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Findings From the Third National Health and Nutrition Examination Survey, 1988-1994

Stephen Cook, MD; Michael Weitzman, MD; Peggy Auinger, MS; Michael Nguyen; William H. Dietz, MD, PhD

Arch Pediatr Adolesc Med. 2003;157:821-827.

Background  In adults the metabolic syndrome imposes a substantial risk for type 2 diabetes mellitus and premature coronary heart disease. Even so, no national estimate is currently available of the prevalence of this syndrome in adolescents.

Objective  To estimate the prevalence and distribution of a metabolic syndrome among adolescents in the United States.

Design and Setting  Analyses of cross-sectional data obtained from the Third National Health and Nutrition Examination Survey (1988-1994), which was administered to a representative sample of the noninstitutionalized civilian population of the United States.

Participants  Male and female respondents aged 12 to 19 years (n = 2430).

Main Outcome Measures  The prevalence and distribution of a metabolic syndrome among US adolescents, using the National Cholesterol Education Program (Adult Treatment Panel III) definition modified for age.

Results  The overall prevalence of the metabolic syndrome among adolescents aged 12 to 19 years was 4.2%; 6.1% of males and 2.1% of females were affected (P= .01). The syndrome was present in 28.7% of overweight adolescents (body mass index [BMI], 95th percentile) compared with 6.8% of at-risk adolescents (BMI, 85th to <95th percentile) and 0.1% of those with a BMI below the 85th percentile (P<.001). Based on population-weighted estimates, approximately 910 000 US adolescents have the metabolic syndrome.

Conclusions  Perhaps 4% of adolescents and nearly 30% of overweight adolescents in the United States meet these criteria for a metabolic syndrome, a constellation of metabolic derangements associated with obesity. These findings may have significant implications for both public health and clinical interventions directed at this high-risk group of mostly overweight young people.

From the Strong Children's Research Center, Department of Pediatrics, University of Rochester School of Medicine and Dentistry (Drs Cook and Weitzman, Ms Auinger, and Mr Nguyen), and the American Academy of Pediatrics Center for Child Health Research (Dr Weitzman, Ms Auinger, and Mr Nguyen), Rochester, NY; and the Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Dietz).

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