Metabolic Syndrome in Adolescence: Can it be Predicted from Natal and Parental Profile? The Prediction of Metabolic Syndrome in Adolescence (PREMA) Study
Background—There are well-established predisposing factors for the development of metabolic syndrome (MetS) in childhood and/or adolescence, but no specific risk profile has been identified as yet. The PREdiction of Metabolic syndrome in Adolescence (PREMA) study was conducted (i) to construct a classification score that could detect children at high risk for MetS in adolescence, and (ii) to test its predictive accuracy.
Methods and Results—In the derivation cohort (1270 children), data from natal and parental profile, and from initial laboratory assessment at age 6-8 were used to detect independent predictors of MetS at 13-15 years according to the International Diabetes Federation definition. In the validation cohort (1091 adolescents), the discriminatory capacity of the derived prediction score was tested on an independent adolescent population. MetS was diagnosed in 105 (8%) adolescents in the derivation phase, whereas birth weight <10th percentile (odds ratio 6.02 [95% confidence intervals 2.53, 10.12]; p <0.001), birth head circumference <10th percentile (4.15 [2.04, 7.14]; p <0.001), and parental overweight or obesity (at least in one parent) (3.22 [1.30, 5.29]; p <0.01) were independently associated with diagnosis of MetS in adolescence. Among adolescents of the validation cohort (86 [8%] with MetS), the presence of all these 3 predictors predicted MetS with sensitivity 91% and specificity 98%.
Conclusions—The co-existence of low birth weight, small head circumference and parental history of overweight or obesity may be useful for detection of children at risk of developing MetS in adolescence.
- Received March 29, 2011.
- Accepted January 9, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited