The multi centre cross-sectional study done by the International Diabetes Federation, on 10,842 children in five cities --Delhi, Chennai, Kolkata, Pune and Raipur, suggests that cut off values of waist circumferences can be used as screening for metabolic syndrome (MS) in Indian children.
"MS in children has been defined as the presence of high triglyceride levels in blood, Low HDL cholesterol (good cholesterol), increased fasting blood glucose levels, high systolic blood pressure and waist circumference > 75th percentile," said Dr Archana Dayal Arya, Paediatric Endocrinologist of Sir Ganga Ram Hospital, New Delhi and co-author of the study.
Metabolic Syndrome results in increased risk for hypertension, type 2 diabetes mellitus, and atherosclerosis cardiovascular disease. It is shocking to see children as young as 6 yrs old with diseases like hypertension, diabetes mellitus and abnormalities in the lipid profile, she said.
The International Diabetes Federation's definition of the MS in children, includes waist circumference (WC) as a criterion for the diagnosis of MS in children.
With reference to WC percentiles, it is easy to identify the cutoff level above which the risk for MS increases.
The National Health and Nutrition Examination Survey (NHANES), USA has proposed the 90th percentile as the cutoff for central obesity in children.
The previous Indian studies have suggested an empirical cutoff of the 75th percentile to screen for MS, but so far no study has proposed a biologically rational cutoff.
"The objective of the present study was to develop WC percentiles curves and to define cutoff of WC for Indian children so that they can be identified for risks for metabolic syndrome," said Dr Archana.
The study which has been accepted for publication in the forthcoming issue of the Journal of Paediatrics found that 3.3 per cent or 358 children out of total sample size of 10,842 children were hypertensive.
The study also found that risk factor for Indian children for developing MS was at 70th WC percentile which is significantly lower than International proposed WC cutoff of 90th percentile, said Dr Anuradha Khadilkar, consultant paediatrician in Jehangir Hospital, Pune and corresponding author of the study.
"We found that primary or essential hypertension, commonly seen in adults, is becoming common in children, who are obese or overweight. Therefore it is very essential for them to change their lifestyle and lose weight," she said.
They should be encouraged to participate in outdoor sports and other physical activities. They should cut down on the intake of high calorie foods with poor nutritional value (junk food) and a high fat diet, added Khadilkar.