1 Million Teens at Risk for Diabetes and Heart Disease

First Study to Quantify Metabolic Syndrome in Teens

August 11, 2003

Stephen Cook, M.D., pediatric research fellow, Golisano Children's Hospital at Strong

Close to 1 million adolescents in the United States — or 4 percent — are affected by a cluster of cardiac risk factors known as metabolic syndrome that is proven to lead to the early onset of diabetes or heart disease, according to a study published in the August 2003 issue of Archives of Pediatrics and Adolescent Medicine.

Researchers reviewed data on 2,430 adolescents ages 12 to 19 from a national survey to find how many of them exhibited at least three of the five factors that characterize metabolic syndrome--high blood pressure, high triglycerides, low HDL-cholesterol, high blood sugar, and abdominal obesity. The study, the first to look at this issue in teens, also showed that some factors might be more prevalent among certain racial groups.

According to Stephen Cook, M.D., lead author, and Michael Weitzman, M.D., senior author and director of the American Academy of Pediatrics’ Center for Child Health Research and professor of pediatrics at the University of Rochester, the study indicates that at least 4 percent of all U.S. adolescents and 30 percent of all overweight adolescents met the criteria for the metabolic syndrome.

These results are significant because in adults, obesity and the presence of the cardiovascular risk factors associated with metabolic syndrome, such as high blood pressure and trigylcerides, frequently lead to the development of Type II diabetes and premature coronary heart disease. Today, more than 20 percent of adults are affected by the metabolic syndrome. Before this study there was no national estimate of the number of adolescents with metabolic syndrome, or information about which groups were most susceptible.

“With this new information, when doctors see adolescent patients who are overweight, they will know to look for signs of metabolic syndrome, and to aggressively work with the patient to promote a healthier diet and lifestyle,” Weitzman said.

Obesity causes approximately 300,000 deaths a year and costs an estimated $117 billion annually in direct and indirect costs. It is approaching epidemic status in the United States, with almost one-third of adults considered obese according to their body mass index (BMI), a 61 percent increase since 1991.

Adolescents are also becoming heavier, with 15 percent of all adolescents considered overweight, up from 11 percent in 1994.  This new study points to a new cause for concern for obese adolescents, due to obesity’s now documented association with metabolic syndrome.  The study showed that 73 percent of adolescents with metabolic syndrome are overweight. 

The financial impact of metabolic syndrome may be nearly as threatening as its health risks, if teens with the syndrome develop diabetes or heart disease as adults.

 “Diabetes is a chronic and expensive disease, and if a growing number of adolescents develop it as adults, it could have huge financial impact on our nation’s healthcare system,” Cook, a research fellow in pediatrics at Golisano Children’s Hospital at Strong, said.

The study also looked at the association of race with metabolic syndrome and discovered that certain racial groups have a greater prevalence for certain risk factors. White adolescents had the highest rate of high lipids, or fatty acids, in the bloodstream at 25.5 percent, Mexican American adolescents had the highest rate of abdominal obesity at 13 percent, and black adolescents had the highest rate of elevated blood pressure at 6.2 percent.

“Now that we know how large the problem is and who is most affected by it, we can investigate what can be done to preserve the health of this high-risk group of adolescents,” Cook added.

The research study is based on the National Health and Nutritional Examination Survey that took place from 1988-1994. Cook suspects that the overall number of teens with metabolic syndrome could now be as high as seven percent, based on a known 30 percent increase in overweight teens since that time.

The study was funded through a grant from the University of Rochester Medical Center, and modified its definition of metabolic syndrome from the definition for adults outlined in the Third Report of the National Cholesterol Education Program.

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