Background. Metabolic syndrome (MS) is perceived as a cluster of risk factors for cardiovascular disease and type 2 diabetes. The prevalence of MS in children and adolescents rea­ches 6–39 % depending on the identification criteria. Despite the considerable attention paid to MS in children and adolescents, there is no unified agreed consensus on its early scree­ning. Consequently, the purpose of the study was along with the gene­rally accepted criteria evaluate additional markers for MS early screening in children and adolescents. Materials and methods. A cross sectional study was conducted with 155 children aged 9–18 years, which formed 2 groups: a group of children with MS — 90 children with MS on the background of abdominal obesity and a group of children without MS — 65 children with normal body weight. Clinical (antrometric data, blood pressure) and laboratory (fasting glucose, fasting insulin, lipids) parameters were assessed. MS verification was performed according to the recommendations of the IDF Сonsensus (2007). Results. For MS screening in addition to the generally accepted criteria accor­ding to IDF Consensus (2007): abdominal obesity (waist circumference > 90th percentile according to age and gender), fasting glucose > 5.6 mmol/l, triglycerides > 1.7 mmol/l, blood pressure > 130/85 mm Hg, the most probable additional markers were established: neck and hip circumference, waist/hip ratio, body surface area > 90th percentile of distribution according to age and sex, fasting insulin > 15.0 mU/l, homeostasis model assessment for insulin ratio (HOMA-IR) > 2.8, total cholesterol > 5.2 mmol/l, LDL-C > 3.25 mmol/l, VLDL-C > 0.78 mmol/l, blood pressure in terms of distribution > 95th percentile, which contributes to its early detection and correction. Conclusions. Expanding the list of MS additional markers for its early screening in the pediatric and adolescent population is relevant and provides a basis for its timely correction and prevention.

Background. Insulin resistance is the major sign of etiology and pathogenesis of type 2 diabetes mellitus and metabolic syndrome and can precede its development for many years. Early identifying the beginning of insulin resistance in children is important to prevent diabetes mellitus in adult life. The purpose was to identify metabolic and somatic changes in children with insulin resistance. Material and methods. Out of 182 children of the general sample, who was estimated fasting plasma insulin and glucose, HOMA-IR, and glucose/insulin ratio, 2 groups were formed: group 1 — children with IR — 56 (30.8 %) and group 2 — 126 (69.2 %) children with normal insulin sensitivity. In children anthropometric data, lipid metabolism (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C), blood pressure, leptin were determined. Results. From examined subjects 56 children were generally obese (BMI > 95th percentile), 71 children were abdominally obese (WC > 90th percentile), 55 children were with normal body mass (BMI < 90th percentile). Insulin resistance was identified in 21 (37.5 %) children with general obesity more rarely, than in 38 (39.4 %) children with abdominal obesity (p = .049) and in 7 (12.7 %) children with normal BMI (p = .003). In insulin-resistant children BMI, waist and hip circumference was larger than in children with normal insulin sensitivity. The lipid profile in children with different insulin sensitivity did not differ, but in insulin-resistant children an association of basal glucose with TG/HDL-C ratio (r = .53; p = .001), blood insulin with TG (r = .34; p = .018), and TG/HDL-C ratio (r = .54; p = .001) was estimated. The HOMA-IR significantly correlated with VLD-C (r = .40; p = .005), TG (r = .49; p = .001), TG/HDL-C ratio (r = .43; p = .002). The glucose/insulin ratio was in significant association with the TG/non-HDL-C ratio. The incidence of hypetension (> 95th percentile) diagnosis in insulin-resistant children was by 33.8 % higher (p = .001). Blood leptin concentration was 1.8 falled higher in insulin-resistant children and significantly correlates with waist circumference, fasting insulin, HOMA-IR, and diastolic blood pressure. Conclusions. Insulin resistance is related to cardiometabolic risks, such as general and abdominal obesity, hypertension, dyslipidemia, hyperleptinemia, and leptin resistance, and is a screening biomarker for children and adolescents with an increased risk of cardiometabolic diseases.