Criteria in the Diagnosis of Metabolic Syndrome in Children: A Scoping Review

Figures & data

Table 1 Information Search Strategy in PubMed

Search Code	Search
#1	(“metabolic syndrome” [Title/Abstract] OR “metabolic syndrome” [MeSH Terms] OR “metabolic syndrome” [Other Term] OR (“cardiometabolic syndrome” [Title/Abstract] OR “metabolic syndrome” [MeSH Terms] OR “cardiometabolic syndrome” [Other Term]))
#2	(“Child” [Title/Abstract] OR “Child” [MeSH Terms] OR “Child” [Other Term] OR (“Children” [Title/Abstract] OR “Child” [MeSH Terms] OR “Children” [Other Term]) OR (“Childhood” [Title/Abstract] OR “Childhood” [Other Term])) (“Child” [Title/Abstract] OR “Child” [MeSH Terms] OR “Child” [Other Term] OR (“Children” [Title/Abstract] OR “Child” [MeSH Terms] OR “Children” [Other Term]) OR (“Childhood”[Title/Abstract] OR “Childhood” [Other Term]))
#3	(“WHO criteria” [Title/Abstract] OR “WHO criteria” [Other Term] OR (“IDF” [Title/Abstract] OR “IDF” [Other Term]) OR (“NCEP-ATP III” [Title/Abstract] OR “NCEP-ATP III” [Other Term]) OR (“Ferranti”[Title/Abstract] OR “Ferranti” [Other Term]) OR (“Cook” [Title/Abstract] OR “Cook”[Other Term]) OR (“Weiss” [Title/Abstract] OR “Weiss”[Other Term])))
#7	#1 AND #2 AND #3

Table 2 Information Search Strategy for Scopus, Web of Science, and Google Scholar

Search Code	Search
#1	TITLE-ABS-KEY (“Metabolic Syndrome” OR “Cardiometabolic Syndrome)”
#2	TITLE-ABS-KEY (child OR children OR childhood)
#3	TITLE-ABS-KEY (“IDF” OR “WHO criteria” OR “NCEP-ATP III” OR “Cook” OR “Ferranti” OR “Weiss”)
#4	#1 AND #2 AND #3

Figure 1 Flowchart of the process of identification and selection of literature.

Table 3 Diagnostic Criteria for Metabolic Syndrome in Children

Ref.	Author	Year	Country	Number of Participants	Criteria Used
[13]	Rosini et al	2015	Brazil	592	ATPIII NCEP modified
[14]	Heshmat et al	2018	Iran	4200	ATPIII NCEP modified
[15]	Shah et al	2020	United Arab Emirates	234	ATPIII NCEP modified
[16]	Zhang Li et al	2021	China	683	ATPIII NCEP modified
[20]	Matsushita et al	2015	Japan	376	IDF
[21]	Guzmán-Guzmán et al	2015	Mexico	225	IDF
[22]	Jankowska et al	2021	Poland	591	IDF
[26]	Oyarzún et al	2018	Chile	3523	Cook
[27]	Sapunar et al	2018	Chile	208	Cook
[28]	Ávila-Curiel et al	2018	Mexico	1017	Cook
[29]	Barzin et al	2018	Iran	1033	Cook
[30]	Gonzales-Gil et al	2019	Mexico	126	Cook
[32]	Andaki et al	2018	Brazil	1014	de Ferranti
[33]	Ramirez-Velez et al	2018	Colombia	1047	de Ferranti
[17]	Serrano et al	2019	Colombia	1282	ATPIII, IDF
[23]	Wang et al	2015	China	618	IDF, Cook
[24]	Guilherme et al	2019	Brasil	241	IDF, Cook, de Ferranti
[25]	Beysel y Celik	2022	Turkey	286	IDF, Cook, de Ferranti
[31]	Goncalves et al	2021	Brazil	290	Cook, Boney, de Ferreira
[18]	Peña-Espinoza et al	2017	Mexico	508	IDF, ATPIII, cook, Ferranti, Weiss
[19]	Koohmanaee et al	2019	Iran	725	IDF, Cook, ATPIII, de Ferranti, Viner and others
[34]	Shi et al	2015	Kuwait	8112	Continuous composite Z score for SM
[35]	Barbalho et al	2017	Brazil	150	Agudelo and Arias
[36]	Leone et al	2020	Italy	84	Ahrens
[37]	Das et al	2020	India	244	Boney
[38]	Vizzuso et al	2021	Italy	129	Ahrens

Abbreviation: Ref, Reference.

Table 4 Overall Averages for Metabolic Syndrome Risk Factors in Children Within Included Studies

Studies	BMI kg/mm^2	Waist circumference (cm)	Fasting blood glucose (mg/dL)	Diastolic blood pressure (mmHg)	Systolic blood pressure (mmHg)	Triglycerides (mg/dL)	Cholesterol (mg/dL)	cHDL (mg/dL)
[15,24–29,33,34,38]	19.97 ± 3.38				107.37± 4.99
[15,24–26,28,29,34,38]		71.62 ±9.72
[15,24,25,27–29,33,38]			86.65± 3.11
[15,25–28,33,34,38]				66.05± 4.96
[15,24–29,33,38]						95.94 ± 18.13
[15,24,25,27,28,33,38]							163.93 ± 14.55
[15,24–28,33,38]								46.18 ± 5.16

Table 5 Prevalence of Metabolic Syndrome Risk Factors in Children Diagnosed with Metabolic Syndrome in Included Studies

Studies	High BMI (%)	Elevated waist circumference (%)	High blood glucose (%)	High blood pressure (%)*	Elevated triglycerides (%)	Low cHDL (%)
[13,15,18,21,30,35]	61.43 ± 32.07
[13,18,20,30]		94.94± 2.86
[13,18,20–22]			19.60± 17.79
[13,18,20,21,30]				47.33± 35.09
[13,18,20,21]					54.34± 38.87	49.43 ± 38.01

Notes:*This prevalence was considered based on the high percentage of elevated systolic or diastolic blood pressure.

Table 6 Prevalence of Metabolic Syndrome in Children, According to Diagnostic Criteria, Age, and Sex

Author	Age of the participants (years)	MetS prevalence in girls (%)	MetS prevalence in boys (%)	MetS prevalence in the total (%)
Rosini et al^Citation13	6–10	ND	ND	10.6^a
Heshmat et al^Citation14	6–12	1.78^a	3.05^a	4.83^a
Shah et al^Citation15	6–11	9.9^a	7.9^a	8.9^a
Zhang et al^Citation16	8–12	3.6^a	3.9^a	ND
Matsushita et al^Citation20	6–9	3.7^b	1.5^b	ND
	10–12	15.0^b	2.1^b
Guzmán-Guzmán et al^Citation21	6–12	ND	ND	21.3^b
Jankowska et al^Citation22	10–12	10.9^b	14.6^b	12.9^b
Oyarzun et al^Citation26	6–12	ND	ND	7.20^b
Sapunar et al^Citation27	10	ND	ND	12^c
Ávila-Curiel et al^Citation28	6–12	44.3^c	43.5^c	43.85^c
Barzin et al^Citation29	7–11	7.7^c	5.5^c	6.7^c
Gonzales-Gil et al^Citation30	6–12	50	50	31.74^c
Ribeiro et al^Citation32	6–10	12.6^a	8.5^a	ND
Ramirez-Velez et al^Citation33	9–12	14.6^d	12.9^d	ND
Serrano et al^Citation17	6–10	ND	ND	9.5^a
				8^b
Wang et al^Citation23	10–11	ND	ND	2^b 3.2^c
	11–12			3.6^b 4.5^c
Guilherme et al^Citation24	10–12	ND	ND	1.5^b
				1.5^c
				17.9^d
Beysel and Celik^Citation25	6–12	ND	ND	7.7^b
				12.9^c
				25^d
Goncalves et al^Citation31	6–10	7.58^c	5.06^c	6.2^c
Peña-Espinoza et al^Citation18	9–13	ND	ND	21.1^a
				15.5^b
				13.8^c
				45.9^d
				2.4^e
Koohmanaee et al^Citation19	12	ND	ND	8^a
				4.27^b
				6.89^c
				17.52^d
				0.83^e
Shi et al^Citation34	6–10	1.11^e	1.22^e	1.14^e
Barbalho et al^Citation35	6–10	ND	ND	17.8^e
Leone et al^Citation36	7–10	ND	ND	44^e
Das et al^Citation37	6–10	ND	ND	11.1^e
Vizzuso et al^Citation38	<10	ND	ND	34.1^e

Notes: ^aNational Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). ^bFederación internacional de diabetes (IDF). ^cCook. ^dde Ferranti. ^eOthers.

Abbreviations: MetS, metabolic syndrome; ND, Not determined.

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