How to define metabolic syndrome

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Metabolic syndrome, which is a constellation of central obesity, blood pressure elevation, high triglycerides, low HDL-cholesterol, and high fasting blood sugar, appears to be an important risk factor for cardiovascular disease in adults. It has been less clear whether metabolic syndrome exists in children and, if it does, how best to define it. In this issue of The Journal, Chi et al compared proposed definitions of the metabolic syndrome in preadolescent girls. They found that there was poor agreement among proposed pediatric definitions of the metabolic syndrome, with the prevalence varying between 0.4% to 26.3% depending on the population studied and the definition used.

It is clear that further work is needed to more precisely define the metabolic syndrome for young individuals. This will include better understanding of which variables to use and how to define cut points for abnormality of those variables. Accomplishing this will be important if it better determines which children and adolescents are at greater risk for future cardiovascular disease.