Tool for Your Practice: Identifying Children at Risk of Developing Metabolic Syndrome IDF Definition

Identifying Children at Risk of Developing Metabolic Syndrome IDF Definition

In children aged 6 to younger than 10 years, the IDF definition of the at-risk group for later development of metabolic syndrome consists of obesity (waist circumference ≥ 90th percentile). Although metabolic syndrome should not be diagnosed in this age group, a strong message for weight reduction should be delivered for those with abdominal obesity, and further measurements should be made if there is a family history of metabolic syndrome, type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, hypertension, or obesity.

In adolescents aged 10 to younger than 16 years, metabolic syndrome can be diagnosed by abdominal obesity (waist circumference ≥ 90th percentile, or adult cutoff if lower) and the presence of 2 or more other clinical features (triglycerides ≥ 1.7 mmol/L; high-density lipoprotein cholesterol < 1.03 mmol/L; blood pressure ≥ 130 mm Hg systolic or ≥ 85 mm Hg diastolic; glucose ≥ 5.6 mmol/L [oral glucose tolerance test recommended]; or known type 2 diabetes mellitus).
For adolescents older than 16 years, existing IDF criteria for adults should be used.

"Early identification of children who are at risk of developing the syndrome, type 2 diabetes mellitus, and cardiovascular disease in later life is important," the authors write. "Circumstances in utero and in early childhood predispose a child to disorders such as obesity, dysglycaemia, and the metabolic syndrome. Furthermore, urbanisation, unhealthy diet, and sedentary lifestyle are major contributors to such disorders."

"Early detection followed by treatment — particularly lifestyle intervention — is vital to halt the progression of the metabolic syndrome in children and adolescents," the authors conclude. "Such action should reduce morbidity and mortality in adulthood and help keep to a minimum the global burden of cardiovascular disease and type 2 diabetes mellitus. Governments and society must be made more aware of the problems associated with obesity and the likelihood of progression to the metabolic syndrome in children and adolescents."

The IDF Consensus workshop was supported by Sanofi-Aventis. Some of the authors report consultancy, speaker fees, and/or research support from relevant drug companies, and one author is a shareholder in Diabetes Prevention Services.
Lancet. 2007;369:2059-2061.