J Compr Ped. 2016 August; 7(3):e37703.
Published online 2016 August 6.
doi: 10.17795/compreped-37703.
Research Article
Prevalence of Metabolic Syndrome in Children With Type 1 Diabetes in
South of Iran
Forough Saki
1,*
1
Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
*
Corresponding author: Forough Saki, Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: + 98-7116473096,
E-mail: Sakeif@sums.ac.ir
Received 2016 March 09; Revised 2016 June 12; Accepted 2016 July 24.
Abstract
Objectives: The aim of this study was to investigate the prevalence of metabolic syndrome, in children with type one diabetes
mellitus (T1DM) for the first time in a population in the Middle East, and assess the influence of type of insulin therapy, daily dosage
of insulin, family history of type 2 diabetes, gender and level of HbA1c on the prevalence of metabolic syndrome.
Methods: This cross-sectional study was conducted on children with T1DM aged < 20 years, and duration of T1DM >2 years during
years 2013 to 2014. Waist circumference, blood pressure, height and weight of children with diabetes, for calculation of body mass
index (BMI), were measured by one physician. Fasting blood glucose and lipids were also measured. According to the age-modified
standards of the ATPIII, metabolic syndrome was defined. All data were analyzed using the SPSS 18 software.
Results: In this study, 87 children with diabetes (48 females and 39 males) aged 12.38 ± 4.2 were enrolled. Overall, 40.9% of our
patients had hypertension, 55.2% had hypertriglyceridemia, 36.8% had low high-density lipoprotein (HDL) and 6.9% of patients had
abdominal obesity. Furthermore, 29.9% of these children had metabolic syndrome, which did not have a significant association
with the type of insulin regimen (P = 0.97), nor the daily dosage of insulin (P = 0.234), however the serum concentration of HbA1c
had a significant correlation with metabolic syndrome (P = 0.027).
Conclusions: This study provides evidence indicating high prevalence of metabolic syndrome in children with T1DM in southern
Iran. Preventive programs aimed towards decreasing the risk factors of metabolic syndrome and interpretation of a healthier diet
and physical activity for children with T1DM should be considered in our country.
Keywords: Hypertension, Hypertriglyceridemia, High Density Lipoprotein, Obesity, Metabolic Syndrome, Type 1 Diabetes Mellitus
1. Background
Type 1 diabetes mellitus (T1DM) is one of the most preva-
lent autoimmune diseases in children (1). Although insulin
therapy has decreased the development of microvascular
and macrovascular complications of diabetes (2), it could
promote weight gain and obesity-associated cardiovascu-
lar risk factors (2-4). A group of cardiovascular risk factors
known as metabolic syndrome (abdominal obesity, insulin
resistance, abnormal lipid profile and hypertension) are
also associated with increasing atherosclerosis in children
with T1DM (5). It could increase the mortality of children
with T1DM by four to eight folds compared to non-diabetic
age-matched children (6). Up to now, four studies in Nor-
way, Germany, Poland and the Netherlands were done to
evaluate the prevalence of metabolic syndrome in children
with T1DM (2, 7-9). They showed that metabolic syndrome
was seen in 13 to 28% of children with T1DM in these Euro-
pean countries (2, 7-9).
2. Objectives
The present study investigated the prevalence of
metabolic syndrome in children with T1DM for the first
time in a population from the Middle East. We also stud-
ied metabolic syndrome, according to an adjusted pedi-
atric definition, and assessed the influence of type insulin
therapy, daily dosage of insulin, family history of type 2
diabetes, gender and level of HbA1c on the prevalence of
metabolic syndrome.
3. Methods
3.1. Patients
This was a cross-sectional study on all children with
T1DM, whom were referred to the pediatric diabetes clinic
affiliated with the Shiraz University of Medical Sciences, be-
tween July 2013 and August 2014.
The inclusion criteria were, age of < 20 years, duration
of T1DM more than two years, Fasting blood sugar (FBS)
Copyright © 2016, Iranian Society of Pediatrics. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0
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