Cardiorespiratory Fitness and Body Mass Index predicts variation of Metabolic Syndrome Criteria in Schoolchildren (PACH study)

Objective. Metabolic syndrome (MetS) has become an alarming health problem worldwide in younger population. Despite the increasing prevalence of MetS, there are no united guidelines for MetS criteria in children. To avoid future physical and mental health problems effective, simple and cost-efficient screening methods applied in schools for early recognition of MetS are needed. The aim of this study was to estimate cardiorespiratory fitness (CRF) and body mass index (BMI) as indicators for early detection and prevention of MetS.
Materials and methods. Prospective longitudinal study investigated the prevalence of MetS criteria in 8–10-year-old schoolchildren (46 boys and 60 girls) over 3 consecutive years. Anthropometric measurements (waist (WC), height), blood pressure (BP) and CRF level were determined. Fasting blood glucose and lipid profile was analysed by E.Gulbis laboratory. General Linear Mixed Model (GLMM) was used to assess effect of CRF and BMI on various parameters of MetS determined by Principal Component Analysis (PCA).
Results. Prevalence of MetS remained at 2% from 2017 till 2019 but increased significantly to 7.7% in 2020. The most frequent combination of MetS criteria in children included elevated WC, BP, and triglycerides. PCA identified 5 principal components which explained 69% of the variability of cardiometabolic health parameters (lipid profile, glucose homeostasis, BP). CRF proved to be excellent predictor of variance of glucose homeostasis, meanwhile BMI of the variance of lipid profile and BP.
Conclusions. The prevalence of MetS in children progresses with age. CRF and BMI were identified as significant predictors of variation in MetS criteria. CRF and BMI, as accessible, simple, non-invasive, and cost-effective tools, should be officially recognized and implemented as reliable screening methods for MetS in children to promote early detection and intervention.