomaa B, Almgren P, Tuomi T et al (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24:683–689

    Article  CAS  PubMed  Google Scholar 

  27. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH (2003) Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 157:821–827

    Article  PubMed  Google Scholar 

  28. Cruz ML, Weigensberg MJ, Huang TT et al (2004) The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 89:108–113

    Article  CAS  PubMed  Google Scholar 

  29. Atabek ME, Pirgon O, Kurtoglu S (2006) Prevalence of metabolic syndrome in obese Turkish children and adolescents. Diabetes Res Clin Pract 72:315–321

    Article  CAS  PubMed  Google Scholar 

  30. Fu JF, Shi HB, Liu LR et al (2011) Non-alcoholic fatty liver disease: an early mediator predicting metabolic syndrome in obese children? World J Gastroenterol 14(17):735–742

    Article  Google Scholar 

  31. Ying X, Jiang Y, Qian Y et al (2012) Association between insulin resistance, metabolic syndrome and nonalcoholic fatty liver disease in Chinese adults. Iran J Public Health 41:45–49

    CAS  PubMed Central  PubMed  Google Scholar 

  32. Boyraz M, Cekmez F, Karaoglu A, Cinaz P, Durak M, Bideci A (2013) Serum adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease. Biomark Med 7:737–745

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Necmettin Erbakan University, School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Konya, 42080, Turkey

    Mehmet Emre Atabek, Beray Selver Eklioglu & Nesibe Akyürek

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  1. Mehmet Emre Atabek
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  2. Beray Selver Eklioglu
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  3. Nesibe Akyürek
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Correspondence to Beray Selver Eklioglu.

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Atabek, M.E., Selver Eklioglu, B. & Akyürek, N. Which metabolic syndrome criteria best predict non-alcoholic fatty liver disease in children?. Eat Weight Disord 19, 495–501 (2014). https://doi.org/10.1007/s40519-014-0129-0

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  • DOI: https://doi.org/10.1007/s40519-014-0129-0

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