Is metabolic syndrome prevailing in Iraqi children?

Sir,

Pediatric metabolic syndrome (MS) includes a cluster of cardiovascular risk factors such as insulin resistance, dyslipidemia (including increased triglycerides and decreased high density lipoprotein-cholesterol), hypertension, and obesity in children. The median prevalence of MS is estimated to be 3.3% (range 0-19.2%) in whole pediatric populations, 11.9% (range 2.8-29.3%) in overweight children, and 29.2% (range 10-66%) in obese children.[1] The prevalence is rising worldwide. This is partly due to a significant increase in the prevalence of obesity.[2] The exact prevalence of MS in Iraqi children is yet unknown as no studies have been conducted on that issue. However, the following evidences could point out to its substantial existence: (1) Hypertension and obesity were reported in 1.7% and 7.3% of Iraqi children respectively.[3] (2) Though no studies are yet present considering the exact prevalence of pediatric diabetes mellitus in Iraq, the available data generally showed 12.2% prevalence in general Iraqi population.[4] (3) Alteration in lipid profile in Iraqi diabetic children was assessed and revealed that the mean total cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C), and LDL-C/HDL-C ratio were significantly higher in diabetic children compared to control group.[5] Various obstacles do present that hamper studying MS in Iraqi children. These include the following: (1) Absence of Iraqi age and gender-specific cut-off values for growth parameters essential to diagnose obesity. (2) Absence of Iraqi age and gender-specific laboratory standards considering lipid profile and blood sugar necessary to diagnose dyslipidemia and diabetes mellitus respectively. (3) The significant budget needed to cover the financial context. (4) Poor knowledge and limited awareness of pediatricians and public on MS and its grave consequences. Therefore, alleviation of these obstacles is critical to successfully conduct studies on MS with the objective of halting accelerated atherogenesis as Iraqi children move into adulthood.