The prevalence of the metabolic syndrome and type 2 diabetes mellitus in children and adolescents

Abstract

OBJECTIVE:To review the prevalence of the metabolic syndrome and type 2 diabetes in children and adolescents. METHOD: Literature review. RESULTS: It is well demonstrated that cardiovascular risk factors are frequent in childhood obesity and they tend to cluster. However, the frequency of the metabolic syndrome in childhood and adolescence has been investigated only by few studies. In spite of the diverse criteria used for defining the metabolic syndrome, it is evident that the syndrome is already highly prevalent among obese children and adolescents. Population-based data suggest that the epidemic of pediatric obesity is being followed by an increase of type 2 diabetes mellitus, especially in the United States and in minorities. For the European countries, there are no population-based incidence and prevalence data concerning type 2 diabetes mellitus in children and adolescents. From the available data, the magnitude of the problem in the European Caucasian population seems to be much less than in North America. CONCLUSION: There is an urgent need to establish internationally acceptable criteria for the metabolic syndrome in children and adolescents and to commence screening for this syndrome. Although type 2 diabetes mellitus is still rare among European children, screening is recommended for type 2 diabetes mellitus or impaired glucose tolerance in children and especially in adolescents with substantial risk for the development of this disease.

Type 2 diabetes mellitus and impaired glucose regulation in overweight and obese children and adolescents living in Serbia

“…2,18 Scarce available data on the prevalence of pediatric T2DM in Europe are mainly derived from multiple clinical studies, each with some recruitment bias. 5 The results of the first report regarding T2DM in a clinic population of otherwise healthy overweight and obese youth living in Serbia indicate a low prevalence of previously undiagnosed T2DM in this population, but a substantial prevalence of other disturbances in glucose metabolism. These findings correlate well with the results of other European clinical studies, and, in the absence of population-based prevalence data, provide the only insight regarding pediatric T2DM in the region.…”

“…3,4 In Europe, there are no data on population-based incidence and prevalence of T2DM in children and adolescents, though the rising prevalence of T2DM has been observed in studies conducted in clinic cohorts of overweight and obese children, ranging from 0.1% in Italy to 1.9% in Hungary. 2,5 Prevalence of IGT reported by these studies varies from 4.5 to 17.3%, and while similar data are available for Germany, France and Finland, there are so far no data for most of Europe, including Serbia. 2,6,7 …”

The IDEFICS cohort: design, characteristics and participation in the baseline survey

“…This restriction resulted in 1328 case-control pairs providing these required measurements. Although several studies describe the prevalence of the metabolic syndrome in children, 28,29 there is no established definition of this disorder in young children. It was therefore decided to address only one well-defined component of the metabolic syndrome, that is, insulin resistance as assessed by the HOMA index.…”

Modulation of food reward by adiposity signals

“…We base this perspective on both studies within obesity research which have clearly demonstrated that diet composition, concomitant with or independent of consequent obesity, can impact on the efficacy of insulin and leptin energy-regulatory effects (50); and on human data demonstrating the extension of significant obesity and onset of type 2 diabetes into younger and younger populations, such that there is a major increase in both pathologies within pediatric and adolescent populations in the U.S. and Westernized societies (51,52). Therefore, we are beginning systematic studies of the effect of changing baseline diet in adult and post-weanling rats prior to testing for motivated work for food rewards (self-administration).…”