The metabolic syndrome in pediatrics: do we have a reliable definition? A systematic review

Abstract

Objective: Metabolic syndrome is a cluster of cardio-metabolic risk factors associated with an increased risk of cardiovascular disease and type 2 diabetes. In the last two decades, several definitions of metabolic syndrome have been proposed for the pediatric population; all of them agree on the defining components but differ in the suggested criteria for diagnosis. This review aims to analyze the current diagnostic criteria of metabolic syndrome in pediatrics with a reference to their feasibility and reliability in clinical practice. Methods: The systemic research was conducted from January 2003 to June 2020 through MEDLINE via PubMed, Cochrane Library and EMBASE databases. Results: After the selection phase, a total of 15 studies (182 screened) met the inclusion and exclusion criteria and hence they were reported in the present review. Twelve studies were cross-sectional, 2 were longitudinal and 1 was a consensus report. The sample population consisted of multiethnic group or single ethnic group including Turkish, European, Asian and Hispanic subjects. Conclusions: To date, there is not a univocal, internationally accepted pediatric definition of metabolic syndrome, which guarantees a high sensitivity and stability of the diagnosis. The definition proposed by IDF results the most straightforward and easy to use in clinical practice, having the unquestionable advantage of requiring measurements quickly accessible in clinical practice, without the adoption of multiple reference tables. Further research is needed to validate a new version of such definition which includes the diagnostic cut-off points recently suggested by published guidelines.

Angiopoietin-Like Proteins 2 and 3 in Children and Adolescents with Obesity and Their Relationship with Hypertension and Metabolic Syndrome

“…Metabolic syndrome (MetS) was diagnosed according to the criteria of the International Diabetes Federation (IDF) consensus guidelines for children and adolescents [ 29 ], because it has been shown that the definition proposed by IDF is more straightforward, accessible, and practical and is best applied for clinical use [ 30 ]. Based on these criteria, the subjects with WC being above the 90th percentile for their age and sex, representing abdominal obesity, together with two or more of the other parameters of MetS such as high SBP or DBP, FPG, TG, or low HDL-C, were considered as having MetS.…”

Youth‐onset type 2 diabetes in Israel: A national cohort

“…Modified International Diabetes Federation (IDF) criteria for Metabolic Syndrome definition were assessed in our study cohort. 29,30 The criteria included the diagnosis of T2D (one positive criterion), a body mass index (BMI) percentile ≥95 (z-score ≥1.645; second positive criterion) and one of the following (third positive criterion): high triglycerides (>150 mg/dl), low high-density lipoproteins cholesterol (HDL-c) of <40 mg/dl, and elevated systolic or diastolic blood pressure (≥130 or ≥85 mmHg). Mean triglycerides to HDL-c ratio (TG/HDL-c), known as a cardio metabolic risk factor, was evaluated (pediatric normal value < 2).…”

Relationship between cholelithiasis and metabolic syndrome: the role of genetic factors

“…gov) происходит увеличение интереса мирового научного сообщества к проблеме метаболического синдрома. Метаболическим синдромом (МС) называют комплекс взаимосвязанных и модифицируемых факторов риска развития сердечнососудистых заболеваний, и сахарного диабета 2 типа [19]. Составляющими МС являются: абдоминальное ожирение, дислипидемия, артериальная гипертензия, нарушение толерантности к глюкозе или сахарный диабет 2 типа, резистентность к инсулину или соответствующая гиполипидемическая, гипотензивная и/или сахароснижающая терапии [20].…”

“…Метаболический синдром имеет многофакторный характер развития, его этиология до конца не изучена. Однако существуют исследования, которые сообщают о том, что сидячий образ жизни и несбалансированное питание могут играть наиважнейшую роль в развитии МС [19]. Особое влияние оказывает характер работы, нежели внерабочая активность человека.…”