Metabolic Syndrome In Children Research Articles

The method of determining abdominal obesity by waist circumference in Ukrainian children

Background. The prevalence of obesity in children has a trend of constant growth. A third of the pediatric population suffers from excess body weight and obesity, which are associated with such pathological conditions as hypertension, insulin resistance, hyperglycemia, type 2 diabetes, dyslipidemia, metabolic syndrome (MS) and early cardiovascular dysfunction. Waist circumference (WC) measurement is a simple noninvasive screening tool to identify children with abdominal obesity, MS, and increased cardiovascular risk. The purpose of the study was to develop age- and gender-specific WC percentiles for Ukrainian children aged 10–17 years and to determine possible WC cut-offs for detecting abdominal obesity. Materials and methods. 1566 children aged 10–17 were examined, 759 boys and 807 girls. According to the WHO protocol, WC was measured using a flexible centimeter tape in a standing position midway between the lower rib and the upper front edge of the ilium. The threshold point for detecting abdominal obesity was WC ≥ 90th percentile of the distribution according to age and sex (IDF Consensus, 2007). Results. Age and gender percentiles of WC and cut-off at the level of the 90th percentile in Ukrainian children and adolescents are presented. The importance of gender assessment of WC lies in the reliable difference of indicators in children aged 10–12 and 15–17 years and growth of parameters with age in both boys and girls. The need for age assessment of WC is due to increasing the 90th percentile indicators in girls aged 10–17 from 76 to 90.5 cm and in boys from 75.9 to 94 cm. The data obtained can serve as a source for screening and identifying children with abdominal obesity, increased metabolic risk and a better understanding of current trends in childhood obesity. It has been suggested that new WC reference values should be added to clinical examinations to help pediatricians and family physicians reduce cardiovascular risk in children. Conclusions. In the diagnosis of MS in children, it is recommended to use the proposed specific percentiles of WC for sex and age, the values of which ≥ 90th percentile of the distribution should be utilized for detection of abdominal obesity and further diagnosis of MS. Measuring and evaluating WC in routine pediatric examinations is important.

Early Endocrine and Metabolic Complications in Childhood Cancer Survivors—Experience from a Tertiary Care Pediatric Oncology Center in South India

Background Endocrine abnormalities and metabolic complications remain one of the common late effects after cancer therapy in children. Data on the incidence and pattern of complications would help to guide appropriate monitoring and treatment of childhood cancer survivors. Methods, Aims, and Objectives Purpose of study is to determine endocrine and metabolic effects in childhood cancer survivors including both hematological malignancies and solid tumors due to cancer per se and treatment-related, including different chemotherapeutic agents and radiotherapy. Results Among 97 participants, 84 children (84.5%) had at least one endocrine or metabolic complication; 41 children (42.3%) had more than two endocrine/metabolic complications. Common endocrine complications included precocious puberty (6.2%), short stature (6.2%), and hypothyroidism (5.1%). Among metabolic complications, dyslipidemia was the highest with an incidence of 68%, followed by fasting hyperinsulinism (32%), diastolic hypertension (18.6%), systolic hypertension (11.3%), obesity (8.8%), and metabolic syndrome (8.2%) and impaired fasting glucose (4.1%).Among endocrine complications, there was a significant increase in incidence of hypothyroidism among children receiving radiotherapy (odds ratio [OR]: 7.13, 95% confidence interval [CI]: 1.1–46.2), and among metabolic complications, a significant increase in incidence of metabolic syndrome in children treated with L-asparaginase compared with those not treated with L-asparaginase was observed (OR: 5.61, 95% CI: 1.07–29.5). There was no significant difference between incidence of observed endocrine and metabolic complications based on type of tumor, gender, and puberty status of study participants. Conclusion This study suggests that there is significant incidence of endocrine and metabolic complications in childhood cancer survivors, hence timely and appropriate recognition of these complications by appropriate screening recommendations and pursuing further endocrine evaluation rationally is needed.

Influence of Nutrition on Growth and Development of Metabolic Syndrome in Children

Obesity is currently an increasing public health burden due to its related metabolic and cardiovascular complications. In Western countries, a significant number of people are overweight or obese, and this trend is, unfortunately, becoming increasingly common even among the pediatric population. In this narrative review, we analyzed the role of nutrition during growth and its impact on the risk of developing metabolic syndrome and cardiovascular complications later in life. An impactful role in determining the phenotypic characteristics of the offspring is the parental diet carried out before conception. During intrauterine growth, the main risk factors are represented by an unbalanced maternal diet, excessive gestational weight gain, and impaired glycemic status. Breastfeeding, on the other hand, has many beneficial effects, but at the same time the quality of breast milk may be modified if maternal overweight or obesity subsists. Complementary feeding is likewise pivotal because an early introduction before 4 months of age and a high protein intake contribute to weight gain later. Knowledge of these mechanisms may allow early modification of risk factors by implementing targeted preventive strategies.

Navigating the Global Pandemic in Pediatric Overweight and Obesity: Emerging Challenges and Proposed Solutions.

Since 1990, childhood overweight and obesity have been rising on every continent and have almost doubled worldwide. The deleterious consequences include hypertension, type 2 diabetes mellitus, and dyslipidemia leading to metabolic syndrome in childhood and myocardial infarction, stroke, cancer and other disabling conditions in adulthood. In Southern Europe, including Greece, Italy, and Spain, 10 to 15% of children are obese. Obesity in Eastern European countries is somewhat lower, but the rates of rise are very steep and will approach those in Southern Europe during the next few years. Worldwide, Asia accounts for nearly half of all overweight children under the age of 5, while Africa is home to one quarter of overweight children under 5. In Latin America, about 20% of children under 20 are overweight. Further, children living in poverty can suffer simultaneous overweight and obesity as well as malnutrition. In the US, the risk of being overweight in adolescence is several times higher when a younger child has a body mass index (BMI) in the 50th or greater percentile. If the clinical, non-clinical and public health communities ignore these challenges, such inaction will surely portend an unprecedented future pandemic of overweight and obesity in children and adolescents leading to future premature morbidity and mortality. All clinical, non-clinical and public health professionals should exert concerted efforts concerning their individual patients, their families, communities, and policymakers. Such coordinated interdisciplinary efforts may curb these alarming trends and secure healthier futures for children and their families throughout the world.

The phenotype of the pediatric patient with Cushing syndrome but without obesity.

Cushing syndrome (CS) often presents with obesity that is not as severe in children as it is in adults. The role of obesity in the severity of metabolic syndrome in children with CS has not been studied. This study evaluates whether pediatric patients with CS have obesity-specific differences in their demographic, biochemical, and presenting findings. Cohort study. We analyzed 273 patients with young onset of CS at ≤18 years old and who were classified as patients with or without obesity based on their BMI z scores. Patients without obesity (n = 84, 31%) were more frequently females with an older age of onset compared with patients with obesity (n = 189, 69%). Consistent with their older age, patients without obesity were also more likely to have advanced Tanner stages. Patients with and without obesity had a similar duration of disease, but patients with obesity showed higher markers of hypercortisolemia (urinary free cortisol, UFC). A higher prevalence of hypertension and insulin resistance was seen in patients with obesity than those without obesity, adjusting for UFC (P < .05 for all comparisons). While fatty liver disease was not statistically different among the entire cohort, elevated alanine transaminase and metabolic dysfunction-associated steatotic liver disease scores were more common in ACTH-dependent CS patients with obesity (P < .05). Weight gain appears to mediate some but not all the cortisol-associated complications in pediatric CS. Therefore, obesity may be a modifiable risk factor among these patients.

Increased serum carboxylesterase-1 levels are associated with metabolic dysfunction associated steatotic liver disease and metabolic syndrome in children with obesity

BackgroundCarboxylesterase 1(CES1) is expressed mainly in the liver and adipose tissue and is highly hypothesized to play an essential role in metabolism. Our study aimed to investigate the association between CES1 and metabolic syndrome (MetS) and metabolic dysfunction associated steatotic liver disease (MASLD) in children with obesity in China.MethodsThis study included 72 children with obesity aged 6-13years (including 25(35%) diagnosed as MetS and 36(50%) diagnosed as MASLD). All subjects were measured in anthropometry, serum level of biochemical parameters related to obesity, circumstance levels of insulin-like growth factor1, adipokines (adiponectin, leptin and growth differentiation factor 15) and CES1.ResultsHigher serum CES1 level were found in the MetS group (P = 0.004) and the MASLD group (P < 0.001) of children with obesity. Serum CES1 levels were positively correlated with alanine aminotransferase, aspartate aminotransferase, triglyceride, cholesterol, low-density lipoprotein cholesterol, GDF15, Leptin and negatively correlated with high-density lipoprotein cholesterol, adiponectin and IGF1. We also found a multivariable logistic regression analysis of MASLD and MetS predicted by CES1 significantly (MASLD P < 0.01, MetS P < 0.05). The combination of CES1, sex, age and BMI Z-score showed a sensitivity and specificity of 92.7% for the identification of MASLD and 78.6% for the identification of MetS. The cutoff for CES1 of MASLD is 56.30 ng/mL and of MetS is 97.79 ng/mL.ConclusionsCES1 is associated with an increasing risk of MetS and MASLD and can be established as a biomarker for metabolic syndrome and MASLD of children with obesity.

Developmental aspects of metabolic syndrome in children under treatment with gastrointestinal lipase inhibitors

Alongside the increasing trends in obesity rates, there is a documented rise in the prevalence of metabolic syndrome (MetS) in children, dictating that each component of MetS should be identified as early as possible;and the treatment goal consists of reducing obesity, managing metabolic complications, insulin resistance, and also addressing hypertension (HTN).Aim of the study. To determine risk factors, the role of certain proinflammatory markers (TNF α, hs-CRP), and adipokines (leptin, adiponectin) in the onset of MetS in children and their evolution under treatment with gastrointestinal lipase inhibitors (GLI). Material and methods. The presented results were obtained as part of a project within the State Program 2020-2023 titled “Evolutionary Aspects of Metabolic Syndrome in Children Under Treatment with Gastrointestinal Lipase Inhibitors”, project number 20.80009.8007.33. The study included 57 children with MS (IDF, 2007). Depending on the pharmacological therapy associated with non-pharmacological treatment, the children in the research were divided into 3 groups: Group I- 23 children who received orlistat (orlip) - GLI, Group II - 15 children who received Angiotensin Converting Enzyme Inhibitors (ACEIs), and Group III - 19 children who received both GLI and ACEIs. The control group consisted of 50 normotensive and normal-weight children of similar age (gender ratio: 1:1). Risk factors, body mass index (BMI), waist circumference (WC), blood pressure values, total cholesterol (TC), LDL-C, HDL-C, triglycerides (TG), basal glycemia (BG), serum insulin, TNFα, hs-CRP, leptin, and adiponectin were analyzed initially and at the 3-month interval.The study protocol was approved by the Medical Ethics Committee of the Institute of Cardiology, Republic of Moldova (minutes no.2 dated February 20, 2020).Results: The majority of children in the study had a history of hereditary aggravated HTN and obesity, were sedentary or moderately sedentary, and had poor dietary habits. Among the components of MetS (IDF, 2007) associated with abdominal obesity, the following predominated: hypertension in 38 (66.7%) children, hypertriglyceridemia - 32 (56.1%%) children, increased basal blood glucose (BG) - 17(29.8%) children and hypo-HDL-C - 11 (19.3%) children. BMI at the 3-month interval from the initiation of medication decreased most significantly in group I (-4.025±1.267 kg/ m2), followed by group II (-3.33±0.972 kg/m2), and III (-3.046±0.840 kg/m2). WC decreased most notably in group III (-10.63±3.732 cm) compared to group II (-9.167±1.783 cm) and group I (-4.700±2.352 cm). Similar trends were observed for blood pressure values: group III (-18.75±1.897 mm Hg) vs group II (-12.167±1.359 mm Hg) vs group I (-3.900±4.613 mm Hg). LDL-C decreased essentially in group II (-0.46±0.211 mmol/l), while TG decreased in group III (-0.77±0.325 mmol/l) and II (-0.53±0.112 mmol/l). HDL-C increased by +0.60±0.274 mmol/l in group I, by +0.15±0.066 mmol/l in group II, and by +0.12±0.031 mmol/l in group III. Serum insulin decreased predominantly in group III (-9.36±4.53 µU/ mL). Similar trends were observed for BG (group III -1.24±0.322 mmol/l). TNF α decreased most significantly in group III (-2.65±0.911 pg/ml) compared to group I (-1.24±0.508 pg/ml) and group II (-1.61±1.018 pg/ml). hs-CRP decreased mainly in group I (-0.69±0.785 mg/l) and group II (-0.74±0.593 mg/l) compared to group III (-0.42±0.617 mg/l). Leptin values decreased significantly in all study groups at the 3-month interval from the initiation of medication (group I by-8.80±3.64 ng/ml, group II by -10.92±4.084 ng/ml, group III by -9.75±6.172 ng/ml). Adiponectin values increased by+1.83±1.087 µg/L in group III of the study.Conclusion: In combination with a calorie-restricted diet, regular physical exercise, and behavioral modifications, treatment with ILG and ACEIs in children with MetS in the study contributed to a decrease in the degree of obesity, blood pressure values, and normalization of the lipid and glucose profile, respectively. Additionally, it highlighted both the importance of prevention, early detection, and management of obesity, as well as the causal link between obesity, hypertension, and chronic inflammation.

Dietary intake, obesity, and metabolic risk factors among children and adolescents in the SEACO-CH20 cross-sectional study

We investigated the association between dietary intake and metabolic risk factors in children and adolescents within a semi-rural Malaysian community. Using an interviewer-led questionnaire, we surveyed 623 participants aged 7–18 from the South East Asia Community Observatory (SEACO). Anthropometric and blood pressure data were collected from all participants, while a subset (n = 162) provided blood samples for biomarker analysis, including fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Metabolic syndrome was determined using the International Diabetes Federation’s Definition of Metabolic Syndrome in Children and Adolescents. Most participants were Malay (66.8%), with a median household income of MYR1,500 and a balanced sex distribution. Cereals, processed foods, beverages, fruits, and vegetables were commonly consumed. Obesity and abdominal obesity were prevalent, affecting more than a third of participants. Adherence to dietary recommendations was generally poor (ranging from 19.9 to 58.1%) and varied across age, sex, and ethnicity. Notably, some food groups displayed unexpected associations with health markers; for instance, fruit consumption was linked to abdominal obesity in children (abdominal obesity vs. normal: 2.4 servings/day vs. 1.6 servings/day). These findings emphasise the necessity of longitudinal studies to explore the complex relationship between diet and long-term health outcomes, including cardiometabolic diseases, while acknowledging the unique challenges posed by the COVID-19 pandemic on data collection and analysis.

Metabolic syndrome in children and adolescents

Background: Metabolic syndrome is a serious condition associated with multiple diseases. The prevalence of metabolic syndrome is increasing caused by an increase in obesity rates among children and adolescents.Current Concepts: Owing to the various definitions used, there is lack of consensus regarding the diagnostic criteria for metabolic syndrome in children and adolescents. Although the exact pathogenesis remains unclear, insulin resistance and subsequent inflammation are key mechanistic contributors. Metabolic syndrome is characterized by overweight and obesity accompanied by abnormalities in glucose metabolism, dyslipidemia, and hypertension and is associated with other conditions such as fatty liver, polycystic ovary syndrome, and a pro-inflammatory state. Prevention and management of metabolic syndrome can be achieved through lifestyle modifications, behavioral interventions, pharmacotherapy, and surgical interventions.Discussion and Conclusion: Childhood and adolescent obesity serves as a risk factor for metabolic syndrome during later life. Early identification and intervention are important to prevent the progression of metabolic syndrome. Clinicians must identify at-risk children and adolescents and provide guidance for the prevention and management of metabolic syndrome.

Association between Mothers' Working Hours and Metabolic Syndrome in Children and Adolescents: Data from the Korea National Health and Nutrition Examination Survey, 2016-2020.

Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers' working hours. The present study was conducted to determine the relationship between mothers' working hours and MetS in their children. Data from the 2016-2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10-18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers' working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers' working hours and the number of risk factors for MetS. Abdominal obesity in children was higher when the mothers' working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21-4.25). In the trend analysis, the OR of children's abdominal obesity increased significantly as mothers' working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954-18.822). Mothers' working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

METABOLIC SYNDROME IN PEDIATRIC PRACTICE: DEFINITION, DIAGNOSTIC CRITERIA AND PRINCIPLES OF PATIENT MANAGEMENT (OVERVIEW)

The article comprehensively reviews epidemiological indicators, risk factors, pathophysiological mechanisms, diagnostic criteria, and contemporary management principles of metabolic syndrome in pediatric practice. The study relies on the extensive analysis of literature sources retrieved from electronic databases such as PubMed, UpToDate, Web of Science, ScienceDirect, Scopus, MedLine, and Elsevier. The literature review highlights the escalating prevalence of metabolic syndrome as an urgent medical and social concern among children and adolescents, primarily attributed to the global epidemic of childhood obesity. The article not only outlines key findings but also presents recommendations from international medical societies concerning screening strategies, diagnostics, and therapeutic approaches for the individual components contributing to metabolic syndrome in childhood. The review also focuses on pivotal studies exploring alternative therapies targeting the principal pathogenic factors of the disease. In conclusion, the authors emphasize the pressing issue of the absence of standardized criteria for diagnosing metabolic syndrome in children, highlighting the imperative role of a multidisciplinary team of specialists in the effective management of this pathology in pediatric practice.

The Benefits of the Mediterranean Diet on Inflamm-Aging in Childhood Obesity.

(1) Background: Numerous elements of the Mediterranean diet (MD) have antioxidant and anti-inflammatory qualities. (2) Methods: We present a narrative review of the potential benefits of the Mediterranean dietary pattern (MD) in mitigating aging-related inflammation (inflamm-aging) associated with childhood obesity. The mechanisms underlying chronic inflammation in obesity are also discussed. A total of 130 papers were included after screening abstracts and full texts. (3) Results: A complex interplay between obesity, chronic inflammation, and related comorbidities is documented. The MD emerges as a promising dietary pattern for mitigating inflammation. Studies suggest that the MD may contribute to weight control, improved lipid profiles, insulin sensitivity, and endothelial function, thereby reducing the risk of metabolic syndrome in children and adolescents with obesity. (4) Conclusions: While evidence supporting the anti-inflammatory effects of the MD in pediatric obesity is still evolving, the existing literature underscores its potential as a preventive and therapeutic strategy. However, MD adherence remains low among children and adolescents, necessitating targeted interventions to promote healthier dietary habits. Future high-quality intervention studies are necessary to elucidate the specific impact of the MD on inflammation in diverse pediatric populations with obesity and associated comorbidities.

Pre-Pregnancy Obesity and Infants' Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden?

Pre-pregnancy obesity is a significant public health concern with profound implications for maternal and child health. The burgeoning evidence suggests that maternal obesity prior to conception is intricately linked with an increased risk of gestational complications, as well as with adverse neonatal outcomes. Furthermore, the long and short-term health of offspring, including the risk of early motor development impairment, obesity, and metabolic syndrome in childhood and adulthood, may be adversely affected as well. Addressing pre-pregnancy obesity is critical for improving overall maternal and child health outcomes, and therefore, the aim of this study was to evaluate the connections linking pre-pregnancy obesity with infants' motor development within the first twelve months of infants' lives. This study included 200 mother-infant pairs divided into two groups based on their pre-pregnancy body mass index values. To assess infants' early motor development, we used the Alberta Infant Motor Scale (AIMS) and evaluated the parameters of infants' early motor development at the ages of three, six, nine, and twelve months. Pre-pregnancy overweight/obesity was significantly associated with excessive gestational weight gain (p < 0.001), fetal macrosomia (p = 0.022), and a family history of diabetes and cardiovascular diseases (p = 0.048 and p = 0.041, respectively), as well as with all observed parameters of early motor development at the ages of three, six, nine, and twelve months: AIMS 3 months total (p < 0.001), AIMS 6 months total (p < 0.001), AIMS 9 months total (p < 0.001), and AIMS 12 months total (p < 0.001). Furthermore, pre-pregnancy overweight/obesity was a significant predictor for AIMS 6 months total (p = 0.043) and AIMS 6 months supination (p = 0.017). Pre-pregnancy obesity is a critical determinant of pregnancy outcomes and offspring early motor development, with possible far-reaching implications for children's long-term well-being. Addressing this issue requires a comprehensive approach that includes preconception weight management, targeted interventions during the pregnancy and postpartum periods, and ongoing research to better understand the underlying mechanisms and develop effective strategies for prevention and management.

Complete Blood Count-Derived Inflammation Indexes Are Useful in Predicting Metabolic Syndrome in Children and Adolescents with Severe Obesity.

Background: Childhood obesity is a globally increasing pathological condition leading to long-term health issues such as cardiovascular diseases and metabolic syndrome (MetS). This study aimed to determine the clinical value of the Complete Blood Count-derived inflammation indexes Monocyte/HDL-C ratio (MHR), Lymphocyte/HDL-C ratio (LHR), Neutrophil/HDL-C ratio (NHR), and System Inflammation Response Index (SIRI) to predict the presence of metabolic syndrome and its association with cardiovascular risk markers (HOMA-IR, TG/HDL-C, and non-HDL-C) in children and adolescents with obesity. Methods: The study included a total of 552 children/adolescents with severe obesity (BMI: 36.4 [32.7-40.7] kg/m2; 219 males, 333 females; age: 14.8 [12.9-16.3] years), who were further subdivided based on the presence or absence of metabolic syndrome (MetS+ and MetS respectively). Results: The MHR, LHR, and NHR indexes (p < 0.0001), but not SIRI (p = 0.524), were significantly higher in the MetS+ compared to the MetS- subgroup, showing a positive correlation with the degree of MetS severity (p < 0.0001). Furthermore, MHR, LHR, and NHR were positively associated with cardiometabolic risk biomarkers (HOMA-IR: MHR p = 0.000, LHR p = 0.001, NHR p < 0.0001; TG/HDL-C: MHR, LHR, NHR p < 0.000; non-HDL-C: MHR, LHR p < 0.0001, NHR p = 0.000). Finally, the ROC curve analysis demonstrated that among the analyzed indexes, only MHR, LHR, and NHR had diagnostic value in distinguishing MetS patients among children and adolescents with obesity (MHR: AUC = 0.7045; LHR: AUC = 0.7205; NHR: AUC = 0.6934; p < 0.0001). Conclusions: In conclusion, the MHR, LHR, and NHR indexes, but not the SIRI index, can be considered useful tools for pediatricians to assess the risk of MetS and cardiometabolic diseases in children and adolescents with obesity and to develop multidisciplinary intervention strategies to counteract the widespread disease.

Understanding Vatavyadhi as a Sequelaeae of Metabolic Syndrome And Its Management - A Review

The increasing occurrence of metabolic syndrome in children and teenagers is alarming due to the potential for significant long-term health issues. Recognizing and addressing this condition early are essential to avoid permanent harm. Traditional Ayurvedic perspectives offer valuable insights into this issue. Conditions such as Sthaulya (Obesity), Prameha (Diabetes), Shonita Dusti (Blood Impurity), and Dhamani Pratichaya (Vascular Diseases) share similarities with metabolic syndrome. These arise from excessive intake and accumulation (Santarpana nidana), leading to a build-up of Kapha (one of three senses of humor having unctuous property) and Medha (fat), eventually affecting other Doshas (humor) and multiple tissues. Ayurvedic treatments aim to manage these conditions, as they tend to be chronic and prone to complications, potentially progressing to Vatavyadhi (neurological disorders) over time. The interplay of kapha and medha in blocking channels (Margavarana) is a crucial consequence of these conditions, contributing to the development of vatavyadhi. This review article highlights the importance of early intervention and traditional Ayurvedic approaches in managing metabolic syndrome-like conditions in children and adolescents to prevent long-term complications.

Nonalcoholic Fatty Liver Disease and Continuous Metabolic Syndrome in Adolescents with Overweight/Obesity.

Nonalcoholic fatty liver disease is the leading cause of pediatric chronic liver disease. Although nonalcoholic fatty liver disease is closely associated with obesity, its relationship with metabolic syndrome in children is not fully understood. The main aim of this study was to evaluate the association between nonalcoholic fatty liver disease and a combination of cardiometabolic risk factors in adolescents with overweight/obesity, using a pediatric metabolic syndrome score (PsiMS) to predict metabolic syndrome. A retrospective cohort study was conducted. Subjects with overweight/obesity aged 10 to 17 followed at two clinical centers in Portugal (2018 - 2021) were enrolled. The independent association of nonalcoholic fatty liver disease with PsiMS, and of other potential predictors, was tested through multiple regression analyses. Receiver operator characteristic curve analysis was performed to estimate the optimal cutoff of PsiMS to discriminate metabolic syndrome. Eighty-four subjects were included (median age at baseline 11.5 years). The prevalence rate of nonalcoholic fatty liver disease was 51% and the prevalence rate of metabolic syndrome was 7%. The mean PsiMS was 2.05 ± 0.48 at the first evaluation, and 2.11 ± 0.52 at the last evaluation (mean follow-up time was 15 months). The nonalcoholic fatty liver disease group had significantly (p < 0.05) higher weight and body mass index z-scores, higher rate of severe obesity and higher waist circumference percentile. PsiMS was highly accurate in predicting metabolic syndrome (area under the curve = 0.96), with an optimal cutoff of 2.46 (sensitivity 100%, specificity 89%). In the univariate analysis, no statistically significant association was observed between nonalcoholic fatty liver disease and PsiMS. In the multiple regression analysis, female sex had a negative association with PsiMS (first and last evaluation). Independent predictors of a higher PsiMS at first evaluation were: ≥ 2 metabolic syndrome criteria, body mass index z-score, insulin resistance and dyslipidemia. At the last evaluation, independent predictors of a higher PsiMS were: nonalcoholic fatty liver disease, baseline PsiMS and body mass index increase from baseline. The results suggest a good performance of the PsiMS to assess metabolic syndrome and that nonalcoholic fatty liver disease is associated with PsiMS at follow-up.

Metabolic syndrome in children with overweight and obesity: a hospital based cross sectional study

Background: Objective of the research was to study metabolic syndrome (MS) in children with overweight and obesity. Methods: A cross sectional descriptive study was carried out on 264 children aged 3-16 years with overweight and obesity attending the endocrinology clinic of a tertiary care hospital in South India from January 2016 to March 2018. Children with and without MS were compared. Results: Out of 264 children with overweight or obesity, 80 had MS (30.3%). Among children with obesity, proportion of patients with MS (40.5% versus 24.2%, p=0.012), hypertriglyceridemia (54.8% versus 37.5%, p=0.013), low high density lipoprotein cholesterol (HDL-C) (42.9% versus 28.1%, p=0.027) and dyslipidemia (78.6% versus 59.4%, p=0.004) were higher among girls versus boys. Proportion of patients with elevated systolic blood pressure (BP) (18.8% versus 4.3%, p&lt;0.0001), elevated diastolic BP (34.5% versus 5.4%, p&lt;0.0001), impaired fasting glucose (16.2% versus 7.6%, p=0.033), hypertriglyceridemia (85% versus 26.6%, p&lt;0.0001), low HDL-C (75% versus 15.2%, p&lt;0.0001) and dyslipidemia (97.5% versus 57.1%, p&lt;0.0001) were higher in those with MS versus those without. Conclusions: MS noted in younger children with overweight and obesity in the current study is concerning as these children are at increased risk for hypertension, type 2 diabetes and cardiovascular disease in early adulthood leading to huge economic burden on the country. It is therefore of utmost importance to take necessary steps to identify these children, manage obesity effectively before MS sets in and initiate preventive measures thereby ensuring a healthy young generation in the coming years.

Obesitas pada Anak

The global prevalence of obesity in children increases every year. Many factors influence the occurrence of obesity in children. Diagnosis is based on the distribution of fatty tissue with typical clinical manifestations such as a rounded face, chubby cheeks, double chin, relatively short neck, pendulous abdomen, and abdominal striae. Management and prevention are essential to prevent metabolic syndrome in children.

Waist Circumference as an Indicator for Metabolic Syndrome in Children: A Narrative Review

Waist Circumference as an Indicator for Metabolic Syndrome in Children: A Narrative Review

Dietary habits and salivary cortisol levels as an early predictor of metabolic syndrome in children: a case-control study

Dietary habits and salivary cortisol levels as an early predictor of metabolic syndrome in children: a case-control study