Metabolic Syndrome In Children Research Articles

Comparative analyses of surrogates of metabolic syndrome in children and adolescents with metabolically healthy obesity vs. metabolically unhealthy obesity according to Damanhoury's criteria.

Metabolically healthy obesity (MHO) has been reported with varying frequencies in children. The reasons of metabolically healthy phenotype in some obese subjects are unclear. Our aim was to identify the frequency of MHOinobese subjects, to assess the potential associations ofdemographic characteristics, serum uric acid, alanine transaminase (ALT), pediatric nonalcoholic fatty liver disease fibsosis score probability (PNFS p) with MHO statusand to evaluate the differences between MHO and metabolically unhealthy obesity (MUO) with regard to metabolic syndrome surrogates. 251 consecutive obese subjects (125 females) aged7-18 years were included. Subjects were classified as having MHO according to Damanhoury's criteria. Several metabolic variables were measured, PNFS p was calculated by using the formula: z=1.1+(0.34*sqrt(ALT))+ (0.002*ALP)-(1.1*log(platelets)-(0.02*GGT). Median age of the subjects was 12.5yr (range: 7.0-17.0yr). The frequency of MHO was 41%. Subjects withMHO were significantly younger, had lower waist circumference (WC) and waist height ratio (WHtR) and lowerHOMA-IR than those without MHO(p<0.05 for all). Frequencies of hyperuricemia, hypertransaminasemia, hepatosteatosis and PNFS p values≥8 were similar betwen the groups. When putatively influential factors associated with MHO status were assessed with logistic regression analysis, only WC(β=1.03) and HOMA-IR(β=1.166) emerged assignificant factors(Nagelkerke R2=0.142). None of the investigated demographic factors were associated with MHOstatus. We found a remarkably high frequency of MHO status. Nevertheless, the absence of decreased frequencies of hyperuricemia, hypertransaminasemia andPNFS in subjects with MHO may suggest the need to reconsider the validity of the criteria defining MHO.

Cardiovascular Risk Score among Adolescents - Review of Its Methods and Outcome

World Health Organization reported that cardiovascular disease (CVD) is the leading cause of death, which has taken approximately 17.9 million lives across the globe. Current studies identified high prevalence and severity of metabolic syndrome in children which is likely increase the incidence of premature death and contribute to the statistical number of cardiovascular disease and related events worldwide. Therefore, measurement of the cardiovascular risk score among the children, specifically adolescent need to be implemented in order to modify the risk and improve the disease outcomes. This review aims to identify the assessment methods and the implications. Full-text article on case control, cohort and cross-sectional studies published from 1st Jan 2012 until 30th September 2022, were searched using PubMed, CINAHL and Scopus. Teenagers or adolescent age range from 11 to 19 years were included in this study. The cardiovascular risk and score assessment methods as well as the outcomes of the assessment were included in this study. 8 out of 40 articles met the eligibility criteria and were selected. Two out of eight studies classify the risk factors into categories. One study classified the participants into high, medium and low risk group while another study categorised them into fit and unfit. Most studies agreed that assessment of CVD risk should focus on multiple risk factors instead of individual risk. Two studies suggest increase physical activities among children can reduce the obesity. Another study recommended family-based intervention to prevent CVD risk factors particularly obesity. In conclusion, predicting CVD from childhood and adolescence required a multifactorial assessment. Majority of study showed that multiple risk assessment is required to predict cardiovascular events and early interventions are needed in children who pose higher risk compared to others

Identifying the Novel Gut Microbial Metabolite Contributing to Metabolic Syndrome in Children Based on Integrative Analyses of Microbiome-Metabolome Signatures.

The pathogenesis of gut microbiota and their metabolites in the development of metabolic syndrome (MS) remains unclear. This study aimed to evaluate the signatures of gut microbiota and metabolites as well as their functions in obese children with MS. A case-control study was conducted based on 23 MS children and 31 obese controls. The gut microbiome and metabolome were measured using 16S rRNA gene amplicon sequencing and liquid chromatography-mass spectrometry. An integrative analysis was conducted, combining the results of the gut microbiome and metabolome with extensive clinical indicators. The biological functions of the candidate microbial metabolites were validated in vitro. We identified 9 microbiota and 26 metabolites that were significantly different from the MS and the control group. The clinical indicators of MS were correlated with the altered microbiota Lachnoclostridium, Dialister, and Bacteroides, as well as with the altered metabolites all-trans-13,14-dihydroretinol, DL-dipalmitoylphosphatidylcholine (DPPC), LPC 24: 1, PC (14:1e/10:0), and 4-phenyl-3-buten-2-one, etc. The association network analysis further identified three MS-linked metabolites, including all-trans-13,14-dihydroretinol, DPPC, and 4-phenyl-3-buten-2-one, that were significantly correlated with the altered microbiota. Bio-functional validation showed that all-trans-13, 14-dihydroretinol could significantly upregulate the expression of lipid synthesis genes and inflammatory genes. This study identified a new biomarker that may contribute to MS development. These findings provided new insights regarding the development of efficient therapeutic strategies for MS. IMPORTANCE Metabolic syndrome (MS) has become a health concern worldwide. Gut microbiota and metabolites play an important role in human health. We first endeavored to comprehensively analyze the microbiome and metabolome signatures in obese children and found the novel microbial metabolites in MS. We further validated the biological functions of the metabolites in vitro and illustrated the effects of the microbial metabolites on lipid synthesis and inflammation. The microbial metabolite all-trans-13, 14-dihydroretinol may be a new biomarker in the pathogenesis of MS, especially in obese children. These findings were not available in previous studies, and they provide new insights regarding the management of metabolic syndrome.

Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study

BackgroundThe increasing trend in childhood obesity needs to be closely monitored and intervened due to long-term health issues such as metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes. We aimed to determine and compare the cut-off values for the visceral adiposity index (VAI), triglyceride-glucose index (TyG), and HOMA-IR for predicting metabolic syndrome (MetS).MethodsThis population-based cross-sectional study was conducted in May 2019 in Samsun, Turkey. The study included 169 children with obesity aged 9 and 10 years. After anthropometric and clinical evaluation, fasting blood samples were collected from the children. The areas under the curve of the visceral adiposity index, triglyceride-glucose index, and HOMA-IR were compared by receiver-operating-characteristic (ROC) analysis in predicting the MetS.ResultsThe total prevalence of MetS was 21.3% in children with obesity, and it was two times higher in girls than in boys. The mean values of TyG and VAI were significantly different in those who have and have not MetS in both genders. However, the HOMA-IR index was higher only in girls with MetS and did not differ in boys by having MetS. The VAI and the TyG index both had statistically significant cut-off values in both sexes and a larger ROC area than the HOMA-IR index in predicting MetS.ConclusionsThe VAI and TyG index are effective indicators in assessing the MetS risk in children with obesity. Both indexes can be considered useful tools in pediatric research and the evaluation of interventions. However, the HOMA-IR index formula needs to be developed taking into account age, gender, and ethnicity.

Metabolic Derangements with Anticonvulsants in Children with Generalised Tonic-clonic Epilepsy: A Cross-sectional Study

Introduction: Epilepsy is one of the most prevalent noncommunicable neurologic conditions, accounting for significant disability and mortality. The effects of Antiepileptic Drugs (AEDs) on total cholesterol, triglycerides, High-Density Lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, and apolipoprotein levels have been demonstrated in many studies, mainly conducted with adults. However, there have been very few studies in children. Derangement of lipid profile and other metabolic abnormalities could lead to the development of metabolic syndrome in children. The adverse metabolic effects of anti-epileptics are underestimated, as only a few studies have been done in this area, which is a legitimate concern. Aim: To assess the impact of AEDs on metabolic parameters in children with epilepsy. Materials and Methods: This was a descriptive, crosssectional study conducted in the Department of Paediatrics and Pharmacology at Pt. BD Sharma PGIMS, Rohtak, Haryana, India. The study included 100 children with epilepsy from May 2022 to October 2022. A predefined case record form, including demographic and clinical characteristics, was filled for each participant. The parameters recorded were age, gender, outpatient number, type of epilepsy, history of duration of epilepsy, current AED history, and seizure frequency over the preceding six months, as per the case record form. Guidelines from the International Diabetes Federation were used for diagnosing metabolic syndrome in children. The data was entered into Microsoft excel and presented using descriptive statistics. The chi-square test was used to differentiate between categorical variables. Results: The mean age of the study participants was 10.2±2.97 years. There were more males (62%) than females (38%). A 48% of the patients received monotherapy, while 52% received polytherapy. A total of 24% of the patients had derangement in lipid profile (increased triglycerides and decreased HDL), with 14% of patients on monotherapy and 10% on polytherapy. The difference in metabolic derangements between monotherapy and polytherapy was not statistically significant (p=0.25). Out of 100 participants, 3% fulfilled the criteria for metabolic syndrome, with a predominance in males. Conclusion: Metabolic derangements are known with 1st generation AEDs, but 2nd generation AEDs can also lead to significant metabolic abnormalities.

Vitamin D supplementation combined with aerobic physical exercise restores the cell density in hypothalamic nuclei of rats exposed to monosodium glutamate.

In view of the increase in the prevalence of obesity and metabolic syndrome in childhood and adolescence, this study proposed the early and combined use of treatments to restore brain areas related to satiety. The vitamin D supplementation, aerobic exercise and the combination of these interventions on the structure of arcuate (ARC) and ventromedial (VMH) nuclei of hypothalamus were investigated in monosodium glutamate (MSG)-treated rats. Wistar rats were separated into five groups: Control group (CT); Obese group injected with MSG (OB); Obese group supplemented with vitamin D (OBvd); Obese group submitted to forced swimming training (OBexe) and Obese group treated with vitamin D supplementation and forced swimming training (OBvd+exe). In the OB group, the visceral fat weight was significantly higher, there was a reduction in the number of glial cells in the ARC nucleus and also in the number of neurons in the ARC and VMH nuclei. Aerobic exercise was able to reduce the visceral fat weight in the OBexe group. The combination of treatments used in the OBvd+exe group reversed the loss of neurons and glial cells produced by MSG in the ARC nucleus. All treated groups exhibited a higher number of neurons in VMH nucleus, but an increase in the glial cells were observed only in the OBexe and OBvd+exe groups. The effectiveness of obesity treatment can be favored through the early and combined use of vitamin D supplementation and aerobic exercise, since these therapies are able to restore brain nuclei involved in the control of food intake.

Association of urinary and ambient black carbon, and other ambient air pollutants with risk of prediabetes and metabolic syndrome in children and adolescents

The effects of exposure to black carbon (BC) on various diseases remains unclear, one reason being potential exposure misclassification following modelling of ambient air pollution levels. Urinary BC particles may be a more precise measure to analyze the health effects of BC. We aimed to assess the risk of prediabetes and metabolic syndrome (MetS) in relation to urinary BC particles and ambient BC and to compare their associations in 5453 children from IDEFICS/I. Family cohort. We determined the amount of BC particles in urine using label-free white-light generation under femtosecond pulsed laser illumination. We assessed annual exposure to ambient air pollutants (BC, PM2.5 and NO2) at the place of residence using land use regression models for Europe, and we calculated the residential distance to major roads (≤250 m vs. more). We analyzed the cross-sectional relationships between urinary BC and air pollutants (BC, PM2.5 and NO2) and distance to roads, and the associations of all these variables to the risk of prediabetes and MetS, using logistic and linear regression models. Though we did not observe associations between urinary and ambient BC in overall analysis, we observed a positive association between urinary and ambient BC levels in boys and in children living ≤250 m to a major road compared to those living >250 m away from a major road. We observed a positive association between log-transformed urinary BC particles and MetS (ORper unit increase = 1.72, 95% CI = 1.21; 2.45). An association between ambient BC and MetS was only observed in children living closer to a major road. Our findings suggest that exposure to BC (ambient and biomarker) may contribute to the risk of MetS in children. By measuring the internal dose, the BC particles in urine may have additionally captured non-residential sources and reduced exposure misclassification. Larger studies, with longitudinal design including measurement of urinary BC at multiple time-points are warranted to confirm our findings.

Metabolic syndrome in children: algorithms of diagnostic and therapeutic and preventive measures

There is an increase in the incidence of obesity and metabolic syndrome (MS) among children and adolescents. The purpose of the study: to improve the algorithms of diagnostic and therapeutic and preventive measures for MS in obese children. Materials and methods. A comprehensive examination of 483 children with exogenous constitutional obesity aged 6-17 years (285 boys and 198 girls) (SDS BMI ≥ 2.0) was conducted. Results. MS (IDF, 2007) was diagnosed in 49% of the examined children. Adolescents aged 12-17 prevailed (77%). Boys 61%, girls 39% (p<0.05). 61% of adolescents were obese for 5 years or more. 54% of children had a combination of abdominal obesity with two additional components (an incomplete version of MS), 33% - with three, 13% of adolescents had complete MS (a combination of all five components). The analysis of hereditary burden has established a high incidence of obesity, type 2 diabetes, diseases of the cardiovascular system in the mother and maternal grandmother. An increase in blood pressure was detected in 79% of children with MS, arterial hypertension of the I degree - in 34%, hypertension of the II degree - in 22%. Pronounced disorders of glucose metabolism were revealed in the form of a high frequency of IR (81%) and compensatory hyperinsulinemia (55%). Changes in the lipid profile were recorded in 77% of children with MS. An increase in the level of TG and a decrease in HDL cholesterol, which are components of MS, were in 48% and 55% of children, respectively, and their combination was in 27%. Non-alcoholic fatty liver disease was diagnosed in 70% of children with MS, signs of non-alcoholic steatohepatitis - in 13%. In 29%, cholesterosis of the gallbladder was detected, in 34% - biliary sludge, in 7% - gallstones. Conclusion. Based on a comprehensive examination, a diagnostic algorithm and a three-level MS prevention program have been developed, as well as a mathematical model for predicting MS based on the assessment of indicators such as the size of the pancreatic head, thyroid volume, serum alanine aminotransferase (ALT) level, fasting serum glucose level, increased liver echogenicity, according to which it is possible to predict the development of MS in children at the outpatient level at the early stages metabolic disorders.

Clustering patterns of metabolic syndrome: A cross-sectional study in children and adolescents in Kyiv.

The aim: to identify subgroups by cluster analysis according parameters: original homeostatic model of insulin resistance (HOMA-1 IR), updated computer model of insulin resistance (HOMA-2 IR), β-cell function (%B) and insulin sensitivity (%S) for the prognosis of different variants of metabolic syndrome in children for more individualized treatment selection. The observational cross-sectional study on 75 children aged from 10 to 17 with metabolic syndrome according to the International Diabetes Federation criteria was conducted at the Cardiology Department of Children's Clinical Hospital No.6 in Kyiv. HOMA-1 IR was calculated as follows: fasting insulin (µIU/ml) × fasting glucose (mmol/L)/22.5. HOMA-2 IR with %B and %S were calculated according to the computer model in [http://www.dtu.ox.ac.uk]. All biochemical analysis were carried out using Cobas 6000 analyzer and Roche Diagnostics (Switzerland). The statistical analysis was performed using STATISTICA 7.0 and Easy R. The hierarchical method Ward was used for cluster analysis according the parameters: HOMA-1 IR, HOMA-2 IR, %B and %S. Four clusters were identified from the dendrogram, which could predict four variants in the course of metabolic syndrome such that children in cluster 1 would have the worst values of the studied parameters and those in cluster 4 - the best. It was found that HOMA-1 IR was much higher in cluster 1 (6.32 ± 0.66) than in cluster 4 (2.19 ± 0.13). HOMA-2 IR was also much higher in cluster 1 (3.80 ± 0.34) than in cluster 4 (1.31 ± 0.06). By the analysis of variance using Scheffe's multiple comparison method, a statistically significant difference was obtained between the laboratory parameters among the subgroups: HOMA-1 IR (p < 0,001), glucose (p < 0.001), insulin (p < 0,001), HOMA-2 IR (p < 0.001), %B (p < 0.001), %S (p < 0.001), TG ( p = 0.005) and VLDL-C (p = 0.002). A cluster analysis revealed that the first two subgroups of children had the worst insulin resistance and lipid profile parameters. It was found positive correlation between HOMA-1 IR, HOMA-2 IR, %B and %S with lipid metabolism parameters TG and VLDL-C and negative correlation between %B and HDL-C in children with metabolic syndrome (MetS).The risk of getting a high TG result in the blood analysis in children with MetS was significantly dependent with the HOMA-2 IR >2.26.

ODP382 Circulating Adipokines and Gamma-Glutamyl Transferase As Markers Associated With Metabolic Syndrome in Mexican Children Aged 6 to 12 Years

Abstract Obesity and metabolic syndrome are prevalent diseases in children. Circulating leptin, adiponectin, tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and gamma-glutamyl transferase (GGT) are markers associated with cardiometabolic diseases in adults. However, there is a lack of scientific evidence in children. Identifying these markers, which are non-invasive, accessible, and allow early detection and treatment of these diseases at an early age, becomes crucial. We examined the association between circulating adipokines and GGT with the metabolic syndrome in Mexican school-age children. The non-probabilistic sample was 140 school children aged 6 to 12 from Nuevo León, México. Nutritional assessment was performed using BMI Z-score from the World Health Organization; the criteria for metabolic syndrome for children and adolescents were from the International Diabetes Federation. Blood samples were obtained by puncturing the antecubital vein with a 12-hour fast. Serum levels of leptin, adiponectin, TNF-α and IL-6 were measured with the Luminex® xMAP® RIA Kit, and the GGT by kinetic reaction with the Dxc Beckman Coulter equipment. A multivariate statistical analysis was carried out to identify the association with the metabolic syndrome, using Student's T-Test and Simple Linear Regression with the IBM SPSS® software. Results,60 children (43%) presented overweight/obesity; 33 obese children were diagnosed with metabolic syndrome (55%). Significant differences were found in leptin (30.61±18.60 vs. 4.14±3.19 ng/mL; P=0. 00), adiponectin (29.54±23.95 vs. 67.71±41.63µg/mL; P=0. 00) and GGT (21.86±13.49 vs. 15. 00±2.69 U/L; P=0. 00), between the groups of children with and without obesity; no significant differences were found between IL-6 (5.11±4.30 vs. 4.26±5.30 pg/mL; P=0.31) and TNF-α (6.64±3.66 vs. 5.94±4.47 pg/mL; P=0.32). In children with or without metabolic syndrome we found significant differences in leptin (32.42±21.39 vs. 10.26±13.11 ng/mL; P=0. 00) and adiponectin (28. 00±19.98vs. 58.55±41.71µg/mL; P=0. 00), between the groups; no significant differences were found between GGT (18.34±7.77 vs. 17.82±10.18 U/L; P=0.78), IL-6 (5.53±4.90 vs. 4.34±4.88 pg/mL; P=0.22) and TNF-α (6.71±4.15 vs. 6. 09±4.15 pg/mL; P=0.46). In the Simple Linear Regression analysis, leptin explains 27% of the variance and adiponectin 10% of the variance. The frequency of overweight and obese children with metabolic syndrome is like other studies (1). The levels of TNF-α and IL-6 did not show a significant association in children with obesity and metabolic syndrome. Leptin and adiponectin are significantly associated with metabolic syndrome in children. In our study GGT is not associated with metabolic syndrome. However, we highlight the importance to continue studying the association of these metabolic markers in clinical practice in children. Reference: (1)López-Jaramillo et al.,Horm Mol BiolClin Invest.2014;18(1): 1–9. Presentation: No date and time listed

Is low cardiorespiratory fitness a feature of metabolic syndrome in children and adults?

Cardiorespiratory fitness has been inversely associated with risk of cardiometabolic diseases. However, there are no studies comparing the independent associations of cardiorespiratory fitness scaled by body size and composition using different approaches with cardiometabolic risk factors between children and adults. We therefore investigated these associations in children and adults using same measures for cardiorespiratory fitness and cardiometabolic risk factors. Cross-sectional. A total of 352 children (47.2 % girls) and 572 men were included in the study. Peak oxygen uptake (V̇O2peak) was measured during a maximal exercise test on a cycle ergometer and was scaled by total body mass, total fat free mass, and allometrically modelled body mass, fat free mass, and stature. Insulin, glucose, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were assessed from fasting blood samples and systolic blood pressure and diastolic blood pressure were measured. Homeostatic model assessment for insulin resistance and continuous metabolic risk score were computed. V̇O2peak scaled by body mass was inversely associated with insulin, homeostatic model assessment for insulin resistance, triglycerides, diastolic blood pressure, the cardiometabolic risk score and the number of cardiometabolic risk factors in children and adults. However, these associations attenuated remarkably when V̇O2peak was scaled by total fat free mass or allometrically modelled body mass, fat free mass, or stature. V̇O2peak was consistently and positively associated with high-density lipoprotein cholesterol in children and adults irrespective of the scaling approach. The inverse associations of cardiorespiratory fitness with cardiometabolic risk factors among children and adults attenuated remarkably when body size and composition were appropriately controlled for. However, the positive association between cardiorespiratory fitness and high-density lipoprotein cholesterol was consistent irrespective of the scaling approach.

ODP396 The Relationship Between Baseline Metabolic Factors and Post-surgical Weight Loss Outcomes in Adolescents Undergoing Laparoscopic Sleeve Gastrectomy

Abstract Introduction: There is a paucity of data exploring the effect of baseline metabolic factors on weight loss success following laparoscopic sleeve gastrectomy (LSG) in adolescents. This study aimed to identify if there is a relationship between abnormal baseline metabolic characteristics including Metabolic Syndrome (MeS), elevated Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), impaired glucose tolerance, and liver function in adolescents presenting for LSG and subsequent weight loss. METHODS: This was a retrospective study at the Center for Adolescent Bariatric Surgery. Subjects were recruited from 2010-2021. Patients with diabetes, identified by fasting blood glucose ≥ 125 mg/dl, 2-hour blood glucose ≥ 200 mg/dl, or HbA1c ≥ 6.5%, were excluded. Anthropometric measurements, fasting triglycerides, HDL, glucose, ALT, HbA1c, and oral glucose tolerance test results were collected pre-surgery and at 6 and/or 12 months post-surgery. Subjects were classified as having childhood MeS using de Ferranti et. al. [1] criteria. Successful weight loss was defined by a change in BMI of at least -11.49 kg/m 2 in the 6-month group and -13. 05 kg/m 2 in the 12-month group. ALT &amp;gt; 22 mg/dl for females and &amp;gt; 26 mg/dl for males, HbA1c ≥ 5.7%, and HOMA-IR &amp;gt; 2.7 were considered abnormal. Chi-squared or Fisher's analyses were performed using RStudio [2], calculating the presence of a relationship between abnormal metabolic factors pre-surgery and subsequent weight loss at 6 and 12 months. A p-value of &amp;lt;0. 05 was considered significant. RESULTS: 143 patients (6-month group: n = 122, 12-month group: n= 78) with a mean baseline age of 16 ± 1.82 years were included. The mean baseline BMI was 46.7 ± 7.9 kg/m 2 . At baseline, 45% of patients had MeS. A greater number of patients with baseline elevated systolic blood pressure (SBP) were in the successful weight loss group compared to the unsuccessful weight loss group at 6 (p = 0. 0163) and 12 (p = 0. 0315) months. Additionally, there were more patients with abnormal baseline HbA1c in the successful weight loss group at 6 months (p = 0. 0239), albeit this was not significant at 12 months. CONCLUSION: Our results suggest that patients with elevated versus normal HbA1c levels may have greater weight loss success after LSG surgery. Performing bariatric surgery in patients with prediabetes may therefore be a key to weight loss success in the adolescent population. Further analyses are needed to elucidate the relationship between glucose metabolism dysregulation and elevated SBP at baseline and weight loss success. REFERENCES: 1. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110(16): 2494-7. 2. Holleran S, Ramakrishnan R (2021). cufunctions, a package to facilitate statistical analyses in R, http: //biomath. net/cufunctions.html"&amp;gt; NOTES: *ACB and ASF are co-first authors. Presentation: No date and time listed

Metabolic Syndrome in Children and Adolescents

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that include hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity and is strongly associated with an increased risk for diabetes and cardiovascular disease onset in obese adults and children. A progressively greater number of children and adolescents are being affected by this syndrome due to the constant increase in the prevalence of obesity. Like obesity, childhood MetS highly tracks to adulthood. The pathogenesis of MetS includes the interaction between obesity, insulin resistance, and inflammation. Early diagnosis and intervention are important in order to conduct lifestyle modification. In this article, we review the definition and pathophysiology of MetS, the importance of screening, and prevention and treatment options for MetS in childhood.

The Abnormal Ratio of Android-Gynoid Fat, Measured by Dual-Energy X-Ray Absorptiometry (DEXA) Scans, is Moderately Useful for Diagnosing Metabolic Syndrome in Children and Adolescents

Background and Aim: Abnormal android to-gynoid-fat ratio (A/G) measured by dual-energy X-ray absorptiometry (DEXA) in children may index cardiometabolic abnormalities including metabolic syndrome (MS) whose diagnosis was not done based on age, sex, and Country specific methods in previous studies. Methodology: Anthropometric measures, blood pressure, liver function, biochemical and lipid and glucose profile were obtained in 82 consecutive children and adolescents (43 girls and 39 boys, aged 5-14 years) out of a consecutive series of 119 of all ages who resided in an urban area and were screened for obesity and/or dyslipidemia during 4 years and submitted to DEXA. The diagnosis of MS was based on Country specific ≥90th percentile for waist circumference, triglycerides, blood glucose, and systolic or diastolic pressures and ≤10th percentile for HDL cholesterol and coded 1 when 3 of 5 abnormal components were present. In a different MS definition waist circumference was withhold. Results and Conclusions: There were statistically significant (0.001<p<0.05) differences among abnormal DEXA values of the A/G mass ratio (>1), consisting in higher BMI, arm, waist and hip circumferences and higher amylase, ALT, γGT, uric acid, ferritin, CRP, insulin, and HOMA levels. Total cholesterol and apolipoprotein-A levels were lower and gynoid fat mass was significantly higher. Among subjects with MS, there were higher height and uric acid levels whereas the A/G ratio was higher but borderline significant (p=0.07). Abnormal A/G ratio was moderately useful to index MS when the diagnosis was performed appropriately, not at all if waist circumference was not included in defining MS.

Thyroid Function and Metabolic Syndrome in Children and Adolescents with Neuromotor Disability.

Thyroid function plays a crucial role in nervous system integrity and metabolic homeostasis. We evaluated the pattern of TSH, FT4 and FT3 release in children with neuromotor impairment (NI) in relationship with metabolic syndrome (MS). We enrolled 55 patients with NI and 30 controls. Clinical parameters, thyroid function and MS presence were recorded. Principal component analysis (PCA), cluster analysis, and logistic regression models were performed. MS was detected in 54.5% of patients. Four clusters were identified: the first one included only controls and, contrasting with cluster 4, was exclusively characterized by children with disability and MS. This latter showed increased FT4 and FT3 and decreased TSH levels. Cluster 2, characterized by disability without MS showed high FT4 and FT3, whereas cluster 3 with low FT4 and FT3 mainly included disability (90%) and showed prevalent MS (57%). The association between TSH and NI is represented by a U-shape structure. The TSH, FT3 and FT4 release patterns may reflect thyrotropic adaptation, allostatic response and compensatory mechanisms. These mechanisms, found in both MS and disability, show that the odds of having a condition of NI with or without MS increase as the TSH values deviate, in both directions, from a value of 2.5 mLU/mL.

3.64 Association of ADHD and Obesity With Metabolic Syndrome in Child and Adolescent Patients With Bipolar Disorder

Previous studies report an increased prevalence of metabolic syndrome (MetS) in children and adolescents (<18 years old) diagnosed with bipolar disorder (BD). This study investigates potential risk factors associated with MetS in children and adolescents diagnosed with BD.

Caffeine intake and being at-risk for metabolic syndrome in children

Caffeine intake and being at-risk for metabolic syndrome in children

Association of zinc serum level with metabolic syndrome in iranian children and adolescents: The CASPIAN-V study.

IntroductionMetabolic syndrome comprises a set of metabolic risk factors associated with cardiovascular disease and type 2 diabetes. Zinc plays an essential role in numerous enzyme functions that may be associated with metabolic dysfunctions. The relationship between serum zinc levels and metabolic syndrome in adolescents has not been specifically studied. Therefore, this study was performed to determine the relationship between serum zinc levels and metabolic syndrome in Iranian children and adolescents.Materials and methodsThis cross-sectional study was performed using data collected in the CASPIAN-V study. In this project, data were collected using interviews, examinations, biochemical assessments, anthropometric studies, and the nutritional status of participants. The variables considered in this study included serum zinc levels, triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting blood sugar, height, weight, abdominal circumference, and systolic and diastolic blood pressure.ResultsA total of 1371 participants were included in this study, with a mean age of 12.24 ± 3.23 years. In total, 12.40% (n = 170) of the study population had metabolic syndrome, of which 55.7% were boys and 44.3% were girls. Mean zinc levels (μg/dL) in patients with and without metabolic syndrome were 107.03 and 110.6, respectively (p-value = 0.211) and 111.8 for boys and 109.10 for girls (p-value = 0.677).ConclusionThis cross-sectional study showed no association between serum zinc levels and metabolic syndrome in children. Further similar studies and cohort studies with large sample sizes are needed to reveal the exact relationship between serum zinc levels and metabolic syndrome.

Metabolic Syndrome in Children with Overweight and Obesity

Background: While many studies have been conducted on the prevalence and complications of metabolic syndrome in adults, few pediatric studies are available, particularly in developing countries. The aim of this study is to determine the prevalence of metabolic syndrome and its components among children and adolescents with overweight and obesity in Sfax, Tunisia. as well as to look for predictive factors for the occurrence of this pathology. Methods: This cross-sectional study involved 84 children and adolescents with overweight and obesity admitted to the endocrinology department of Hédi Chaker Hospital, Sfax from 2015 to 2019. For each participant included in the study, a clinical examination was conducted to determine height (cm), weight (kg), waist circumference (cm), and BMI as weight/height² (kg/m2). A fasting blood sample was taken to assay the different biological parameters. Results: Between 44 boys and 40 girls, the average age was 11.83 years. Family history of obesity was noted in 84.5% of cases. The average weight was 72.68 kg, with an average BMI of 31.55 kg/m². Obesity was reported in 78.6% of patients and overweight without obesity in 21.4%. According to adapted NCEP/ATP III criteria, 16.7% of patients had metabolic syndrome. Metabolic syndrome was observed in 15.9% of boys and 17.5% of girls, with no significant difference. In our study, no predictive factors were found. Conclusion: The prevalence of metabolic syndrome was high in our study. We suggest targeted screening programs for at-risk children and adolescents to control obesity and metabolic syndrome in Tunisia.

High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity

High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity