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Cardiometabolic risk factors and metabolic syndrome based on severity of obesity in Korean children and adolescents: data from the Korea National Health and Nutrition Examination Survey 2007-2018.

Background
Data regarding cardiometabolic risk factors (CMRFs) and metabolic syndrome (MetS) by body mass index (BMI) category in Korean youth are sparse.


Methods
Among the participants of the Korea National Health and Nutrition Examination Survey 2007-2018, 9,984 youth aged 10-18 years were included in the study. Study participants were classified into four groups based on BMI status: normal weight, overweight, and class I, class II/III obesity. The prevalences of CMRFs including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, glycated hemoglobin, and MetS were determined using the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria based on BMI category.


Results
The prevalences of overweight, class I, class II, and class III obesity were 9.52%, 7.73%, 2.10%, and 0.32%, respectively. The mean CMRFs values showed a tendency to increase as BMI increased, except for HDL-C. Age- and sex-adjusted odds ratios (ORs) for prediction of CMRFs also showed a tendency to increase with increasing BMI category. Adjusted ORs for MetS among overweight, Class I, and Class II/II obesity were 54.2, 283.3, and 950.3 for IDF criteria and 9.56, 37.9, and 126.8 for NCEP-ATP III criteria (all P <0.001).


Conclusion
Class II and III obesity in Korean children and adolescents were associated with significantly increased prevalences of CMRFs and MetS. Therefore, it can be useful to measure CMRFs in obese children and adolescents, and further studies are required to establish a screening guideline based on the severity of obesity.