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Prevalence of metabolic syndrome highly unstable during adolescence.

CHICAGO -- Metabolic syndrome is a markedly unstable diagnosis during the transition from adolescence to adulthood, a prospective cohort study indicates.

When 728 healthy white and black public school students, half of them boys, enrolled in the study during 2001-2002 at an average age of 14 years, at that time 3.2% met American Heart Association criteria for metabolic syndrome on the basis of having at least three of the five risk criteria.

Seven years later, prevalence of metabolic syndrome had more than tripled to 10.3%. But in the interim, 52% of those with metabolic syndrome at baseline had remitted, Dr. Elizabeth Goodman said.

Fourteen percent of subjects with metabolic syndrome had the condition only at the interim 3-year follow-up assessment, added Dr. Goodman of Massachusetts General Hospital, Boston.

Thus, most of the increase in metabolic syndrome during the transition to adulthood was attributable to the higher prevalence of obesity rather than persistence of metabolic syndrome in individuals.

At baseline, 60% of subjects were normal weight, 19% were overweight, and 21% were obese. Seven years later, 74% of youths who were normal weight at baseline remained so. Similarly, 78% of those who were obese at baseline were obese at follow-up. But only 42% of those who were overweight at baseline remained in that weight category 7 years later.

The prevalence of obesity after 7 years of follow-up was 25.4%. One-quarter of persistently obese subjects developed metabolic syndrome, compared to 4.7% of persistently overweight youths and 1% of persistently normal weight subjects. No baseline obese or overweight youths who dropped a weight category during follow-up developed metabolic syndrome.

Of the 14 persistently obese subjects who met criteria for metabolic syndrome at baseline, 6 remitted, 7 had metabolic syndrome continuously, and 1 remitted at 3 years only to once again meet criteria at 7 years. Three of the six persistently obese remitters had an increasing body mass index over the 7 years, underscoring the point that not all of the instability in gain and loss of metabolic syndrome during this period of transition is related to changes in weight status, Dr. Goodman said.

She declared having no relevant financial interests.


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Title Annotation:ENDOCRINOLOGY
Author:Jancin, Bruce
Publication:Internal Medicine News
Article Type:Clinical report
Date:Feb 15, 2011
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