Cardiometabolic Risk Factors in South American Children: A Systematic Review and Meta-Analysis

We aimed to quantify the burden of cardiometabolic risk factors (CMRF) in South American children. We included primary quantitative white and gray literature in any language reporting after 1999 on the prevalence of glucose intolerance, obesity, hypertension and/or dyslipidemia in South Americans aged 2–21 years old. Studies were excluded for lack of available data, population with additional comorbidity, and/or CMRF criteria not defined. We searched PubMed, the Latin American and Caribbean Health Sciences Literature, and Google Scholar and performed reference handsearching. We assigned data quality via Effective Public Healthcare Panacea Project Quality Assessment Tool for Quantitative Studies modified for selection bias and data collection. We analyzed CMRF by available sociodemographic variables. Included studies (68 of 1,179; n = 115,674 children aged 2–19 years) came from 8 countries (Argentina, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru and Venezuela). CMRF definitions ranged widely. By any definition, 33.41% (n = 4,480/13,408) had low HDL cholesterol, 25.33% (n = 3,396/13,408) had elevated triglycerides, 13.92% (n = 2,900/20,830) had elevated waist circumference, 10.38% (n = 3,909/37,646) were obese by any definition, 10.49% (n = 858/9,672) had elevated blood pressure (BP), and 5.62% (n = 1,015/15,270) had glucose intolerance. By International Diabetes Federation definitions, 33.39% (n = 3,495/10,466) had HDL ≤ 40 mg/dL (16/22 studies); 23.45% (n = 909/3,876) had triglycerides ≥ 150 mg/dL (6/22 studies); 8.84% (n = 1,373/15,533) had waist circumference ≥ 90% for age, gender and height (20/30 studies); 6.10% (n = 733/12,010) had fasting glucose ≥ 100 mg/dL (17/21 studies) and 14.04% (n = 404/2,877) had systolic BP ≥ 130 mmHg (4/4 studies). CMRF varied by country, study setting (rural, urban or mixed), and indigenous population. Overall, Brazil had the highest prevalence of glucose intolerance and elevated BP; Chile had the highest prevalence of obesity and low HDL. Obesity was more prevalent in rural settings (7/65 studies); urban settings (19/28) had increased dyslipidemia. South American children experience a high prevalence of CMRF and need further characterization of the sociomedical determinants of their risk. None.