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The Metabolic Syndrome: Look for It in Children and Adolescents, Too!

The first 300 words of the full text of this article appear below.

	Introduction

 
The third National Cholesterol Education Program Adult Treatment Panel (ATP III)¹ defines the metabolic (or insulin resistance) syndrome as the presence in an individual of at least three of the following five risk factors: central or abdominal obesity, hypertriglyceridemia, hypertension, low HDL cholesterol, and high fasting glucose levels. The metabolic syndrome is a major risk factor for cardiovascular disease (CVD) and type 2 diabetes. Although insulin resistance is also a key risk factor for CVD and type 2 diabetes, hyperinsulinemia is not included as a potential risk factor by the ATP III; its definition was designed for use in clinical practice with adults, and insulin levels are not usually assessed in clinical practice.

	IDENTIFYING THE METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS

 
Components of the metabolic syndrome are present in children and adolescents as well as in adults,^2-5 but there is no agreement on the definition of the metabolic syndrome as a whole in this population. Some researchers use definitions that follow the ATP III guidelines (having at least three or five components),^6-8 whereas others have added an elevated fasting insulin level as a component of the syndrome.¹

This variability of definition is at least in part because of the growth and developmental changes that occur during childhood and adolescence and complicates the choice of cut-off points for risk factors. Norms for several of the factors, such as blood pressure, height, weight, and BMI, differ between males and females and are age-specific in that most increase normally with age.

In addition, overweight is defined differently in children than it is in adults. Because children are growing and thus changing in height and weight over time, it is not possible to provide a simple cut-point to define overweight or obesity, as is done for adults. In fact, the recent Centers for Disease Control and Prevention (CDC) definitions of overweight . . . [Full Text of this Article]

	PUBERTY AND THE METABOLIC SYNDROME

 

	PREVALENCE OF THE METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS

 

	RELATIONSHIPS AMONG METABOLIC SYNDROME COMPONENTS

 

	IMPLICATIONS FOR PRACTICE

 
Screening
Management and Prevention

	CONCLUSION

 

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