Metabolic syndrome and obesity among marginalised school-going adolescents in Karachi, Pakistan: a cross-sectional study.

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors which increase the likelihood of developing type 2 diabetes and cardiovascular disease. This study aimed to determine the prevalence of MetS among adolescents living in slums aged 11-18 years in Karachi, Pakistan. Methods: Data were collected from 689 adolescents attending five schools in two slum areas of Karachi, Korangi and Baldia, from February 2023 to March 2023. Measurements of weight, height, waist circumference, and blood pressure were obtained from the study participants. Blood samples were collected to assess fasting plasma glucose, High density lipoprotein HDL-cholesterol, and triglyceride levels as per National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). The prevalence of MetS was estimated using five diagnostic criteria, i.e., International Diabetes Federation (IDF-2007), World Health Organization, NCEP-ATP III, de Ferranti et al., and Cruz and Goran. Findings: The study revealed an overall prevalence of MetS among the adolescents in the two slum areas as 16.7%. A higher prevalence of MetS was observed among females (9.1%) and those with lower body mass index BMI (13.6%). The diagnostic criteria proposed by Cruz and Goran were found to be the most sensitive, with a MetS diagnosis rate of 22.93%. The study also identified several significant risk factors associated with MetS, including sedentary lifestyle (7.7%), lack of physical activity (7.5%), increased screen time (1.5%), lower fruit consumption (6.1%), and underweight (7.7%). Among slum-dwelling adolescents, low levels of HDL-cholesterol (33.96 ± 5.21), high triglyceride levels (161.45 ± 63.09), and elevated fasting plasma glucose levels (112.59 ± 28.92) were prevalent components of MetS. Interpretation: This study provides compelling evidence of a high prevalence of MetS among marginalised school-going adolescents in Karachi, Pakistan. The findings underscore the importance of early identification of adolescents at risk of developing MetS (especially those living in slum areas) and the implementation of effective preventive strategies to mitigate the risk of type 2 diabetes and cardiovascular disease in later life. Funding: None.