Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur

A case control study

Bee S. Wee, Bee Koon Poh, Awang Bulgiba, Mohd N. Ismail, Ruzita Abd. Talib, Andrew P. Hills

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs. Methods. A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome. Results: Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC 90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds. Conclusions: We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.

Original languageEnglish
Article number333
JournalBMC Public Health
Volume11
DOIs
Publication statusPublished - 2011

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Case-Control Studies
Weights and Measures
Waist Circumference
Pediatric Obesity
Malaysia
Body Composition
LDL Cholesterol
HDL Cholesterol
Communicable Diseases
Blood Glucose
Adipose Tissue
Fasting
Triglycerides
Logistic Models
Cholesterol
Blood Pressure
Hypertension
Lipids

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur : A case control study. / Wee, Bee S.; Poh, Bee Koon; Bulgiba, Awang; Ismail, Mohd N.; Abd. Talib, Ruzita; Hills, Andrew P.

In: BMC Public Health, Vol. 11, 333, 2011.

Research output: Contribution to journalArticle

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abstract = "Background: With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs. Methods. A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome. Results: Participants comprised 60.9{\%} (n = 245) Malay, 30.9{\%} (n = 124) Chinese and 8.2{\%} (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC 90th percentile was found to have the highest odds (OR = 189.0; 95{\%}CI 70.8, 504.8), followed by HDL-C1.03 mmol/L (OR = 5.0; 95{\%}CI 2.4, 11.1) and high BP (OR = 4.2; 95{\%}CI 1.3, 18.7). Metabolic syndrome was found in 5.3{\%} of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95{\%}CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95{\%}CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95{\%}CI 0.0, 2.7) having the lowest odds. Conclusions: We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.",
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