Abstract
The metabolic syndrome (MS) in adults is defined as a concurrence of obesity, disturbed glucose and insulin metabolism, hypertension and dyslipidemia, and is associated with increased morbidity and mortality from cardiovascular diseases and type 2 diabetes. Studies now indicate that many of its components are also present in children and adolescents. Moreover, the clustering of these risk factors has been documented in some children, who are at increased cardiovascular risk in adulthood. The MS is highly prevalent among overweight children and adolescents. Identifying these children is important for early prevention and treatment of different components of the syndrome. The first-line treatment comprises lifestyle modification consisting of diet and exercise. The most effective tool for prevention of the MS is to stop the development of childhood obesity. The first attempt at consensus-based pediatric diagnostic criteria was published in 2007 by the International Diabetes Federation. Nevertheless, national prevalence data, based on uniform pediatric definition, protocols for prevention, early recognition and effective treatment of pediatric MS are still needed.The aim of this article is to provide a short overview of the diagnosis and treatment options of childhood MS, as well as to present the relationships between MS and its individual components.
Highlights
More than 20 years have passed since the first description of metabolic syndrome (MS) in adults.[1]
We have been able to conduct a study on prevalence of MS in our children with essential hypertension and MS was diagnosed in 19.2% (NCEP/ATPIII) and 14.4% (IDF) of hypertensives, respectively, which is comparable with other similar studies.[42]
The mechanism of the influence of obesity on CV diseases and type 2 diabetes is presented in Figure 1.14 Obesity is closely related to insulin resistance, the most common abnormality seen in obesity
Summary
More than 20 years have passed since the first description of metabolic syndrome (MS) in adults.[1]. At present the view held is that in each adult patient with a single CV risk factor, all the other known risk factors have to be looked for and individually treated.[6,7] On the other hand, in children, till only one consensus-based definition of pediatric MS has been published,[8] many studies have shown that MS and its components do appear in childhood.[9] their prevalence is on the increase,[10,11] mostly on account of obesity.[12,13] Obesity and the closely linked insulin resistance are presumed to play a central role in the development of MS.[14,15] Many studies have shown that clustering of CV risk factors continues into adulthood[16] and predicts the risk of future CV events and diabetes.[17,18] In numerous epidemiological studies, the negative influence of MS on CV morbidity and mortality and on type 2 diabetes has been documented.[19,20] On the other hand, lower CV risk and prevalence of MS have been established in children and adults with MS components in the lower normal range, independent of a positive family history of CV disease (clinical marker of genetic predisposition).[21,22] This further indicates the important role of a healthy lifestyle in early childhood in the prevention of CV diseases. In this review article we describe definitions of MS, discuss its pathophysiology, point out the management and treatment options, and present physiological mechanisms between MS and its constitutive elements
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call