Metabolic Syndrome In Children Research Articles

Prevalence of Metabolic Syndrome in Children and Adolescents with Type 1 Diabetes Mellitus and Possibilities of Prevention and Treatment: A Systematic Review.

Overweight and obesity are an increasingly common problem, not only among the healthy population, but also in adolescents with type 1 diabetes (T1DM). Excess body weight is related to many cardiometabolic complications as well as a high risk of metabolic syndrome (MetS). The purpose of this systematic review is to provide a concise and critical overview of the prevalence of MetS in children and adolescents with T1DM and, ultimately, to discuss prevention and treatment options. The study was conducted in accordance with PRISMA guidelines. This review shows that, apart from the growing percentage of overweight and obese children and adolescents with T1DM (on average 20.1% and 9.5%, respectively), the problem of the increasing incidence of MetS (range from 3.2 to 29.9%, depending on the criteria used) is one of the most important phenomena of our time. One of the methods of prevention and treatment is a combined approach: changing eating habits and lifestyle, but there are also reports about the beneficial effects of the gut microflora.

Associations Between Single-Child Status and Metabolic Syndrome in Children and Adolescents in China.

Objective: To evaluate the associations between single-child status and metabolic syndrome (MS) and to identify the highest risk group of MS among single children.Methods: Differences in participants' characteristics by sex were examined by Student's t-test for continuous variables and Pearson's chi-squared test for categorical variables. Multivariate logistic regression analysis was performed to estimate the odds ratios (OR) and 95% confidence intervals (CI) for MS and its components according to the single-child status. Radar maps were used to compare the composition of different components in MS.Results: In total, 11,784 (5,880 boys) children and adolescents were included in this study, with a mean age of (11.3 ± 3.1) years. MS was observed in 7.1% of participants, with a higher prevalence in boys (8.2%) than girls (5.9%) (P < 0.05). The prevalence of MS, elevated blood pressure and abdominal obesity in single children were higher than that in children with siblings, particularly in boys (P < 0.001). Elevated risk of abdominal obesity was observed in single children [boys (1.56, 95% CI: 1.31, 1.85), girls (1.40, 95% CI: 1.19, 1.63)], however, increased ORs of elevated blood pressure and metabolic syndrome were observed in single-child boys only (1.19, 95% CI: 1.01, 1.40 and 1.76, 95% CI: 1.34, 2.31, respectively). Results showed that a statistically significant association between single child status and MS was mainly observed in urban boys (2.04, 95% CI: 1.33, 3.12) and rural boys (1.50, 95% CI: 1.05, 2.15), but not in girls. Among all the combinations of MS, two combinations were significantly associated with the single-child status, including the combination of elevated blood pressure, abdominal and low HDL-C (1.45, 1.04, 2.04) and the combination of elevated blood pressure, abdominal obesity, low HDL-C and hypertriglyceridemia (2.04, 1.40, 3.06) (P < 0.05).Conclusions: The present study found that single children and adolescents had a higher risk of MS, elevated blood pressure and abdominal obesity. The associations were stronger in urban boys. Further attention should be directed to the prevention and control strategies targeting the high-risk population of MS.

Investigating the connections between night eating syndrome and metabolic syndrome in children

Investigating the connections between night eating syndrome and metabolic syndrome in children

Three faces of the metabolic syndrome in children

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Three faces of the metabolic syndrome in children

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Three faces of the metabolic syndrome in children

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Blunted circadian cortisol in children is associated with poor cardiovascular health and may reflect circadian misalignment

ObjectivesCircadian cues in children (sunlight, exercise, diet patterns) may be associated with health outcomes. The primary objective was to assess associations of daily cortisol fluctuations (morning, night) with cardiovascular health outcomes. A secondary objective was to determine if 1-year longitudinal changes in circadian cortisol levels are associated with longitudinal changes in health outcomes. Study designThe Cardiovascular Health Intervention Program (CHIP) was a cross-sectional and longitudinal study of cardiovascular risk profiles in public elementary school children in Southern Maine. Participants were 689 students in 4th grade (baseline; age = 9.20 ± 0.41 years), and 647 students in 5th grade (age = 10.53 ± 0.52 years). Longitudinal data (4th and 5th grade) was available for 347 participants. Clinical outcomes were blood pressure, hip/waist ratios, body mass index, percent fat. Laboratory measures were fasting glucose, lipids, and salivary cortisol measures (morning and evening). ResultsLower first-in-morning diurnal cortisol levels were associated with increased blood pressure (β −0.23 ± 0.05; p < 0.001), increased body fat (β −0.22 ± 0.05; p < 0.001), and poor lipid profiles (β −0.15 ± 0.07; p < 0.05). Inclusion of night cortisol in the model (stress-related) improved associations of the model with bodyfat composition (morning β −0.27 ± 0.05; p < 0.001; night β +0.16 ± 0.06; p < 0.01). Adjustments for potential confounding variables improved associations of morning cortisol with lipids (β −0.19 ± 0.07; p < 0.01). Longitudinal analysis showed that lower morning diurnal cortisol in 4th grade was associated with increases in blood pressure a year later (β −0.18 ± 0.08; p = 0.017) after adjusting for confounding variables. ConclusionData presented suggest adding circadian misalignment (lower amplitude of first-in-morning cortisol) to existing models of metabolic syndrome in children. Further, circadian misalignment may be a factor contributing to high blood pressure.

Anti-diabetic properties of Stevia rebaudiana Bertoni as sugar substitute: a mini-review

The incidence of obesity, type II diabetes mellitus, and metabolic syndrome in children and adults show an alarming increase worldwide. This increase was supported by one factor: the increasing availability of high-calorie foods and beverages, thus increasing the need for sweeteners. Researchers are driven to find a sweetener that can replace sugar. One of the natural sweeteners that can be used is the Stevia plant. Stevia contains stevioside, which is a natural sweetener with 300 times sweetness compared to sucrose. Besides, stevioside can reduce blood sugar levels and show benefits for people with diabetes.

Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography.

The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5±1.8years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.

Prenatal exposure to persistent organic pollutants as a risk factor of offspring metabolic syndrome development during childhood.

Persistent Organic Pollutants (POPs) are exogenous, artificially made chemicals that can disrupt the biological system of individuals and animals. POPs encompass a variety of chemicals including, dioxins, organochlorines (OCs), polychlorinated biphenyl (PCBs), and perfluoroalkyl substances (PFASs) that contain a long half-life and highly resistant to biodegradation. These environmental pollutants accumulate over time in adipose tissues of living organisms and alter various insulin function-related genes. Childhood Metabolic Syndrome (MetS) consists of multiple cardiovascular risk factors, insulin function being one of them. Over the years, the incidence of the syndrome has increased dramatically. It is imperative to explore the role of persistent organic pollutants in the development of Childhood Metabolic Syndrome. Some epidemiological studies have reported an association between prenatal exposure to POPs and offspring MetS development throughout childhood. These findings have been replicated in animal studies in which these pollutants exercise negative health outcomes such as obesity and increased waist circumference. This review discusses the role of prenatal exposure to POPs among offspring who develop MetS in childhood, the latest research on the MetS concept, epidemiological and experimental findings on MetS, and the POPs modes of action. This literature review identified consistent research results on this topic. Even though the studies in this review had many strengths, one major weakness was the usage of different combinations of MetS criteria to measure the outcomes. These findings elucidate the urgent need to solidify the pediatric MetS definition. An accurate definition will permit scientists to measure the MetS as a health outcome properly and allow clinicians to diagnose pediatric MetS and provide individualized treatment appropriately.

Long-term follow-up of children with in utero exposure tosulfonylurea medications.

BackgroundOffspring born to mothers with gestational diabetes mellitus (GDM) are more likely to have negative neurodevelopmental health outcomes, early obesity, type 2 diabetes, and metabolic syndrome in childhood, adolescence, and adulthood. Standard of care management for GDM and type 2 diabetes mellitus during pregnancy is insulin, but oral sulfonylurea use is increasing, and these medications cross the placenta. Literature on treatment with sulfonylureas for maternal GDM has focused on maternal glycemic control and neonatal outcomes. Studies that have evaluated the long‐term outcomes of children exposed to sulfonylureas in utero are limited.ObjectiveThis study evaluated anthropometric and neurodevelopmental outcomes of 55 children (ages 5–10) born to mothers with diabetes during pregnancy treated with sulfonylurea or insulin.Methods and ResultsA group of 25 sulfonylurea‐exposed and 30 insulin‐exposed participants were age‐ and sex‐matched between groups. No significant differences were identified in z‐scores for body mass index (BMI), waist circumference, skinfold measurements, and body fat or rates of overweight/obese BMI between groups. On performance‐based cognitive assessment, the sulfonylurea‐exposed group had significantly lower scores on inhibition (p = 0.043).ConclusionIn summary, children with in utero sulfonylurea exposure had similar physical measurements compared to children with insulin exposure and lower performance on a measure of executive function (inhibition), which is associated with adverse health outcomes.

The Burden of Antipsychotic-Induced Weight Gain and Metabolic Syndrome in Children.

Antipsychotic medications are critical to child and adolescent psychiatry, from the stabilization of psychotic disorders like schizophrenia, bipolar disorder, and psychotic depression to behavioral treatment of autism spectrum disorder, tic disorders, and pediatric aggression. While effective, these medications carry serious risk of adverse events—most commonly, weight gain and cardiometabolic abnormalities. Negative metabolic consequences affect up to 60% of patients and present a major obstacle to long-term treatment. Since antipsychotics are often chronically prescribed beginning in childhood, cardiometabolic risk accumulates. An increased susceptibility to antipsychotic-induced weight gain (AIWG) has been repeatedly documented in children, particularly rapid weight gain. Associated cardiometabolic abnormalities include central obesity, insulin resistance, dyslipidemia, and systemic inflammation. Lifestyle interventions and medications such as metformin have been proposed to reduce risk but remain limited in efficacy. Furthermore, antipsychotic medications touted to be weight-neutral in adults can cause substantial weight gain in children. A better understanding of the biological underpinnings of AIWG could inform targeted and potentially more fruitful treatments; however, little is known about the underlying mechanism. As yet, modest genetic studies have nominated a few risk genes that explain only a small percentage of the risk. Recent investigations have begun to explore novel potential mechanisms of AIWG, including a role for gut microbiota and microbial metabolites. This article reviews the problem of AIWG and AP metabolic side effects in pediatric populations, proposed mechanisms underlying this serious side effect, and strategies to mitigate adverse impact. We suggest future directions for research efforts that may advance the field and lead to improved clinical interventions.

Growth factors in the fetus and pre-adolescent offspring of hyperglycemic rats.

Background:Maternal hyperglycemia influences childhood metabolic syndrome, including obesity and hyperglycemia. We tested the hypothesis that the maternal hyperglycemia influences growth factors in the fetal and pre-adolescent offspring.Methods:Hyperglycemia was induced in pregnant rats on embryonic day (E)16 using streptozocin followed by implantation with insulin or placebo pellets at embryonic day 18 (E18). Fetuses at E20 and pre-adolescent pups at postnatal day 14 (P14) were studied: (1) normal untreated controls (CTL) at E20; (2) hyperglycemic placebo-treated (HPT) at E20; (3) hyperglycemic insulin-treated (HIT) at E20; (4) CTL at P14; and (5) HIT at P14. Fetal and pre-adolescent growth factors were determined.Results:Biomarkers of hypoxia were elevated in the HPT group at E20. This group did not survive to term. Maternal insulin improved fetal survival despite lower fetal body weight at E20, however, at normal birth (postnatal day 0 (P0)) and at P14, body weights and blood glucose were higher than CTL. These high levels correlated with aberrant growth factors. Maternal hyperglycemia influenced glucose-6-phosphate dehydrogenase, glucagon, insulin, interleukin-10, and leptin genes.Conclusions:The impact of maternal hyperglycemia on pre-adolescent glucose and body weight was not a consequence of maternal overnutrition. This suggests an independent link which may affect offspring metabolic health in later life.

The Unique Role of 11-Oxygenated C19 Steroids in Both Premature Adrenarche and Premature Pubarche

Introduction: Recent studies have shown 11-oxygenated androgens (11oAs) are the dominant androgens in premature adrenarche (PA). Our objective was to compare 11oAs and conventional androgens in a well-defined cohort of children with PA or premature pubarche (PP) and correlate these androgens with metabolic markers. Methods: A prospective cross-sectional study was conducted at a university hospital. Fasting early morning serum steroids (including 11oAs) and metabolic biomarkers were compared and their correlations determined in children ages 3–8 years (F) or 3–9 years (M) with PA or PP (5 M and 15 F) and healthy controls (3 M and 8 F). Results: There were no differences between PA, PP, and controls or between PA and PP subgroups for sex, BMI z-score, or criteria for childhood metabolic syndrome. Dehydroepiandrosterone sulfate (DHEAS) was elevated only in the PA subgroup, as defined. 11oAs were elevated versus controls in PA and PP although no differences in 11oAs were noted between PA and PP. Within the case cohort, there was high correlation of T and A4 with 11-ketotestosterone and 11β-hydroxyandrostenedione. While lipids did not differ, median insulin and HOMA-IR were higher but not statistically different in PA and PP. Conclusions: PA and PP differ only by DHEAS and not by 11oAs or insulin sensitivity, consistent with 11oAs – rather than DHEAS – mediating the phenotypic changes of pubarche. Case correlations suggest association of 11oAs with T and A4. These data are the first to report the early morning steroid profiles including 11oAs in a well-defined group of PA, PP, and healthy children.

Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis

Psoriasis in adults is associated with an increased risk of metabolic disease. Various cardiometabolic comorbidities have been reported in childhood psoriasis, but only a few studies have analyzed the prevalence of metabolic syndrome. We performed a single-center prospective study investigating the prevalence of metabolic syndrome and insulin resistance in children with psoriasis. The prevalence of metabolic syndrome was evaluated in 60 pre-pubertal children with psoriasis (age: 3–10 years), accordingly to recently established criteria for the diagnosis of metabolic syndrome in children. Insulin resistance was considered altered when the homeostatic model assessment (HOMA-IR) for insulin resistance was ≥ 90th sex- and age-specific percentile and HOMA 2-IR was > 1.8. Eighteen (30%) children with psoriasis were found to have metabolic syndrome. Sixteen (27%) children were found to have insulin resistance.Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis.What is Known:• Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.• Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis.What is New:• This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.• In children with psoriasis metabolic syndrome risk factors should be assessed.

Long-term exposure to ambient air pollution and metabolic syndrome in children and adolescents: A national cross-sectional study in China

BackgroundThe prevalence of metabolic syndrome (MetS) rapidly increased over the past decades. However, little evidence exists about the effects of long-term exposure to ambient air pollution on MetS in children and adolescents. ObjectiveThis study aims to assess the association between long-term ambient air pollution and the prevalence of MetS in a large population of Chinese children and adolescents. MethodsIn 2013, a total of 9,897 children and adolescents aged 10 to 18 years were recruited from seven provinces/municipalities in China. MetS was defined based on the recommendation by the International Diabetes Federation (IDF). Satellite based spatio-temporal models were used to estimate exposure to ambient air pollution (including particles with diameters ≤1.0 µm (PM1), ≤2.5 µm (PM2.5), and ≤10 µm (PM10), and nitrogen dioxide (NO2)). Individual exposure was calculated according to 94 schools addresses. After adjustment for a range of covariates, generalized linear mixed-effects models were utilized to evaluate the associations between air pollutants and the prevalence of MetS and its components. In addition, several stratified analyses were examined according to sex, weight status, outdoor physical activity time, and sugar-sweetened beverages (SSBs) intake. ResultsThe prevalence of MetS was 2.8%. The odds ratio of MetS associated with a 10 μg/m3 increase in PM1, PM2.5, PM10 and NO2 was 1.20 (95%CI: 0.99, 1.46), 1.31 (95%CI: 1.05, 1.64), 1.32 (95%CI: 1.08, 1.62), and 1.33 (95%CI: 1.03, 1.72), respectively. Regarding the MetS components, we observed associations between all pollutants and abdominal obesity. In addition, long-term PM1 and NO2 exposures were associated with the prevalence of elevated fasting blood glucose. Stratified analyses detected that the associations between air pollutants and the prevalence of MetS were stronger in boys (Pinteraction < 0.05). ConclusionsWe found that long-term exposure to PM2.5, PM10, and NO2 were positively associated with the prevalence of MetS in children and adolescents. Our findings may have certain public health implications for some comprehensive strategy of environment improvement and lifestyles changes in order to reduce the burden of non-communicable disease.

Associations of dairy intake with risk of incident metabolic syndrome in children and adolescents: Tehran Lipid and Glucose Study.

This cohort study examined the association of total and individual dairy products with the risk of incident MetS and its components in children and adolescents. We prospectively assessed 531 participants aged 6-18years without the MetS at baseline during an average 6.6-year follow-up period. Dairy consumption was estimated with a valid and reliable food frequency questionnaire. The MetS was defined according to the Cook criteria. The multivariable regression model was used to calculate the odds ratio (OR) for incident MetS associated with the consumption of dairy products. The incidence of MetS was 9.8% after an average 6.6-year follow-up. After adjusting for potential confounders, OR (95% confidence interval) for incident MetS was 0.48 (0.23-1.00) for total dairy, 0.44 (0.21-0.92) for low-fat dairy, 0.46 (0.22-0.98) for low-fat milk, and 0.45 (0.21-0.97) for low-fat yogurt when comparing participants in the highest versus lowest tertile. A moderate intake of regular cheese was associated with decreased risk of MetS (OR = 0.43, 95% CI: 0.19-0.97). Replacing one serving/day of total dairy with nuts was associated with a lower (OR: 0.63, 95% CI: 0.42-0.95), whereas replacement by red and processed meat was associated with higher (OR: 1.55, 95%CI: 1.21-1.97) MetS risk. No significant association was found between high-fat dairy and MetS risk. Higher consumption of dairy products, particularly low-fat milk and yogurt, was associated with reduced risk of incident MetS, suggesting the capability of low-fat dairy products in the primary prevention of MetS in children and adolescents.

Dysregulation of Circulating miR-24-3p in Children with Obesity and Its Predictive Value for Metabolic Syndrome

Introduction: Obesity is a major risk factor for metabolic disorders in children. Therefore, it is particularly important to study the abnormal regulation of circulating miR-24-3p in obese children and its predictive value for metabolic syndrome. Methods: Serum samples were obtained from children with obesity (n = 45), obese children with metabolic syndrome (n = 52), and healthy controls (n = 50). The expression levels of miR-24-3p were detected by reverse transcription quantitative PCR. The ROC curve was used to evaluate the diagnostic value of miR-24-3p. Pearson’s correlation analysis was performed to evaluate the relationship between serum miR-24-3p and different clinical parameters. Logistic regression analysis was used to evaluate the relationship between miR-24-3p and obesity with metabolic syndrome in children. Results: The expression of miR-24-3p was the highest in obese children with metabolic syndrome. ROC results showed that miR-24-3p had the ability to distinguish healthy individuals from obese children (area under the curve [AUC] = 0.951) and can predict the occurrence of metabolic syndrome for obese children (AUC = 0.890). The expression level of miR-24-3p was positively correlated with body mass index (r = 0.817, p < 0.001), fasting blood glucose (r = 0.798, p < 0.001), triglycerides (r = 0.773, p < 0.001), systolic blood pressure (r = 0.746, p < 0.001), and diastolic blood pressure (r = 0.623, p < 0.001), respectively. Logistic regression analysis showed that miR-24-3p was an independent influence factor for the occurrence of metabolic syndrome in obese children. Discussion/Conclusion: MiR-24-3p is a potential noninvasive marker for children with obesity and has predictive value for the occurrence of metabolic syndrome.

Triglycerides/high-density lipoprotein-cholesterol ratio in children with metabolic syndrome

ABSTRACT The incidence of metabolic syndrome in children is increasing due to the obesity epidemic. Accessible biochemical studies are required to diagnose and treat it in a timely manner. This cross-sectional study aims to assess the usefulness of the triglycerides/high-density lipoprotein-cholesterol (TG/HDL-c) index as a predictor of metabolic syndrome according to the diagnostic criteria of the European initiative Identification and prevention of Dietary- and lifestyle-induced health EFects In Children and infantS (IDEFICS) in obese children 3 to 10 years of age. Descriptive, observational, retrospective study in the pediatric service of León General Hospital, Guanajuato, México, from January 2017 to December 2018. In a group of 73 obese children aged 3 to 10 years, it was found that the TG/HDL-c ratio has an odds ratio of 6 (95% CI 2–18) as a predictor of metabolic syndrome. A cut-off point of 2.4 for this index has a sensitivity of 85%, specificity of 85%, likelihood ratio of 5.6, positive predictive value of 94%, and negative predictive value of 68% to diagnose metabolic syndrome with IDEFICS criteria. The TG/HDL-c index is a useful indicator to diagnose metabolic syndrome in children 3 to 10 years of age with obesity, in whom it is not possible to perform a comprehensive biochemical study.

A COMPARATIVE STUDY OF LIPID PROFILE AND LEPTIN RESISTANCE IN CHILDREN WITH METABOLIC SYNDROME DEPENDING ON HYPERTENSION IN KYIV

The aim: To compare lipid metabolism and leptin levels among the children with and without hypertension to identify associated risk factors for the course of metabolic syndrome in children. Materials and methods: This observational, cross-sectional study recruited children from the Rheumocardiology Department of Children’s Clinical Hospital No 6 in Kyiv, with metabolic syndrome, identification of waist-to-height ratio, leptin level, homeostasis model assessment of insulin resistance and lipid profile. The main group included 41 children with metabolic syndrome and hypertension and the control group included 40 children with metabolic syndrome without hypertension. Statistical data analysis was performed using the MedStat 2.6.2. package. Results: A total of 81 children aged 10 to 17 with metabolic syndrome were examined. The group of children with hypertension had significantly lower high-density lipoprotein cholesterol (0.85±0.04) than children without hypertension (0.94±0.03), with p &lt; 0.05. Leptin resistance was detected in 65.2% of children with hypertension and 35.3% of children with normal blood pressure (p &lt; 0.01). Conclusions: Children with metabolic syndrome and hypertension had a significantly higher body mass index and waist circumference as opposed to children with normal blood pressure. In the lipid profile high-density lipoprotein cholesterol was significantly lower in hypertensive children. There was no reliable difference in other lipid profile indicators between the two groups, but there was an upward trend of them in group with hypertension. Leptin resistance is also significantly higher in hypertensive children.