Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies

Introduction. Metabolic syndrome (MetS) is an assemblage of interconnected cardiovascular risk factors that are prevalent among children and adolescents in high-income countries (HICs). Despite the presence of several studies on the issue, the study findings are incongruent due to the absence of a gold standard diagnostic method of MetS in children. Thus, the findings of the original studies are inconclusive for policy makers and other stakeholders. This systematic review and meta-analysis is aimed at giving conclusive evidence about MetS among children and adolescents in HICs. Methods. We conducted searches using electronic databases (PubMed, Scopus, Web of Science, CINAHL (EBSCOhost), EMBASE (Elsevier), and Medline (EBSCOhost)) and other sources (Google Scholar and Google) up to September 2020. Observational studies reporting the prevalence of MetS were eligible in this study. The pooled estimates were computed in fixed and random effect models using six diagnostic methods (IDF, ATP III, de Ferranti et al., WHO, Weiss et al., and Cruz and Goran). Publication bias was verified using funnel plots and Egger’s regression tests. Subgroup and sensitivity analysis were performed in case of higher heterogeneities among the included studies. Result. In this study, 77 studies with a total population of 125,445 children and adolescents were used in the final analysis. Metabolic syndrome among the overweight and obese population was computed from 28 studies with the pooled prevalence of 25.25%, 24.47%, 39.41%, 29.52%, and 33.36% in IDF, ATP III, de Ferranti et al., WHO, and Weiss et al. criteria, respectively. Likewise, 49 studies were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, MetS was found in 3.70% (IDF), 5.40% (ATP III), 14.78% (de Ferranti et al.), 3.90% (WHO), and, 4.66% (Cruz and Goran) of study participants. Regarding the components of MetS, abdominal obesity in the overweight and obese population, and low HDL-C in the general population were the most common components. Besides, the prevalence of Mets among males was higher than females. Conclusion. This study demonstrates that MetS among children and adolescents is undoubtedly high in HICs. The prevalence of MetS is higher among males than females. Community-based social and behavioral change communications need to be designed to promote healthy eating behaviors and physical activities. Prospective cohort studies could also help to explore all possible risk factors of MetS and to design specific interventions accordingly.

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

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-020-00601-8 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Ermias Getaneh Ayele ◽

Zelalem Tenaw ◽

Anmut Alebel ◽

...

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Obese Population ◽

Low And Middle Income

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.

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Metabolic Syndrome Among Children and Adolescents in Low and Middle Income Countries: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-67581/v1 ◽

2020 ◽

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Ermias Getaneh Ayele ◽

Zelalem Tenaw ◽

Anmut Alebel ◽

...

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Obese Population ◽

Low And Middle Income

Abstract Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is raising the low and middle income countries (LMICs). There are various studies with inconsistent findings, but they 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 the 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.

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Metabolic syndrome among children and adolescents in Low and Middle Income Countries: A systematic review and meta-analysis

10.21203/rs.3.rs-67581/v2 ◽

2020 ◽

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Ermias Getaneh Ayele ◽

Zelalem Tenaw ◽

Anmut Alebel ◽

...

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Children And Adolescents ◽

Meta Analysis ◽

Middle Income ◽

Middle Income Countries ◽

Pooled Prevalence ◽

Obese Population ◽

Low And Middle Income

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.

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Prevalence and Risk Factors for Spasticity After Stroke: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2020.616097 ◽

2021 ◽

Vol 11 ◽

Author(s):

Huangling Zeng ◽

Jian Chen ◽

Yang Guo ◽

Sheng Tan

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Observational Studies ◽

Hemorrhagic Stroke ◽

Meta Analysis ◽

Cochrane Library ◽

Stroke Patients ◽

Pooled Prevalence ◽

Severe Spasticity

Background: Spasticity is a common sequela of stroke. The incidence of poststroke spasticity (PSS) has not been systematically reviewed in recent years, and some risk factors remain debated. This systematic review and meta-analysis was conducted to determine the prevalence and risk factors for PSS.Methods: We searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, WANFANG and CBM) inception to May 12, 2020. Observational studies summarizing the incidence or risk factors for PSS were included. Only cohort studies were enrolled in meta-analysis. For risk factors examined in at least three different studies, we combined effects into odds ratios (OR) and 95% confidence intervals (CI).Results: One thousand four hundred sixty-seven studies were retrieved and 23 were involved in meta-analysis. The pooled prevalence of spasticity after stroke was 25.3% and that after the first-ever stroke was 26.7%. The incidence of spasticity after the first-ever stroke with paresis was 39.5%. The prevalence of disabling or severe spasticity (MAS ≥ 3) in stroke patients with paresis was 9.4% (95% CI 0.056–0.133), and severe spasticity was 10.3% (95% CI 0.058–0.149). Moderate to severe paresis (OR = 6.573, 95% CI 2.579–16.755, I2 = 0.0%), hemorrhagic stroke (OR = 1.879, 95% CI 1.418–2.490, I2 = 27.3%) and sensory disorder were risk factors for PSS.Conclusions: The incidence of PSS was significantly higher in stroke patients with paresis. Patients with moderate to severe paresis and sensory disorder should be closely followed up. The role of hemorrhagic stroke in predicting PSS remains to be further explored.

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Metabolic syndrome prevalence in the Iranian adult’s general population and its trend: A systematic review and meta-analysis of observational studies

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2017.12.023 ◽

2018 ◽

Vol 12 (3) ◽

pp. 441-453 ◽

Cited By ~ 6

Author(s):

Yaser Mokhayeri ◽

Seyed Mohammad Riahi ◽

Shadi Rahimzadeh ◽

Mohammad Amin Pourhoseingholi ◽

Seyed Saeed Hashemi-Nazari

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

General Population ◽

Observational Studies ◽

Meta Analysis

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Prevalence of diabetes and pre-diabetes in Bangladesh: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-036086 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036086

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Aqsa Sarwar ◽

Nida Nasr ◽

Amara Javed ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

General Population ◽

Rural Areas ◽

Urban Areas ◽

Meta Analysis ◽

Cochrane Library ◽

Pooled Prevalence ◽

Significant Difference ◽

Associated Risk Factors

ObjectiveThe purpose of this paper is to perform a systematic review and meta-analysis in order to summarise the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh.DesignSystematic review and meta-analysis.ParticipantsGeneral population of Bangladesh.Data sourcesPubMed, Medline, Embase, Bangladesh Journals Online, Science Direct, Scopus, Cochrane Library and Web of Science were used to search for studies, published between 1st of January 1995 and 31st of August 2019, on the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh. Only articles published in the English language articles were considered. Two authors independently selected studies. The quality of the articles was also assessed.ResultsOut of 996 potentially relevant studies, 26 population-based studies, which together involved a total of 80 775 individuals, were included in the meta-analysis. The pooled prevalence of diabetes in the general population was 7.8% (95% CI: 6.4–9.3). In a sample of 56 452 individuals, the pooled prevalence of pre-diabetes was 10.1% (95% CI: 6.7–14.0; 17 studies). The univariable meta-regression analyses showed that the prevalence of diabetes is associated with the factors: the year of study, age of patients and presence of hypertension. The prevalence of diabetes was significantly higher in urban areas compared with rural areas, while there was no significant gender difference.ConclusionsThis meta-analysis suggests a relatively high prevalence of pre-diabetes and diabetes in Bangladesh, with a significant difference between rural and urban areas. The main factors of diabetes include urbanisation, increasing age, hypertension and time period. Further research is needed to identify strategies for early detecting, prevention and treatment of people with diabetes in the population.PROSPERO registration numberCRD42019148205.

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Prevalence estimates of mental health problems in children and adolescents with intellectual disability: A systematic review and meta-analysis

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420924101 ◽

2020 ◽

Vol 54 (10) ◽

pp. 970-984 ◽

Cited By ~ 1

Author(s):

Nicholas Buckley ◽

Emma J Glasson ◽

Wai Chen ◽

Amy Epstein ◽

Helen Leonard ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Intellectual Disability ◽

General Population ◽

Confidence Interval ◽

Children And Adolescents ◽

Meta Analysis ◽

Pooled Prevalence ◽

Prevalence Estimates ◽

Developmental Behaviour Checklist

Background: Children and adolescents with intellectual disability are at risk of developing psychiatric symptoms and disorders; yet, the estimates reported in the literature have been inconsistent, presenting a potential barrier for service planning and delivery. Sources of variability could arise from differences in measurement instruments as well as subgroup membership by severity of intellectual disability, gender and age. This systematic review aimed to address these gaps. Method: MEDLINE and PsycINFO databases were searched from inception to 2018 and selected studies were reviewed. Studies were included if they reported point prevalence estimates of mental health symptomology or diagnoses in a general population of 6- to 21-year-old individuals with intellectual disability. The Joanna Briggs Institute Prevalence Critical Appraisal Checklist was applied to eligible papers to appraise their scientific strength. Pooled prevalence for mental health symptomology was determined using a random-effects meta-analysis. Results: A total of 19 studies were included, including 6151 children and adolescents. The pooled prevalence estimate captured by the Developmental Behaviour Checklist was 38% (95% confidence interval = [31, 46]), contrasting with 49% (95% confidence interval = [46, 51]) captured by the Child Behaviour Checklist; both rates were higher than a non-intellectual disability population. Severity of intellectual disability did not significantly influence the Developmental Behaviour Checklist risks. Insufficient data were available to conduct statistical analyses on the effects of age, gender and socioeconomic status. Of diagnosed psychiatric disorders, attention deficit/hyperactivity disorder (30%), conduct disorder (3–21%) and anxiety disorders (7–34%) were the most prevalent conditions. Conclusion: This review consists of the largest sample hitherto evaluated. In the intellectual disability population, mental health comorbidities could be better detected by a symptom phenotype than a psychiatric diagnostic phenotype. Crucially, future research needs to address the effect of measurement validity in the intellectual disability population. Estimated prevalence rates were high compared to the general population, indicating the importance of systematic screening, case detection and appropriate management.

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