Novel Insights in the Metabolic Syndrome in Childhood and Adolescence

Abstract

Metabolic syndrome (MetS) is recognized as an escalating major health risk in adults as well as in children and adolescents. Its prevalence ranges from 6 to 39% depending on the applied definition criteria. To date, there is no consensus on a MetS definition for children and adolescents. However, most authors agree on essential components such as glucose intolerance, central obesity, hypertension, and dyslipidemia; each representing a risk for cardiovascular disease. Recently, associations between MetS and non-alcoholic fatty liver disease, hyperuricemia, and sleep disturbances have emerged. Biomarkers like adipocytokines are a subject of current research as they are implicated in the pathogenesis of the MetS. Epigenetics and gestational programming, especially the role of microRNA, comprise a novel, rapidly developing and promising research focus on the topic of MetS. MicroRNAs are increasingly valued for potential roles in the diagnosis, stratification, and therapeutics of MetS. Early detection of risk factors, screening for metabolic disturbances, and the identification of new therapies are major aims to reduce morbidity and mortality related to MetS. Dietary modification and physical activity are currently the only adopted treatment approaches. Pharmacological therapies and bariatric surgery are still contradictory and, therefore, are only recommended in selected high-risk cases.

<p>Converging Relationships of Obesity and Hyperuricemia with Special Reference to Metabolic Disorders and Plausible Therapeutic Implications</p>

“…In the past decades, incidences of obesity have continuously increased among all age groups, and particularly in children and teenagers. 239 This pandemic has attracted immense attention from the public and has placed an enormous burden on both the family and society. Notably, genetic variations have effects on obesity primarily through influences on the central nervous system (CNS).…”

Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

“…Excessive body fat during childhood and adolescence instigates the first changes in the metabolism, vessels, and organs, which may lead to severe cardiometabolic complications, such as increased risk of cardiovascular dysfunction, hypertension, dyslipidemia, and type 2 diabetes mellitus [1]. In fact, both overweight and obesity in children have increased by 47.1% since 1980 [2].…”

Homeostasis Model Assessment - Insulin Resistance and Sensitivity (HOMA-IR and IS) Index in Overweight Children Born Small for Gestational Age (SGA)

“…The difficulties in diagnosing metabolic syndrome (MetS) are widely discussed. [25] Strikingly, only 2% of patients [26] met the criteria although overall prevalence of MetS in children and adolescents ranged between 6% and 39%. [26] The metabolic syndrome diag-nostic criteria (at least 3) [25] we found that 2/4 overweight/obese SGA born children children fulfilled at least 3 critеria.…”

“…[25] Strikingly, only 2% of patients [26] met the criteria although overall prevalence of MetS in children and adolescents ranged between 6% and 39%. [26] The metabolic syndrome diag-nostic criteria (at least 3) [25] we found that 2/4 overweight/obese SGA born children children fulfilled at least 3 critеria. In fact, all 4 children have BMI greater than the 98th percentile with abdominal fat tissue distribution, 2 of them have BMI z-score > 2 SDS (+2.25 and +2.36 SDS), but the other 2 children have BMI z-score between 1.5-2.0 SDS (1.73 and 1.83 SDS), HO-MA-IR in all 4 children is also abnormal, 1 child had HOMA-IR 1.25 and 3 children between 1.7-2.65, and 2 children have insulin >104 uIU/ml (198.00 and 275.00).…”