Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China

Background: Identifying adolescents with metabolic syndrome (MetS) is important in China, where diabetes and MetS is highly prevalent among adults. We aimed to estimate MetS prevalence and to determine risk factors for MetS in adolescents of northeast China. Methods: This cross-sectional study was conducted from December 2010 to March 2011. We recruited 1312 healthy students from 30 high school classes and 910 who met the inclusion criteria (13.80 +/- 1.44 years, 53.3% boys) were enrolled. All subjects underwent anthropometric and biochemical examinations. MetS was defined using the definition specific for children and adolescents proposed by the International Diabetes Federation in 2007. Results: Total prevalence of MetS was 7.6% and was higher in boys than in girls (10.9% vs. 3.8%, p<0.0001). The most frequent component of MetS was low high-density lipoprotein-cholesterol (46.8%), followed by central obesity (22.5%). More than one third of adolescents were overweight or obese. Insulin resistance, hyperuricemia, abnormal lipid profiles, increased aminotransferase, overweight, and obesity were all associated with MetS. Only overweight [odds ratio (OR)=9.29, 95% confidence interval (CI) 5.36-16.00] and obesity (OR=61.85, 95% CI 32.73-116.86) evaluated with body mass index (BMI) were independent predictors for MetS. Receiver operating characteristic curve analysis revealed that BMI had high diagnostic accuracy (area under curve value 0.914, 95% CI 0.882-0.947) and the cutoff point of 23.8 kg/m(2) had maximum accuracy for determining the presence of MetS (sensitivity 92.8%, specificity 80.1%). Conclusions: MetS is highly prevalent among adolescents in northeast China and obesity is the major indicator for this disorder. Early identification and lifestyle modifications are strongly recommended.