Metabolic syndrome in pediatric patients

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The metabolic syndrome represents a cluster of risk factors for type 2 diabetes and cardiovascular disease that can be found in obese individuals, particularly those with central or abdominal obesity. It has been a useful clinical concept for adults but has been more controversial in pediatrics. In this issue of The Journal, two papers focus on the metabolic syndrome in children and adolescents.

Ventura et al evaluated the persistence of metabolic syndrome features in overweight Latino children. They also studied the factors associated with persistence. They found that 19% of their cohort had the metabolic syndrome over 3 visits. The group with persistent metabolic syndrome had faster gain of fat mass and maintained lower insulin sensitivity and beta cell function compared which those who never had metabolic syndrome features. This suggests that those with persistent metabolic syndrome are at increased risk to develop type 2 diabetes.

Park et al evaluated the metabolic syndrome among Korean adolescents. They found that the prevalence of metabolic syndrome has declined over time in Korean youth, despite an increase in obesity over the same time period. Interestingly, in their early surveys, glucose intolerance was more common and a decrease in impaired fasting glucose accounted for much of the decrease in metabolic syndrome. This is in contrast to findings in the United States and other Western countries, where impaired fasting glucose is an uncommon feature of the metabolic syndrome in adolescents. The reasons for the decrease in prevalence of metabolic syndrome in Korea are unclear, but the authors suggest that this could be associated with simultaneous national public health initiatives focused on increasing physical activity in children.

There is still much to be learned about the metabolic syndrome in pediatric patients. These studies add to the expanding body of knowledge in this area.

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