Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Copyright © 2013 The Korean Society for Preventive Medicine
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Metabolic syndrome criteria | NCEP ATP III by Cook et al. [12] | NCEP ATP III by de Ferranti et al. [13] |
New IDF in 2007 [14] |
|
---|---|---|---|---|
10-15 y | ≥16 y | |||
Waist circumference | ≥90th percentile for age and gender | >75th percentile for age and gender | ≥90th percentile for age and gender | 90 cm for men, 80 cm for women |
Triglyceride | ≥110 mg/dL | ≥100 mg/dL | ≥150 mg/dL | ≥150 mg/dL or specific treatment for this lipid abnormality |
HDL cholesterol | ≤40 mg/dL | <50 mg/dL | <40 mg/dL | <40 mg/dL for men, <50 mg/dL for women, or specific treatment for this lipid abnormality |
Blood pressure (systolic or diastolic) | ≥90th percentile for age, gender, height (<age 18 y) | ≥90th percentile for age, gender, height (<age 18 y) | ≥130/85 mmHg | ≥130/85 mmHg or treatment for hypertension |
Fasting glucose | ≥130/85 mmHg (≥age 18 y) ≥110 mg/dL | ≥130/85 mmHg (≥age 18 y) ≥100 mg/dL | ≥100 mg/dL or previous diagnosed type 2 diabetes | ≥100 mg/dL or previous diagnosed type 2 diabetes |
Author (published year) | Subjects (age range, region) | Definition of obesity | Prevalence |
---|---|---|---|
Population based studies | |||
Kim HM et al. (2006) [15] | 1998 KNHANES (n = 1651, 10-18 y) | Overweight (≥95th percentile) with reference to 1998 Korean growth charts | Total 5.4% (5.4% in boys, 5.3% in girls) |
2001 KNHANES (n = 1158, 10-18 y) | Total 11.4% (11.6% in boys, 10.9% in girls) | ||
Lee JW et al. (2007) [16] | 2001 KNHANES (n = 2704, 1-19 y) | Obese (relative body weight ≥120) with reference to 1998 Korean growth charts | Obese: total 12.8% |
Oh K et al. (2008) [8] | 1997 National Growth Survey (n = 70 185, 2-18 y) | Overweight (85th-94th percentile), obese (≥95th percentile including BMI ≥25) with reference to 2007 Korean growth charts | Overweight: total 13.0% (12.4% in boys, 13.8% in girls) |
Obese: total 5.8% (6.1% in boys, 5.5% in girls) | |||
2005 National Growth Survey (n = 112 974, 2-18 y) | Overweight: total 19.0% (19.7% in boys, 18.2% in girls) | ||
Obese: total 9.7% (11.3% in boys, 8.0% in girls) | |||
Park J et al. (2010) [17] | 2005 KNHANES (n = 664, 12-19 y) | Overweight (85th-94th percentile), Obese (≥95th percentile) with reference to 2007 Korean growth charts | Overweight: total 12.0% (12.3% in boys, 11.6% in girls) |
National reports | Obese: total 9.0% (9.3% in boys, 8.5% in girls) | ||
2007 National health statistics reports | 2007 KNHANES (n = 1118, 2-18 y) | Overweight (85th-94th percentile), obese (≥95th percentile including BMI ≥25) with reference to 2007 Korean growth charts | Overweight: total 8.6% (7.5% in boys, 9.9% in girls) |
Obese: total 10.9% (13.4% in boys, 7.9% in girls) | |||
2009 National health statistics reports | 2009 KNHANES (n = 2395, 2-18 y) | The same as above | Overweight: total 8.3% (7.1% in boys, 9.6% in girls) |
Obese: total 9.1% (10.8% in boys, 7.2% in girls) | |||
2011 National health statistics reports | 2011 KNHANES (n = 1716, 2-18 y) | The same as above | Overweight: total 7.7% (5.3% in boys, 10.5% in girls) |
Obese: total 9.7% (11.0% in boys, 8.3% in girls) | |||
Cross-sectional studies | |||
Ryu SY et al. (2007) [18] | 1393 Adolescents (12-13 y, Gwangju) | Overweight (≥85th percentile) with reference to 1998 Korean growth charts | Total 19.0% (22.4% in boys, 15.1% in girls) |
Kim YN et al. (2008) [19] | 136 Children (2-6 y, Gwanju) | International Obesity Task Force BMI cutoff | Overweight: total 8.0% |
Obese: total 2.0% | |||
Lee HA et al. (2011) [20] | 261 Children (7-9 y, Seoul) | Overweight (85th-94th percentile), obese (≥95th percentile) with reference to 2007 Korean growth charts | Overweight: total 11.0% (8.1% in boys, 14.4% in girls) |
Obese: total 7% (7.4% in boys, 7.2% in girls) | |||
Park JY (2011) [10] | 8868 Children (6-11 y, KOCAS) | Overweight (85th-94th percentile), obese (≥95th percentile) with reference to 2007 Korean growth charts | Overweight: total 10.0% (11.3% in boys, 8.6% in girls) |
Obese: total 5.0% (5.7% in boys, 4.3% in girls) | |||
Cho JH et al. (2012) [21] | 631 Adolescents (5th-6th grade, Gyeonggi-do) | Rohrer index1 | Overweight: total 15.7% |
Obese: total 16.5% |
KNHANES, Korean National Health and Nutrition Examination Survey; BMI, body mass index; KoCAS, Korean Children and Adolescents Obesity Cohort Study.
1 Rohrer index=[weight (kg)/height (cm3)]×107 Rohrer index values <140, 141-156, and >157 were categorized as normal, overweight, and obese, respectively.
Author (published year) | Subjects (age, design) | Definition for MetS | Prevalence | Main results | Covariates |
---|---|---|---|---|---|
Seo SJ et al. (2008) [29] | 2001 KNHANES (n = 3431, 10-19 y) | NCEP ATP III proposed by Cook et al. | Total 5.3%, 32.7% in subject with obesity1 in boys and 24.7% in girls | Obesity OR 16.5 (95% CI, 11.2-24.3) in boys, OR 7.8 (95% CI, 5.0-12.0) in girls | None |
NCEP ATP III proposed by Ferranti et al. | Total 14.0%, 47.0 % in subject with obesity1 in boys and 45.1% in girls | Obesity OR 10.5 (95% CI, 7.8-14.1) in boys, OR 5.9 (95% CI, 4.3-8.3) in girls | None | ||
Park J et al. (2010) [17] | 2005 KNHANES (n = 664, 12-19 y) | IDF | Total 2.5%, 5.8% in subject with overweight2 24.3% in subjects with obese2 | - | - |
Kim SJ (2011) [23] | 2005 KNHANES (n = 931, 10-19 y) | NCEP ATP III proposed by Cook et al.3 | Total 6.4%, 9.4% in subject with overweight2 35.0% in subjects with obese2 | Overweight aOR 8.7 (95% CI, 2.3-33.1), obesity aOR 28.1 (95% CI, 11.4-69.1) | Age, gender, smoking, alcohol drinking, and regular exercise |
Ryu SY (2007) [18] | Cross-sectional study in Gwangju (n = 1393, 12-13 y) | Applying to modified criteria from NCEP ATP III proposed by Ferranti et al.4 | Total 5.5% (6.1% in boys and 5.0 in girls), 22.3% in subject with overweight or obese5 | Obesity or overweight aOR 17.7 (95% CI, 10.0-31.2) | Age, gender, family history of hypertension and diabetes mellitus, regular exercise, and amount of meals |
MetS, metabolic syndrome; KNHANES, Korean National Health and Nutrition Examination Survey; NCEP ATP III, National Cholesterol Education Program Adult Treatment Panel III; OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; IDF, International Diabetes Federation.
1 Obesity defined those who have a body weight of 20% or more over an individual’s ideal body weight using 1998 Korean growth charts.
2 Using 2007 Korean growth charts, those with a BMI≥95th percentile for age and gender were classified as obese, and those with a BMI ≥85th but <95th percentile were classified as overweight.
3 Blood pressure cut-off using National Heart, Lung, and Blood Institutes in the US.
4 Of risk components, the criterion for abdominal obesity applied was waist circumference above the 70th percentile instead to waist circumference ≥75th percentile and the criteria applied for glucose was a glucose concentration of more than 110 instead of ≥100 mg/dL.
5 Using 1998 Korean growth charts, overweight or obese was defined as a BMI≥85th percentile for age and gender.
Author (published year) | Subjects | Outcome | Main results OR or aOR (95% CI) | Covariates |
---|---|---|---|---|
Lee HA et al. (2011) [20] | Cross-sectional study in Seoul (n = 261, 7-9 y) | Overweight (≥85th percentile): 11.0% | Overeating (≥2-3 times/wk) aOR 3.1 (95% CI, 1.4-6.9); | Age, sex, mother’s education, mother’s body mass index, and parental diabetes |
Rate of eating aOR 3.3 (95% CI, 1.7-6.4); family meal (fewer than 2-3/mo) aOR 9.5 (95% CI, 1.2-74.8) | ||||
Cho JH et al (2012) [21] | Cross-sectional study in Gyeonggi-do (n = 631, 5th-6th grade) | Overweight (Rohrer index ≥141): 35.9% | TV viewing (2 to 4 h/d) OR 0.7 (95% CI, 0.5-1.1), TV viewing (4 or more h/d) OR 0.4 (95% CI, 0.2-0.7) with reference to TV viewing below 1 h/d | None |
Byun W et al. (2012) [3] | 2005 KNHANES (n = 577, 12-18 y) | Overweight (≥85th percentile): 24.4% | TV watching (h/d) OR 1.17 (95% CI, 1.03-1.33) | Age, sex, annual household income, and moderate to vigorous physical activity |
Daily TV+PC/video (h/d) OR 1.13 (95% CI, 1.02-1.26) | ||||
Ko JA (2008) [30] | 2005 KNHANES (n = 1,922, 2-18 y): 580 children in aged 2-6 y, 790 children in aged 7-12 y, and 552 children aged 13-18 y | Obesity (≥95th percentile): 4.1% in 2-6 y, | Parental obesity aOR 4.8 (95% CI, 1.7-13.5) | Sex, parental obesity, father’s education level, mother’s occupation, and time spent watching TV |
Obesity (≥95th percentile): 6.3% in 7-12 y | TV viewing (2 to 4 h/d) aOR 7.0 (95% CI, 1.6-31.2) | Adjusted for the same covariates as above plus family income and birth weight | ||
Obesity (≥95th percentile): 8.7% in 13-18 y | Parental obesity aOR 4.4 (95% CI, 2.0-9.4) aOR 2.2 (95% CI, 1.1-4.5) | Sex, parental obesity, father’s education level, breakfast skipping, time spent watching TV, VPA, and attempt to control weight | ||
VPA aOR 2.2 (1.0-4.9) | ||||
Attempt to control weight aOR 8.6 (3.6-20.4) | ||||
Park HA et al. (2011) [31] | School-based cohort study (n = 1536, 5th grade children) | Overweight (85th-94th percentile): 11.5% | Skipping breakfast aOR 2.8 (95% CI, 1.1-7.1) for overweight aOR 3.1 (95% CI, 1.1-8.8) for obesity | Age, gender, household income, family structure, maternal education, maternal occupation, sleep duration, sleep start time, and screen time |
Obesity ≥95th percentile): 4.8% | Screen time (h/wk) aOR 1.03 (95% CI, 1.01-1.05) | |||
Overweight (≥85th percentile): 13.0% | ||||
Park S (2011) [32] | 2007 KYRBWS (n = 73 836, 12-18 y) | Overweight (≥85th percentile): 17.7% | Sleep duration aOR 0.94 (0.91-0.96), Sedentary lifestyle during weekdays aOR 1.05 (1.03-1.08), Sedentary lifestyle during weekend aOR 1.03 (1.01-1.06), Frequency of muscle-strengthening exercise per week aOR 0.83 (0.77-0.88) | Age, sex, household income status, father’s education, mother’s education, co-residence with parents, sedentary lifestyle during weekdays, sedentary lifestyle during weekends, skipping breakfast, depression, mental stress, sleep duration, frequency of fast food consumption, and frequency of muscle- strengthening exercise per week |
Kim CW et al. (2012) [33] | School-based cohort study (n = 936, 10-11 y) | Overweight (≥85th percentile): 17.7% | Longer sleep on weekdays aOR 0.68 (95% CI, 0.54-0.86), weekends aOR 0.64 (95% CI, 0.53-0.77) | Age, sex, breakfast eating, screen time, and parental obesity |
Life course | Modifiable risk factors |
---|---|
Early childhood (≤5 y) | Parental obesity [30]1 |
TV viewing [30]1 | |
Childhood (aged 6-11 y) | Parental obesity [30]1 |
TV viewing [30]1 | |
Overeating, rate of eating, familial meal [20] | |
Precooked/frozen food intake [34] | |
Skipping breakfast [31] | |
Sleep duration [33] | |
Adolescents (aged 12-18 y) | Daily TV viewing, playing PC/video games [3] |
Sleep duration [32] |
1 The study conducted by Ko [30] classified subjects as follows: children aged 2 to 6 years, 7 to 12 years, and 13 to 18 years.