File Name: metabolic syndrome among overweight and obese adults in palestinian refugee camps .zip
Objectives To describe the distribution of social factors, lifestyle habits and anthropometric measurements according to hypertension and Type-2 diabetes. There were KeyWords : body mass index ; hypertension ; life style ; obesity ; physical activity ; type 2 diabetes. Education level 0 is low level to moderate and high level.
Metabolic syndrome among overweight and obese adults in Palestinian refugee camps
Ann Clin Lab Res Vol. Background: Warning signs of metabolic syndrome MetS can appear during childhood. Early detection and treatment of MetS is likely to reduce morbidity and mortality in adulthood and help to keep to minimum the global burden of cardiovascular diseases and type II diabetes. Methods: A cross sectional study was conducted in the West Bank-Palestine in the year Out of the schoolchildren, No sex-specific differences in the prevalence of MetS between age groups were determined using both criteria.
Clustering of metabolic abnormalities had significantly increased by increasing body mass index and waist circumferences, and with decreased HDL and elevated triglyceride. Conclusions: The prevalence of MetS among overweight and obese Palestinian schoolchildren is high with dyslipidemia being the most common MetS abnormality. Regardless the definition used to diagnose MetS among children; the findings of this study present a serious threat to current and future health of Palestinian children.
Dyslipidemia; Metabolic syndrome; Obesity; Cardiovascular disease; Palestine. Metabolic syndrome MetS is characterized by a cluster of several metabolic and cardiovascular risk factors such as abdominal obesity, insulin resistance, atherogenic dyslipidemia, and hypertension [ 1 - 3 ].
It was first considered to be a condition of adulthood and linked to cardiovascular morbidity and mortality [ 4 ]. More recently, it has been identified as a condition of childhood [ 4 , 5 ]. However, warning signs of metabolic syndrome can appear during childhood [ 3 ]. Early detection and treatment of MetS is likely to reduce morbidity and mortality in adulthood and help to keep to minimum the global burden of CVD and type II diabetes. Childhood obesity is a significant health problem and associated with several metabolic and cardiovascular complications [ 6 - 8 ].
Overweight and obesity had reached alarming rate among Palestinians [ 9 - 11 ]. Importantly, overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity, therefore, needs high priority. A comprehensive understanding of MetS in overweight and obese children and adolescent population may be important for the specific direction of prevention strategies. To date, no uniform definition has been established to diagnose MetS among children and more studies are recommended for each ethnicity.
A school-based cross-sectional study was conducted in in Nablus Districts in Palestine. A multi-stage stratified proportional sampling method was used to select the subjects form students. In the first stage, participants boys and girls were randomly selected from 12 schools. In the second stage, children who presented with overweight and obesity and had met the inclusion criteria were invited to have blood samples taken no.
European data for WC was used as recommended by IDF criteria as no specific ethnicity cut-off points are available for Palestinian [ 19 , 25 ].
Abdominal obesity was defined using WC percentiles by sex and age. The health status of children was established from the self -administrated questionnaire that was answered by the parents. The parents were also asked about the type of medication that is given to their children to treat diabetes if found. Anthropometrics, blood pressure measurements, and biochemical analysis were done as described previously [ 11 , 15 ].
Means, standard deviations, and percentages wherever appropriate were used to describe variables and the Pearson Chi-square and Fisher Exact test were used to compare the categorical variables. A p-value of less than or equal 0. Stage 1: Out of the children, Sex-specific anthropometric measurements were established for boys and girls and are shown in Additional File 2. Stage 2: Out of overweight and obese children, participants 81 boys and 65 girls underwent the second stage of this study and 70 participants refused to be tested for blood.
Of the agreed to participate in stage 2, Based on gender, no sexspecific differences in the prevalence of MetS between boys and girls were determined using IDF p value 0. Differences in the prevalence of MetS abnormalities based on the diagnostic criteria used.
On the other hand, elevated triglyceride and elevated blood pressure were significantly more prevalent according to NCEP Age: The prevalence of the following abnormalities had significantly increased with increasing age: overweight and obesity p value 0.
Gender: Sex-specific clustering of MetS abnormalities had shown no significant differences between boys and girls using both IDF p value 0. Sex-specific frequency of individual components of the MetS among overweight and obese children is shown in Table 5. Table 5: Sex-specific frequency of individual components of the MetS among overweight and obese children. This includes central obesity according to both criteria p value 0. MetS was significantly more prevalent in obese children than overweight children using IDF p value 0.
Table 6: Risk factors associated with MetS increased waist circumferences, elevated fast blood sugar, decreased high density lipoprotein, elevated blood pressure, and elevated triglyceride. Central obesity: Children with increased central obesity had shown significant increase in clustering of metabolic abnormalities 3 or more Additional File 3 according to NCEP They have shown also higher risk of having MetS according to both criteria Table 6. Metabolic syndrome MetS is one of the major causes of morbidity and mortality in the world [ 32 ].
The clustering of cardio vascular disease CVD risk factors that typifies the metabolic syndrome is now considered the driving force for a CVD epidemic.
The importance of identifying the risk factors of MetS in children is because its presence in this phase of life remains many years in silence and therefore, its identification can contribute to the prevention of chronic diseases and premature death [ 16 , 34 ]. The prevalence of metabolic syndrome in children and adolescents has been reported in various populations using a variety of age and gender specific cut-off points for the different components waist circumference, fast blood sugar , blood pressure, and lipid levels.
Similar frequencies of MetS were reported among overweight and obese children world widely [ 17 , 35 - 37 ]. Higher frequencies were reported in different populations [ 38 , 39 ] and when IDF definition was implemented [ 40 - 44 ]. In order to help policy makers in establishing policies and strategies for preventing MetS among children, we had explored the MetS risk factors among children.
The pathogenesis of the MetS and each of its components is complex and not well understood and continues to challenge the experts but both insulin resistance and central obesity are considered significant factors [ 24 , 27 ].
Obesity is associated with metabolic disorders starting early in life. Obesity, particularly in the central abdominal region, is associated with an increase in risk of cardiovascular disease and has been determined as a key precipitating factor for type II diabetes [ 45 ].
The finding of this study indicate that the prevalence of overweight and obesity was high The IDF groups suggest that the MetS should not be diagnosed in children younger than 10, but that a strong message for weight reduction should be delivered for those with abdominal obesity [ 20 ].
They assume that the IDF criteria for MetS in children and adolescent may change in future as more outcome data become available. These results indicate that obesity but not gender or age could be significant risk factors for increased MetS among Palestinian schoolchildren.
Overweight and obesity, as well as their related diseases, are largely preventable. Prevention of childhood obesity among Palestinian children, therefore, needs high priority. Depending on these results, we assume also that both definitions with their cutoffs used may be not realistic for diagnosing MetS in normal weight Palestinian school children. Most research focus on investigation of how obesity in children should be better defined e.
WC, BMI, weight, etc. Central obesity is a prerequisite risk factor for the diagnosis of the syndrome in the new IDF definition [ 45 ]. Therefore, we had investigated the association between central obesity and FBS with other risk factors.
Children in this study had shown significant increase in the prevalence of central obesity according to IDF Children with increased central obesity had shown significant increase in clustering of metabolic abnormalities 3 or more according to NCEP Therefore, central obesity had significantly increased the risk of having Mets according to NCEP definition.
Surprisingly, central obesity was not associated with increased FBS according to both definitions. Gender is another risk factor. Different studies have been undertaken to characterize the major components of the metabolic syndrome in females and males in different populations [ 19 , 28 , 46 - 49 ].
In agreement with other studies among Palestinians, MetS and its other risk factors were more clustered in girls than boys with no significant differences using both definitions [ 11 , 13 - 15 , 50 ] and increased with increasing obesity [ 11 , 15 ]. Moreover, these risk factors seem to cluster at early age in girls as None of the boys at this age has three of more components or had met the IDF definition. In addition to that, although no statistical differences in BMI between boys and girls in all age groups was determined, central obesity was more prevalent among girls using both definitions and significantly higher using IDF definition.
These results agree with previous studies [ 11 , 14 , 51 , 52 ]. Therefore, more attention should be paid to obese girls especially those with central obesity and elevated levels of fast blood sugar as they are at higher risk for early mortality. The prevalence of suggested risk factors that contribute to the MetS in children varies significantly with the cut off used [ 53 ]. Insufficient data about waist circumferences cut-off points have prevented region-specific definitions to be established for the Arabian population.
The presence of central obesity is an absolute requirement for the IDF criteria but the European threshold to define central obesity in our population may be under-inclusive for our population ethnicity. More data is needed in this subject to establish Palestinian waist circumferences thresholds.
The most prevalent component of MetS among study subjects was reduced HDL-cholesterol using both definitions. Similar results were observed among overweight and obese adult Palestinians in both sexes [ 11 , 15 ]. Moreover, elevated triglyceride was associated significantly with all abnormalities except central obesity according to NCEP definition.
Screening for dyslipidemia among children and adults is necessary especially among children at risk. We are now investigating the risk factors for reduced HDL among Palestinians in both genders and in different age groups.
Overall, obesity, central obesity, and dyslipidemia could be the most significant risk factors for MetS among children in Palestine according to NCEP definition. The findings of this study provide evidence-based data on the considerable prevalence of childhood MetS among Palestinian children.
Obesity and central obesity as well as dyslipidemia were the most significant risk factors for MetS among children. Because the number of overweight and obese children is increasing and because it is evident that MetS starts at early life, we recommend that more attention should be paid on the young population at risk to reduce childhood obesity and subsequent cardiovascular diseases.
Prevention of childhood obesity among Palestinian children needs high priority. Attention should be made through health care providers, social media, and educational campaigns about the benefits of losing weight in reducing MetS and its components. Therefore, we recommend developing ethnic specific age and sex normal ranges for waist circumferences, ideally based on healthy values.
More research is needed in order to identify optimal criteria for defining and establishing cut off for different MetS components for Palestinian at different age groups. The study was carried out in accordance with the ethical standards, Declarations of Helsinki.
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Background: Warning signs of metabolic syndrome MetS can appear during childhood. Early detection and treatment of MetS is likely to reduce morbidity and mortality in adulthood and help to keep to minimum the global burden of cardiovascular diseases and type II diabetes. Save to Library. Create Alert. Launch Research Feed.
Box , Jerusalem, Palestine. Box , Iraklion, Crete, Greece. Box 7, Nablus, West Bank, Palestine. A cross-sectional survey was designed to provide a baseline data on the prevalence and distribution of overweight and obesity and their associations among adults in Palestine. A random representative sample of adults aged 18—64 years was collected between October and October The prevalence of overweight was Adults aged 45—54 years old were significantly more likely to be obese
Metabolic syndrome among overweight and obese adults in Palestinian refugee camps. Basma Damiri,; Mohammed S. Abualsoud,; [ ].
Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency.