Abstract 10180: Stability of Metabolic Syndrome During the Transition to Adulthood: A 7-Year Follow Up Study
Background: Short term studies suggest Metabolic Syndrome (MetS) is highly unstable in youth. Data on long term stability of MetS are lacking. We assess stability of MetS over 7 yrs during the transition to adulthood.
Methods: In ′01-′02, 728 healthy 10–19 yr olds (50% female , 54% non-Hispanic white, baseline age =14.0+/−2.1 yrs) from a Midwestern public school district had a physical exam (waist circumference, ht, wt, BP) and fasting morning blood sample drawn (glucose, HDL, trig). These measures were reassessed 3 and 7 yrs later. MetS was defined using the current AHA/NHLBI definition which requires the presence of >=3 risk criteria.
Results: At baseline, 21% were overweight and 19% obese; MetS prevalence=3.2%. MetS was more common in obese youth (12.9% obese vs 2.0% overweight vs 0.5% normal weight, p<0.001). Weight status did not change for 73.8% of normal wt, 42.1% of overweight and 77.8% of obese subjects. At 7 yrs, obesity prevalence=25.4% and MetS prevalence had tripled to 10.3%. 25.1% of persistently obese subjects developed MetS vs. 4.7% of persistently overweight subjects and 1.0% of normal weight subjects (p<0.001). 24.5% of overweight subjects who became obese (N=49) also developed MetS vs. 4.8% of those who did not become obese (N=62, p=0.001). No overweight/obese subject (N=71) who dropped a weight category developed MetS. MetS remittance rates were higher than incidence rates−−52.1% overall (N=12/23 baseline MetS+). All (N=5/5) baseline MetS+ subjects who dropped a weight category had their MetS remit. Among persistently obese baseline MetS+ subjects (N=14), 42.8% remitted, 50% persisted and one (7.2%) had unstable MetS, meaning MetS remitted at 3 yrs but reappeared at 7 yrs. BMI increased over the 7 yrs for 50.0% of the baseline MetS+ persistently obese subjects who had MetS remit. 13.8% (N=16) of MetS cases were due to those who were Mets+ only at the 3 yr visit; 62.5% of those with unstable MetS did not change wt categories, including 2 persistently normal wt subjects.
Conclusions: During the transition to adulthood, rising MetS prevalence is due to increasing prevalence of obesity, not persistence of MetS within individuals. There is marked instability in both gain and loss of the diagnosis, not all of which is related to changes in BMI or weight status.
- © 2010 by American Heart Association, Inc.