PREVALENCE OF METABOLIC SYNDROME AMONG ADOLESCENTS IN A CITY IN THE MEDITERRANEAN AREA: COMPARISON OF TWO DEFINITIONS.

BACKGROUND AND OBJECTIVE: there are few studies on the prevalence of metabolic syndrome (MetS) in European adolescent populations, and some have reported a higher prevalence in the Mediterranean basin area. Our objective was to examine the prevalence of MetS in adolescents in a Mediterranean city of Spain, comparing two different definitions of MetS and the associated risk factors. METHODS AND RESULTS: a cross-sectional population-based study was conducted among 379 adolescents aged 12-16.9 years, selected using a random sampling method. Anthropometric measurements and fasting blood samples were obtained. The definitions of MetS used were that of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATPIII) and that of the International Diabetes Federation (IDF). Kappa coefficient was used to measure the agreement between definitions and a multivariate logistic regression model to determine the associated risk factors. RESULTS: the prevalence of MetS was 5.7% (95%CI 3.33-8.07) according to the NCEP-ATPIII definition and 3.8% (95%CI 1.85-5.75) according to the IDF definition. No differences between the sexes or by age groups were found. The agreement between the two definitions was very good (kappa 0.815), especially in the obese subsample, but was lower in normal weight adolescents (kappa 0.497). Insulin resistance and obesity were associated with both definitions. CONCLUSIONS: the prevalence of MetS in our adolescent population is higher than the European media. Although the overall agreement between both definitions was very good, the prevalence was higher using the NCEP-ATPIII criteria. Independently of the definition used, obesity and insulin resistance were risk factors for MetS.

Introducción y objetivos: existen escasos estudios acerca de la prevalencia de síndrome metabólico (MetS) en la población general adolescente en Europa. Algunos resultados muestran mayor prevalencia en adolescentes del área mediterránea. Nuestro objetivo fue estudiar la prevalencia de MetS en la población general adolescente de una ciudad del área mediterránea en España, comparando dos definiciones de MetS y los factores de riesgo asociados. Material y métodos: estudio epidemiológico observacional sobre una muestra de base poblacional, elegida de forma aleatoria, representativa de los adolescentes de 12 a 16,9 años escolarizados en la ciudad de Almería. Se recogieron variables antropométricas y analíticas. Se compararon dos definiciones de SM para población adolescente: National Cholesterol Education Program (NECP- ATPIII) e International Diabetes Federation (IDF). Estadística: coeficiente kappa para analizar la concordancia entre definiciones y regresión logística múltiple para el estudio de factores de riesgo asociados. Resultados: la prevalencia de MetS fue 5,7% (95%IC 3,33-8,07) con la definición NECP-ATPIII y 3,8% (95%IC 1,85-5,75) con los criterios IDF. No se encontraron diferencias entre sexos ni entre grupos de edad. La concordancia entre ambas definiciones fue muy buena a nivel global (kappa 0,815) y especialmente en el grupo de obesos, pero empeoró entre adolescentes con normopeso (kappa 0,497). Los factores asociados a ambas definiciones fueron obesidad y resistencia insulínica. Conclusiones: nuestros resultados muestran una prevalencia de MetS en adolescentes mayor a la media europea. Aunque la concordancia entre definiciones fue muy buena a nivel global, la prevalencia fue mayor con la definición NECP-ATPIII. Obesidad y resistencia insulínica fueron los factores de riesgo asociados.

Ovarian juvenile granulosa cell tumors in infants.

Juvenile ovarian granulosa cell tumors (JGCTs) are described infrequently in pediatrics, and their finding in prepubertal patients is exceptional. Most of the tumors are benign, but recurrences up to 4 years of follow-up have been described. We present 2 cases of JGCT in infants: 1 with late recurrence of bilateral ovarian JGCT and 1 in a newborn with Ollier disease. Clinical diagnosis and treatment of JGCT are revised.