Cardiometabolic risk factors in South American children: A systematic review and meta-analysis

Abstract

Background: Cardiometabolic risk factors (impaired fasting glucose, abdominal obesity, high blood pressure, dyslipidemia) cluster in children, may predict adult disease burden, and are inadequately characterized in South American children.

Objectives: To quantify the burden of cardiometabolic risk factors in South American children (0-21 years) and identify knowledge gaps.

Methods: We systematically searched PubMed, Google Scholar, and the Latin American and Caribbean Health Sciences Literature via Virtual Health Library from 2000-2021 in any language. Two independent reviewers screened and extracted all data.

Results: 179 studies of 2,181 screened were included representing 10 countries (n = 2,975,261). 12.2% of South American children experienced obesity, 21.9% elevated waist circumference, 3.0% elevated fasting glucose, 18.1% high triglycerides, 29.6% low HDL cholesterol, and 8.6% high blood pressure. Cardiometabolic risk factor definitions varied widely. Chile exhibited the highest prevalence of obesity/overweight, low HDL, and impaired fasting glucose. Ecuador exhibited the highest prevalence of elevated blood pressure. Rural setting (vs. urban or mixed) and indigenous origin protected against most cardiometabolic risk factors.

Conclusions: South American children experience high rates of obesity, overweight, and dyslipidemia. International consensus on cardiometabolic risk factor definitions for children will lead to improved diagnosis of cardiometabolic risk factors in this population, and future research should ensure inclusion of unreported countries and increased representation of indigenous populations.

Fig 1. PRISMA flow chart.

Fig 2. Cardiometabolic risk factor prevalence in South American children by country.

Box-and-whisker plots showing median and IQR values for each CMRF by country by any definition. Y-axis is prevalence, x-axis is country. A) obesity, B) elevated waist circumference, C) high triglyceride, D) low HDL, E) high blood pressure, F) impaired fasting glucose. HDL = high-density lipoprotein.