Korean J Fam Pract. 2017; 7(3): 372-376  https://doi.org/10.21215/kjfp.2017.7.3.372
The Relationships between Metabolic Syndrome with White Blood Cell Count, Ferritin, and Liver Function Test in Korean Children and Adolescents: The Fifth Korean National Health and Nutrition Examination Survey, 2010–2012
Sun-Jin Hong, Min-Jeong Kim*, Seok-Joong Kim, Song-Hui Kwon, Je-Han Lee, Eun-Sung Sim
Department of Family Medicine, National Medical Center, Seoul, Korea
Min-Jeong Kim
Tel: +82-2-2260-4717, Fax: +82-2-2262-4739
E-mail: seiten@hanmail.net
Received: March 17, 2016; Revised: September 27, 2016; Accepted: October 2, 2016; Published online: June 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The aim of this study was to evaluate the relationship between metabolic syndrome (MetS) and white blood cell (WBC) count, serum ferritin levels, and liver function test results in children and adolescents.
Methods: The data of 2,535 individuals (1,339 men and 1,196 women) aged 10–19 years from the fifth Korea National Health and Nutritional Examination Survey (KNHANES, 2010–2012) were used. We analyzed the relationship between MetS and obesity, physical activity, WBC count, ferritin level, serum gamma-glutamyltranspeptidase (GGT) level, alanine aminotransferase (ALT) level, and aspartate aminotransferase (AST) level, using modified National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III criteria. We used complex sampling; descriptive, multiple, and logistic regression analyses; and analysis of covariance for analyzing the data.
Results: The prevalence of MetS was 4.16% among men and 2.82% among women, based on the modified NCEP-ATP III criteria. When the model included WBC count and ferritin, AST, ALT, and GGT levels as independent variables, MetS was positively associated with GGT and ALT levels in men and with WBC count and GGT, AST, and ALT levels in women. In the multiple logistic regression analyses, MetS increased the odds ratio of AST and ferritin levels in men and AST level in women.
Conclusion: This study suggests that higher AST and ferritin levels in men and higher AST level in women are indicators of MetS.
Keywords: Child; Adolescents; Metabolic Syndrome; Liver Function Tests; Leukocytes; Ferritin
  1. Kahn R, Buse J, Ferrannini E, Stern M; American Diabetes Association; European Association for the Study of Diabetes. The metabolic syndrome:time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2005; 28: 2289-304.
    Pubmed CrossRef
  2. Popkin BM, Conde W, Hou N, Monteiro C. Is there a lag globally in overweight trends for children compared with adults? Obesity (Silver Spring) 2006; 14: 1846-53.
    Pubmed CrossRef
  3. Morrison JA, Friedman LA, Gray-McGuire C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinics Follow-up Study. Pediatrics 2007; 120: 340-5.
    Pubmed CrossRef
  4. Morrison JA, Friedman LA, Wang P, Glueck CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr 2008; 152: 201-6.
    Pubmed CrossRef
  5. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003; 157: 821-7.
    Pubmed CrossRef
  6. Ford ES, Giles WH. A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 2003; 26: 575-81.
  7. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-97.
  8. Rutter MK, Meigs JB, Sullivan LM, D’Agostino RB Sr, Wilson PW. C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation 2004; 110: 380-5.
    Pubmed CrossRef
  9. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391-7.
    Pubmed CrossRef
  10. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340: 448-54.
    Pubmed CrossRef
  11. Lee CH, Lee K, Park TJ, Park DJ, Lee HJ, Jung YH, et al. The relationships between metabolic syndrome with liver function test, pulmonary function test, white blood cell count, and ferritin: the fifth Korean National Health and Nutrition Examination Survey 2010. Korean J Fam Pract 2014; 4: 49-55.
  12. Kim MK, Park JH. Metabolic syndrome. J Korean Med Assoc 2012; 55:1005-13.
  13. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res 2004; 38: 535-9.
    Pubmed CrossRef
  14. Hong CY. Textbook of pediatrics. 11th ed. Seoul: Mirae N Co., Ltd.; 2016.
  15. International Physical Activity Questionnaire. Guidelines for data processing and analysis of the international physical activity questionnaire (IPAQ) [Internet]. International Physical Activity Questionnaire; 2005 [cited 2012 Mar 22].
    Available from: http://www.ipaq.ki.se
  16. Korea Centers for Disease Control and Prevention, The Korean Pediatric Society. 2007 Korean children and adolescents growth standard [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2007 [cited 2015 Oct 1].
    Available from: http://www.cdc.go.kr/
  17. Seo HS, Yun YW, Sohn SJ. Relationship between white blood cell counts and the metabolic syndrome. J Agric Med Community Health 2010; 35: 67-76.
  18. Kang YH, Min HK, Son SM, Kim IJ, Kim YK. The association of serum gamma glutamyltransferase with components of the metabolic syndrome in the Korean adults. Diabetes Res Clin Pract 2007; 77: 306-13.
    Pubmed CrossRef
  19. Kim HK, Lim JH, Kwon ER, Park YJ, Kim NE, Noh WY, et al. Serum ferritin and risk of the metabolic syndrome in Korean adults. Korean J Obes 2010;19: 48-55.

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