Cardiometabolic risk factors and metabolic syndrome based on severity of obesity in Korean children and adolescents: data from the Korea National Health and Nutrition Examination Survey 2007–2018
1
조회
0
다운로드
17
인용
0
참고문헌
키워드
초록
Purpose: Data regarding cardiometabolic risk factors (CMRFs) and metabolic syndrome (MetS) by body mass index (BMI) category in Korean youth are sparse. Methods: Among the participants of the Korea National Health and Nutrition Examination Survey 2007–2018, 9,984 youth aged 10–18 years were included in the study. Participants were classified into 4 groups based on BMI status: normal weight, overweight, class I, and class II/III obesity. CMRF prevalence, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, glycated hemoglobin, and MetS, were determined using the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria based on BMI category. Results: The prevalence of overweight, class I, class II, and class III obesity was 9.52%, 7.73%, 2.10%, and 0.32%, respectively. Mean CMRF values increased with BMI, except high-density lipoprotein cholesterol. Age- and sex-adjusted odds ratios (ORs) for prediction of CMRFs also increased with BMI. Adjusted ORs for MetS among overweight, class I, and class II/II obesity were 54.2, 283.3, and 950.3 for IDF criteria and 9.56, 37.9, and 126.8 for NCEP-ATP III criteria, respectively (all P<0.001). Conclusion: Class II and III obesity in Korean children and adolescents was associated with significantly increased CMRF and MetS prevalence. Therefore, it can be useful to measure CMRFs in obese children and adolescents. Further studies are required to establish screening guidelines based on obesity severity.
Abstract
Purpose: Data regarding cardiometabolic risk factors (CMRFs) and metabolic syndrome (MetS) by body mass index (BMI) category in Korean youth are sparse. Methods: Among the participants of the Korea National Health and Nutrition Examination Survey 2007–2018, 9,984 youth aged 10–18 years were included in the study. Participants were classified into 4 groups based on BMI status: normal weight, overweight, class I, and class II/III obesity. CMRF prevalence, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, glycated hemoglobin, and MetS, were determined using the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria based on BMI category. Results: The prevalence of overweight, class I, class II, and class III obesity was 9.52%, 7.73%, 2.10%, and 0.32%, respectively. Mean CMRF values increased with BMI, except high-density lipoprotein cholesterol. Age- and sex-adjusted odds ratios (ORs) for prediction of CMRFs also increased with BMI. Adjusted ORs for MetS among overweight, class I, and class II/II obesity were 54.2, 283.3, and 950.3 for IDF criteria and 9.56, 37.9, and 126.8 for NCEP-ATP III criteria, respectively (all P<0.001). Conclusion: Class II and III obesity in Korean children and adolescents was associated with significantly increased CMRF and MetS prevalence. Therefore, it can be useful to measure CMRFs in obese children and adolescents. Further studies are required to establish screening guidelines based on obesity severity.
참고문헌 (38)
- NCD Risk Factor Collaboration(NCD-RisC), "Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416population-based measurement studies in 128·9 million children, adolescents, and adults", Lancet, 390, pp.2627~2642 (2017)
- 김재현, "Secular Trends in Pediatric Overweight and Obesity in Korea", Journal of Obesity & Metabolic Syndrome, 29(1), pp.12~17 (2020), 대한비만학회[DOI]
- Lim S, "Changes in metabolic syndrome in American and Korean youth, 1997-2008", Pediatrics, 131, pp.e214~e222 (2013)
- Park MJ, "Prevalence and trends of metabolic syndrome among Korean adolescents : from the Korean NHANES survey, 1998-2005", J Pediatr, 155, pp.529~534 (2009)
- 박성익, "Ten-Year Trends of Metabolic Syndrome Prevalence and Nutrient Intake among Korean Children and Adolescents: A Population-Based Study", Yonsei Medical Journal, 62(4), pp.344~351 (2021), 연세대학교의과대학[DOI]
- 오경원, "한국 소아청소년의 비만 유병률 추이: 1997년과 2005년 비교", Clinical and Experimental Pediatrics, 51(9), pp.950~955 (2008), 대한소아청소년과학회
- Skinner AC, "Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012", JAMA Pediatr, 168, pp.561~566 (2014)
- Skinner AC, "Cardiometabolic risks and severity of obesity in children and young adults", N Engl J Med, 373, pp.1307~1317 (2015)
- Valerio G, "Severe obesity and cardiometabolic risk in children : comparison from two international classification systems", PLoS One, 8, pp.e83793~ (2013)
- US Preventive Services Task Force, "Screening for obesity in children and adolescents : US Preventive Services Task Force recommendation statement", Pediatrics, 125, pp.361~367 (2010)
- Kassi E, "Metabolic syndrome : definitions and controversies", BMC Med, 9, pp.48~ (2011)
- DeFronzo RA, "Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease", Diabetes Care, 14, pp.173~194 (1991)
- Magnussen CG, "Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 diabetes mellitus but is no better than body mass index alone : the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study", Circulation, 122, pp.1604~1611 (2010)
- Morrison JA, "Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later", J Pediatr, 152, pp.201~206 (2008)
- Reisinger C, "The prevalence of pediatric metabolic syndrome-a critical look on the discrepancies between definitions and its clinical importance", Int J Obes(Lond), 45, pp.12~24 (2021)
- Skelton JA, "Prevalence and trends of severe obesity among US children and adolescents", Acad Pediatr, 9, pp.322~329 (2009)
- Cho WK, "Metabolic risk factors in Korean adolescents with severe obesity : results from the Korea National Health and Nutrition Examination Surveys(K-NHANES)2007-2014", Diabetes Res Clin Pract, 138, pp.169~176 (2018)
- Kweon S, "Data resource profile : the Korea National Health and Nutrition Examination Survey(KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)
- 김재현, "The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects", Clinical and Experimental Pediatrics, 61(5), pp.135~149 (2018), 대한소아청소년과학회
- Styne DM, "Pediatric obesity-assessment, treatment, and prevention : an Endocrine Society Clinical Practice Guideline", J Clin Endocrinol Metab, 102, pp.709~757 (2017)
- Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, "Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report", Pediatrics, 128(Suppl 5(Suppl 5)), pp.S213~S256 (2011)
- Jung Sub Lim, "2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents", Clinical and Experimental Pediatrics, 63(12), pp.454~462 (2020), 대한소아청소년과학회[DOI]
- 김성혜, "Blood Pressure Reference Values for Normal Weight Korean Children and Adolescents: Data from The Korea National Health and Nutrition Examination Survey 1998–2016: The Korean Working Group of Pediatric Hypertension", Korean Circulation Journal, 49(12), pp.1167~1180 (2019), 대한심장학회[DOI]
- American Diabetes Association, "2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021", Diabetes Care, 44(Suppl 1), pp.S15~S33 (2021)
- Zimmet P, "The metabolic syndrome in children and adolescents-an IDF consensus report", Pediatr Diabetes, 8, pp.299~306 (2007)
- Cook S, "Prevalence of a metabolic syndrome phenotype in adolescents : findings from the third National Health and Nutrition Examination Survey, 1988-1994", Arch Pediatr Adolesc Med, 157, pp.821~827 (2003)
- Czeczelewski M, "Association of body composition indexes with cardio-metabolic risk factors", Obes Med, 17, pp.100171~ (2020)
- Inge TH, "The effect of obesity in adolescence on adult health status", Pediatrics, 132, pp.1098~1104 (2013)
- Kelly AS, "Severe obesity in children and adolescents : identification, associated health risks, and treatment approaches : a scientific statement from the American Heart Association", Circulation, 128, pp.1689~1712 (2013)
- Shou-Yu Chu, "Risk assessment of metabolic syndrome in adolescents using the triglyceride", high-density lipoprotein cholesterol ratio and the total cholesterol, Annals of Pediatric Endocrinology & Metabolism, pp.2019, 24(1)[DOI]
- Lee Seon Hwa, "Comparison of different criteria for the definition of insulin resistance and its relationship to metabolic risk in children and adolescents", Annals of Pediatric Endocrinology & Metabolism, 25(4), pp.227~233 (2020), 대한소아내분비학회[DOI]
- Geserick M, "Acceleration of BMI in early childhood and risk of sustained obesity", N Engl J Med, 379, pp.1303~1312 (2018)
- Dai XY, "Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention : a retrospective cohort study", Lipids Health Dis, 18, pp.210~ (2019)
- Valeria Castorani, "Insulin resistance and type 2 diabetes in children", Annals of Pediatric Endocrinology & Metabolism, 25(4), pp.217~226 (2020), 대한소아내분비학회[DOI]
- 전연진, "Serum ferritin level is higher in male adolescents with obesity: results from the Korean National Health and Nutrition Examination Survey 2010", Annals of Pediatric Endocrinology & Metabolism, 18(3), pp.141~147 (2013), 대한소아내분비학회
- Ward ZJ, "Simulation of growth trajectories of childhood obesity into adulthood", N Engl J Med, 377, pp.2145~2153 (2017)
- Joon Young Kim, "Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes?", Annals of Pediatric Endocrinology & Metabolism, 25(4), pp.208~216 (2020), 대한소아내분비학회[DOI]
- Cunningham SA, "Incidence of childhood obesity in the United States", N Engl J Med, 370, pp.403~411 (2014)