OBJECTIVETo study the relationship between various metabolic syndrome (MS) components in children and adolescents and to explore its potential pathophysiological mechanism.

METHODSA total of 1 550 children and adolescents aged 7-14 years from the Xiaoshan District of Hangzhou, China were enrolled in March 2010. The anthropometric parameters such as height, weight, waist circumference (WC), and hip circumference, as well as blood pressure, were measured; after adjustment for age and sex, body mass index z score (BMI-z), waist circumference z score (WC-z), waist-to-hip ratio (WHp), and waist-to-height ratio (WHt) were calculated. Fasting blood samples were collected for determination of fasting plasma glucose (FPG), total cholesterol (CHOL), triglyceride (TG), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). Principal component analysis was used for extraction of factors.

RESULTSPrincipal component analysis revealed 5 uncorrelated factors that cumulatively explained 77.76% of the observed variance. Adiposity factor, which accounted for 23.56% of the variance, was the primary factor; it consisted of 3 variables, i.e., WC-z, WHt, and BMI-z, in which WC-z had the highest loading. The remaining factors identified were blood lipid factor 1 (TG, CHOL, and LDL), blood pressure factor, blood lipid factor 2 (TG and HDL), and blood glucose and WHp factor (FPG and WHp).

CONCLUSIONSMore than one pathophysiological mechanism could account for the development of MS in children and adolescents. Obesity, especially central obesity, is the most important factor in the development of MS. Dyslipidemia may not fully explain insulin resistance; they may work together in MS.