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Childhood Metabolic Syndrome Severity Declined Relative to HDL, Triglyceride Changes

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FROM PEDIATRICS

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The severity of childhood metabolic syndrome declined in a study of U.S. adolescents relative to increases in high-density lipoproteins (HDL) and decreases in fasting triglyceride measurements among the individuals examined, reported Arthur M. Lee of the University of Virginia, Charlottesville, and his colleagues.

The metabolic syndrome (MetS) is characterized by central obesity, high fasting glucose, high fasting triglycerides, high blood pressure (BP), and low HDL.

The researchers used regression analysis of individual waves of data from 1999 to 2012 to analyze 5,117 individuals aged 12-19 years. The data came from the Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES, 1999-2012), a cross-sectional, national, stratified, multistage probability survey conducted in 2-year waves. The severity of MetS was calculated using the Pediatric MetS z score. Patients who were pregnant, had an active hepatitis B infection, had physician-diagnosed diabetes, or were currently using antidiabetic or antihyperlipidemic medication were excluded from the study.

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Overall, a linear trend of a decreasing MetS z score (P = .030) was found despite the body mass index z score having increased significantly. While fasting triglyceride measurements declined significantly, HDL levels rose significantly.

The researchers also found temporal trends of decreasing total calorie consumption, decreasing carbohydrate consumption, and increasing unsaturated fat consumption.

“The overall decreasing trend in the MetS z score is likely secondary to the increasing trend in HDL measurements and decreasing trend in fasting triglycerides measurements, ” wrote Mr. Lee and his associates. “The increasing trend in HDL and decreasing fasting triglyceride measurements could be attributable in part to trends of decreasing carbohydrate intake and increasing unsaturated fat intake.”

The researchers recommended future studies on individuals with MetS focus on determining, “the causality of lifestyle factors in improvements of MetS severity.”

Read the study in Pediatrics (doi: 10.1542/peds.2015-3177).

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