Yonsei Med J.  2011 Sep;52(5):746-752. 10.3349/ymj.2011.52.5.746.

Impact of Obesity on Metabolic Syndrome among Adolescents as Compared with Adults in Korea

• Kim SJ
• Lee J
• Nam CM
• Lee SY

• KMID: 1108066
• DOI: http://doi.org/10.3349/ymj.2011.52.5.746

Abstract

PURPOSE
This study aimed to estimate the prevalence of metabolic syndrome (MetS) in adolescents and adults and to compare the impact of body mass index (BMI) on MetS between adolescents and adults in Korea.
MATERIALS AND METHODS
Data were used from 6,186 subjects aged 10 years or more who representatively participated in the Third Korean National Health and Nutrition Examination Survey. Body composition, blood test, and health behavioral factors were measured. We used the definition of MetS from the modified the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) for adolescents and the NCEP-ATP III for adults.
RESULTS
The prevalence of MetS was 6.4 (95% CI 4.5-8.4) and 22.3 (95% CI 20.8-23.8) in adolescents and adults, respectively. The prevalence of MetS among normal, overweight and obese body types for both adolescents and adults differed significantly (p<0.001). After adjustment for covariates, the odds ratios (ORs) of obese and overweight body types on MetS compared with normal BMI in adolescents were 28.1 (95% CI 11.4-69.1) and 8.7 (95% CI 2.3-33.1), respectively. The ORs of obesity on MetS were 32.0 (95% CI 7.5-136.9), 32.2 (95% CI 12.8-80.8), 16.2 (95% CI 9.4-27.9), 7.6 (95% CI 4.7-12.2) and 9.9 (95% CI 6.8-14.6) for subjects in their 20's, 30's, 40's, 50's and older than 60, in order.
CONCLUSION
We found that the prevalence of MetS increased with age and was more prevalent in males. Moreover, the group younger than 39 years of age had a higher chance of having MetS than the group older than 40 years of age. Weight control is more vital in the earlier stages of life for the prevention and management of MetS.

Keyword

Obesity; metabolic syndrome X; prevalence; adolescents; adults

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Child
Female
Health Surveys
Humans
Male
Metabolic Syndrome X/*complications/epidemiology/prevention & control
Middle Aged
Obesity/*complications
Odds Ratio
Overweight/complications
Prevalence
Republic of Korea/epidemiology
Young Adult

Figure

• 

  Fig. 1 Prevalence of metabolic syndrome by gender and age group. Bars are confidence intervals. *Criteria of metabolic syndrome from Table 1 were applied.

• 

  Fig. 2 Comparison of prevalence of metabolic syndrome in Korean adolescents by different criteria. Bars are confidence intervals. *Waist circumference ≥90th percentile for age and gender, triglyceride ≥110 mg/dL, HDL-cholesterol ≤40 mg/dL, blood pressure ≥90th percentile for age, gender, height (75th percentile for age and gender, triglyceride ≥100 mg/dL, HDL-cholesterol <50 mg/dL, blood pressure ≥90th percentile for age, gender, height (

Reference

1. Kimm SY, Obarzanek E. Childhood obesity: a new pandemic of the new millennium. Pediatrics. 2002. 110:1003–1007.

2. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002. 360:473–482.

3. Strauss RS, Pollack HA. Epidemic increase in childhood overweight, 1986-1998. JAMA. 2001. 286:2845–2848.

4. Park YS, Lee DH, Choi JM, Kang YJ, Kim CH. Trend of obesity in school age children in seoul over the past 23 years. Korean J Pediatr. 2004. 47:247–257.

5. Weiss R, Caprio S. The metabolic consequences of childhood obesity. Best Pract Res Clin Endocrinol Metab. 2005. 19:405–419.

6. Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotype among u.s. Adolescents, 1999-2000. Diabetes Care. 2004. 27:2438–2443.

7. Dolan LM, Bean J, D'Alessio D, Cohen RM, Morrison JA, Goodman E, et al. Frequency of abnormal carbohydrate metabolism and diabetes in a population-based screening of adolescents. J Pediatr. 2005. 146:751–758.

8. Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr. 2008. 152:160–164.

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

10. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004. 110:2494–2497.

11. Kim HM, Park J, Kim HS, Kim DH. Prevalence of the metabolic syndrome in Korean adolescents aged 12-19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Pract. 2007. 75:111–114.

12. Ministry of Health and Welfare. The third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 - Health Examination -. 2006. Seoul, Korea: Ministry of Health and Welfare.

13. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001. 285:2486–2497.

14. World Health Organization Regional Office for the Western Pacific (WPRO), the International Association for the Study of Obesity (IASO) and the International Obesity Task Force (IOTF). The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. 2000. Melbourne: Health Communication Australia.

15. Koplan JP, Liverman CT, Kraak VA, editors. Committee on the Prevention of Obesity in Children and Youth. Preventing Childhood Obesity: Health in the balance, Institute of Medicine. 2004. Accessed June11,2009. National Academy of Sciences;Available at: http://www.iom.edu/report.asp?id=22596.

16. Korean Center for Disease Control and Prevention. The Korean Pediatric Society. Committee for Korean Children and Adolescents Growth Standard. 2007 Korean Children and Adolescents Growth Standard.

17. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004. 114:555–576.

18. Alberti KG, Zimmet PZ. 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. 1998. 15:539–553.

19. Rosenbaum P, Gimeno SG, Sanudo A, Franco LJ, Ferreira SR. Japanese-Brazilian Diabetes Study Group. Analysis of criteria for metabolic syndrome in a population-based study of Japanese-Brazilians. Diabetes Obes Metab. 2005. 7:352–359.

20. Dhanaraj E, Bhansali A, Jaggi S, Dutta P, Jain S, Tiwari P, et al. Predictors of metabolic syndrome in Asian north Indians with newly detected type 2 diabetes. Indian J Med Res. 2009. 129:506–514.

21. Li Y, Yang X, Zhai F, Kok FJ, Zhao W, Piao J, et al. Prevalence of the metabolic syndrome in Chinese adolescents. Br J Nutr. 2008. 99:565–570.

22. Esmaillzadeh A, Mirmiran P, Azadbakht L, Etemadi A, Azizi F. High prevalence of the metabolic syndrome in Iranian adolescents. Obesity (Silver Spring). 2006. 14:377–382.

23. Kim HM, Park J, Ryu SY, Kim J. The effect of menopause on the metabolic syndrome among Korean women: the Korean National Health and Nutrition Examination Survey, 2001. Diabetes Care. 2007. 30:701–706.

24. Park HS, Oh SW, Cho SI, Choi WH, Kim YS. The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol. 2004. 33:328–336.

25. Poehlman ET, Toth MJ, Gardner AW. Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med. 1995. 123:673–675.

26. Korean Center for Disease Control and Prevention. In-depth analyses of the Third National Health and Nutrition Examination Survey: the Health Examination Part. 2007. 62–63.

27. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med. 2003. 163:427–436.

28. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005. 28:2745–2749.

29. Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH. Prevalence of the metabolic syndrome among U.S. adolescents using the definition from the International Diabetes Federation. Diabetes Care. 2008. 31:587–589.

30. Kim HM, Kim DJ, Jung IH, Park C, Park J. Prevalence of the metabolic syndrome among Korean adults using the new International Diabetes Federation definition and the new abdominal obesity criteria for the Korean people. Diabetes Res Clin Pract. 2007. 77:99–106.