Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis

Zebenay Workneh Bitew; Ayinalem Alemu; Ermias Getaneh Ayele; Zelalem Tenaw; Anmut Alebel; Teshager Worku

doi:10.1186/s13098-020-00601-8

Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis

Diabetol Metab Syndr. 2020 Oct 27:12:93. doi: 10.1186/s13098-020-00601-8. eCollection 2020.

Authors

Zebenay Workneh Bitew¹, Ayinalem Alemu², Ermias Getaneh Ayele¹, Zelalem Tenaw³, Anmut Alebel^{4

5}, Teshager Worku⁶

Affiliations

¹ St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
² Ethipian Public Health Institute, Addis Ababa, Ethiopia.
³ College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
⁴ College of Health Science, Debremarkose University, Debre Markos, Ethiopia.
⁵ Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia.
⁶ College of Health and Medical Sciences, School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia.

Abstract

Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs.

Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger's regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies.

Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females.

Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.

Keywords: Components of metabolic syndrome; Lmics; Low and middle income countries; MetS; Metabolic syndrome.