SAT-LB021 A Comparison of Criteria for Metabolic Syndrome in Nicaraguan Children

Background: Obesity and metabolic syndrome (MS) prevalence among children and adolescents is rising globally. Little information on pediatric obesity and MS in Central America and Nicaragua has been published. The present study compared the Adult Treatment Panel (ATPIII) and International Diabetes Foundation (IDF) guidelines for the diagnosis of MS and determined insulin resistance in participating children and adolescents with MS. Methods: This study followed 193 children and adolescents . Standard anthropometric and clinical parameters were assessed. A random forest classifier was used to identify risk factors and important cutoff values outside the standard MS definitions. Results: Of the 74 children between the ages 2-9 years, 48.6% were classified with MS by ATPIII. Of the 119 children between the ages of 10-15 years, 55.4% were classified with MS by ATPIII and 43.7% by IDF. A total of 102 children underwent homeostatic model assessment (HOMA) testing for β-cell function and insulin resistance; the median HOMA scores were 5 (IQR 4, 8) for girls and 4 (IQR 2, 6.5) for boys. Among 2-9 year old patients classified with MS by ATPIII, the median HOMA score was 2.5in children between the ages of 10-15, the median HOMA score was 6, regardless of classification tool. The random forest classifier identified weight, waist-to-height ratio, and age as the most important variables with respect to a diagnosis of MS by APTIII criteria. Conclusions: Overall, there was a high prevalence of MS and insulin resistance among the studied at-risk population. Comparing the pediatric MS classification tools, the study found that the ATPIII classification guidelines may be of more use since it allowed for the evaluation of children below 10 years of age and the IDF definition used a particularly high blood pressure cutoff. The algorithm-based evaluation highlighted variables that were either non-modifiable or related to the influence of increased body mass, hence limiting their utility for the purpose of MS medical intervention. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.