Childhood Metabolic Syndrome Predicts Adult Diabetes

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Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later, by John A. Morrison and colleagues. Journal of Pediatrics 152:201–206, 2008

What is the problem and what is known about it so far?

Metabolic syndrome is the presence of three or more of the following factors: large waist circumference, high blood pressure, high triglyceride (blood fat) levels, high blood glucose, and low HDL (“good”) cholesterol. Adults with metabolic syndrome are at high risk for developing diabetes. Whether children with metabolic syndrome are at high risk for developing diabetes as adults is not known.

Why did researchers do this particular study?

The researchers wanted to see if metabolic syndrome in childhood increased the likelihood of metabolic syndrome and type 2 diabetes in adulthood.

Who was studied?

Participants included 814 individuals who had participated as children (aged 5–19 years) in a large heart disease risk study between 1973 and 1976 and as adults in its follow-up study between 2000 and 2004.

How was the study done?

The researchers collected data on participants’ personal details, height, weight, waist circumference, blood pressure, cholesterol levels, and blood glucose levels from the previous studies to find out whether participants who had metabolic syndrome as children were more likely to have metabolic syndrome or type 2 diabetes as adults. They performed statistical analyses to find out whether and how the childhood and adult conditions were related.

What did the researchers find?

Children who had metabolic syndrome, who had parents with diabetes, who were older, or who had a high body mass index were more likely to have metabolic syndrome as adults. Similarly, children who had metabolic syndrome, who were older, who were African American, or who had parents with diabetes were more likely to have type 2 diabetes as adults.

What were the limitations of the study?

The study relied on participants’ reports of their own and their parents’ diabetes, which may have been inaccurate. Data were unavailable on participants’ fasting insulin levels, which are a key aspect of metabolic syndrome. The study relied on casual fasting blood glucose measurements instead of oral glucose tolerance tests, which might have been more accurate. In addition, pubertal development, which may have affected some of the components of metabolic syndrome, was not assessed. Finally, because there is no set definition of childhood metabolic syndrome, other ways of measuring childhood health may yield more accurate predictions of adult diabetes and related conditions.

What are the implications of the study?

Evaluating children for metabolic syndrome and family history of diabetes could identify those who are likely to develop metabolic syndrome or diabetes as adults and allow for aggressive preventive care to avoid these problems.

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