Metabolic syndrome: Definition, pathophysiology, and mechanisms

Miranda, Phillippa J.; DeFronzo, Ralph A.; Califf, Robert M.; Guyton, John R.

doi:10.1016/j.ahj.2004.07.013

“…Ainda não está claro se a influência da obesidade nos parâmetros metabólicos é inteiramente ou parcialmente explicada pela resistência à insulina 36 . Existem estudos na literatura que afirmam a importância da resistência à insulina na SM.…”

Section: Resistência à Insulinaunclassified

Is a diagnosis of metabolic syndrome applicable to children?

Pergher

¹

,

Melo

²

,

Halpern

³

et al. 2010

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Objective: To present the components of the metabolic syndrome in children and adolescents and to discuss how they are assessed in the pediatric population in addition to presenting the major metabolic syndrome classifications for the age group.Sources: A review of literature published from 1986 to 2008 and found on MEDLINE databases. Summary of the findings:The prevalence of childhood obesity has been increasing globally over recent decades and as a result its complications, such as diabetes mellitus, arterial hypertension and dyslipidemia, have also increased. The concept of metabolic syndrome, already common with adults, is now beginning to be applied to children through classifications using the criteria for adults modified for the younger age group. Notwithstanding, these classifications differ in terms of the cutoff points used and whether they employ body mass index or waist circumference to define obesity. The review presents these classifications, highlighting the points on which they differ and the debate about them. Conclusions:If childhood obesity goes untreated, it will have severe consequences in the future. A number of models for classifying metabolic syndrome in children have been published, but there is considerable diversions between them. The criteria for classifying metabolic syndrome in children therefore need to be standardized in order to identify those people at greatest risk of future complications. J Pediatr (Rio J). 2010;86(2):101-108:Childhood obesity, visceral fat, metabolic syndrome, insulin resistance. ResumoObjetivo: Abordar os componentes da síndrome metabólica (SM) na criança e no adolescente discutindo como eles são avaliados na população infantil e apresentando as principais classificações de SM nessa faixa etária. Fontes dos dados:Revisão da literatura utilizando as bases de dados MEDLINE no período de 1986 a 2008. Síntese dos dados:A prevalência de obesidade infantil nas últimas décadas tem aumentado no mundo todo e, consequentemente, suas complicações, como diabetes melito, hipertensão arterial e dislipidemia. O conceito de SM, já usado em adultos, começa a ser aplicado em crianças por meio de classificações que utilizam os critérios para adultos modificados para faixas etárias menores. No entanto, essas classificações apresentam divergências quanto ao valor de pontos de corte usados nos critérios e quanto à utilização do índice de massa corporal ou da medida da circunferência abdominal para definir a obesidade. Esta revisão apresenta essas classificações mostrando os pontos discordantes e a discussão em torno delas. Conclusões:Se não for tratada, a obesidade infantil terá consequên-cias graves no futuro. Alguns modelos de classificação de SM em crianças já foram apresentados, e observam-se consideráveis divergências entre eles. Assim, torna-se necessária a padronização desses critérios para a identificação dos indivíduos com maior risco de complicações futuras. Síndrome metabólica na infância -Pergher RN et al. J Pediatr (Rio J)

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“…36 There are studies in the literature which consider insulin resistance of great importance in the metabolic syndrome. Serum insulin levels have been shown to correlate with other components of the syndrome in some studies conducted with obese children and adolescents.…”

Section: Insulin Resistancementioning

confidence: 99%

O diagnóstico de síndrome metabólica é aplicável às crianças?

Pergher

¹

,

Melo

²

,

Halpern

³

et al. 2010

J. Pediatr. (Rio J.)

8

0

View full text Add to dashboard Cite

Objective: To present the components of the metabolic syndrome in children and adolescents and to discuss how they are assessed in the pediatric population in addition to presenting the major metabolic syndrome classifications for the age group.Sources: A review of literature published from 1986 to 2008 and found on MEDLINE databases. Summary of the findings:The prevalence of childhood obesity has been increasing globally over recent decades and as a result its complications, such as diabetes mellitus, arterial hypertension and dyslipidemia, have also increased. The concept of metabolic syndrome, already common with adults, is now beginning to be applied to children through classifications using the criteria for adults modified for the younger age group. Notwithstanding, these classifications differ in terms of the cutoff points used and whether they employ body mass index or waist circumference to define obesity. The review presents these classifications, highlighting the points on which they differ and the debate about them. Conclusions:If childhood obesity goes untreated, it will have severe consequences in the future. A number of models for classifying metabolic syndrome in children have been published, but there is considerable diversions between them. The criteria for classifying metabolic syndrome in children therefore need to be standardized in order to identify those people at greatest risk of future complications.J Pediatr (Rio J). 2010;86(2):101-108: Childhood obesity, visceral fat, metabolic syndrome, insulin resistance.

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“…[1][2][3][4] Over recent decades a process of nutritional transition has been observed. Comparing data from the National observed in the prevalence of overweight and obesity from 4.1 to 13.9%, among children and adolescents from 6 to 18 years.…”

Section: Reaven Et Al Described the Metabolic Syndrome (Ms)mentioning

confidence: 99%

Síndrome metabólica em crianças obesas e fatores de risco para doenças cardiovasculares de acordo com a resistência à insulina (HOMA-IR)

Ferreira¹,

Oliveira²,

França³

2007

J. Pediatr. (Rio J.)

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Objective: To identify the prevalence of metabolic syndrome and risk factors for the development of cardiovascular diseases and to investigate their relationship with insulin resistance.Methods: This was a cross-sectional study of 52 obese children. The sample was chosen at random after the body mass index [weight (kg)/stature (m) 2 ] of 1,550 schoolchildren had been calculated. Children were defined as obese when their BMI was above the 95th percentile of the Centers for Disease Control and Prevention classification. Blood samples were taken after fasting and glycemia, high-density lipoproteins, triglycerides and insulin were all assayed.Body fat was evaluated using dual energy X-ray absorptiometry. Arterial blood pressure and insulin resistance were also measured. Metabolic syndrome was defined according to National Cholesterol Education Program criteria, with cutoff points adjusted for the age of the sample. Results:Metabolic syndrome was detected in 17.3% of the children investigated. Insulin resistance was significantly different for females (3.8±2.2; 95%CI 2.9-4.8) and males (2.6±1.3; 95%CI 2.1-3.1); p = 0.016. Around 44.2% of the sample exhibited at least two risk factors, and 15% exhibited arterial hypertension. Hypertriglyceridemia was observed in 50 and 70.8% of boys and girls, respectively. Lower than desirable high-density lipoprotein levels were only observed among the girls. Conclusions:Obese children exhibited a high prevalence of metabolic syndrome. The children with greater insulin resistance exhibited more risk factors. In the light of these findings intervention measures are necessary in order to prevent excessive weight gain during childhood.J Pediatr (Rio J). 2007;83(1):21-6: Child, obesity, metabolic syndrome.

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Metabolic syndrome: Definition, pathophysiology, and mechanisms

Cited by 401 publications

References 58 publications

Is a diagnosis of metabolic syndrome applicable to children?

Is a diagnosis of metabolic syndrome applicable to children?

O diagnóstico de síndrome metabólica é aplicável às crianças?

Síndrome metabólica em crianças obesas e fatores de risco para doenças cardiovasculares de acordo com a resistência à insulina (HOMA-IR)

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