Hispanic adults have the highest prevalence of the metabolic syndrome, which imposes a substantial risk for cardiovascular disease and type 2 diabetes. Identification of Hispanic children at risk for the metabolic syndrome is critical for prevention of these chronic illnesses. The purpose of this study was to investigate risk factors that can be used in the primary care setting to identify Hispanic children who have multiple metabolic syndrome components. Eighty-six elementary school students (5-12 years of age; 96% Hispanic) from a school-based health screening program were evaluated for family history of type 2 diabetes and cardiovascular disease in the first- or second-degree relative, body mass index (BMI), acanthosis nigricans (AN), and the following metabolic syndrome components: impaired fasting glucose (glucose ≥ 100 mg/dL), hypertriglyceridemia (≥ 110 mg/dL), low HDL cholesterol (≤ 40 mg/dL), and high blood pressure (systolic or diastolic blood pressure ≥ 90th percentile). Associations between the above risk factors and components of the metabolic syndrome were examined. Among the 86 children, 23% had a BMI ≥ 95th percentile, 22% had AN, 7% had impaired glucose tolerance; 22% had hypertriglyceridemia; 42% had low HDL cholesterol; and 17% had hypertension. The presence of zero, one, two, and three or more features of the metabolic syndrome was 44, 33, 15, and 8%, respectively. As BMI increased, the number of metabolic syndrome components increased (Mantel-Haenszel Χ2 = p < .001). Students with AN have significantly more metabolic syndrome components than students without AN (Mantel-Haenszel Χ2 = p < .001). Family history of type 2 diabetes or cardiovascular disease was not associated with having multiple metabolic syndrome components. Children with a BMI ≥ 95th percentile or with AN had four times the prevalence of multiple metabolic syndrome features compared with children with a BMI < 95th percentile and without AN (p < .001). Hispanic children with BMI ≥ 95th percentile or AN should be screened for metabolic syndrome components.
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