Metabolic Syndrome In Children
The metabolic syndrome in children (MS) is one of the complications that can appear when there is childhood obesity. The prevalence of this syndrome in the child population has been increasing as obesity and overweight in children and adolescents increase. It is a growing problem in recent years and concentrates all the interest of pediatricians.
What is metabolic syndrome in children?
The metabolic syndrome is also known as insulin resistance syndrome or syndrome X. It is a set of risk factors that increase the probability of suffering from certain diseases early, such as different cardiovascular diseases or type 2 diabetes.
Experts determine five characteristic elements of this syndrome:
- Obesity of central or abdominal predominance.
- Hypertension.
- Hypertriglyceridemia.
- Hyperglycemia
- Decrease in HDL cholesterol.
At present, there are different criteria when diagnosing it and there is no consensus to apply it in pediatric ages.
According to Emilio García García, from the U. Pediatric Endocrinology of the Virgen del Rocío Hospital (Seville), the Expert Panel of the US National Cholesterol Education Program (ATPIII) defines MS in adolescents (from puberty) when they are fulfilled at least three of these five criteria:
- Central or abdominal obesity.
- Triglycerides above 110 mg / dl.
- HDL cholesterol below 40 mg / dl.
- Blood pressure greater than the 90th percentile.
- Presence of carbohydrate metabolism disorders (altered basal blood glucose, blood glucose greater than 100 mg / dl, hydrocarbon intolerance, blood glucose greater than 140 mg / dl two hours after oral glucose overload).
This organization does not define criteria for prepubertal children.
The International Diabetes Federation (IDF) published in 2007 criteria for MS for children aged 10 to 16 years. It always requires the presence of abdominal obesity in addition to two of the other four parameters.
What Causes Metabolic Syndrome in Children?
The relationship between the five characteristic elements of MS (abdominal obesity, triglycerides, HDL cholesterol, blood pressure and glycemia) and the role of insulin resistance (IR) are not entirely clear, but experts consider that IR may be the main responsible for the syndrome.
Insulin resistance is the situation in which the action of the hormone insulin is hampered, so it cannot get glucose to the peripheral tissues of the body nor stop the release of glucose from the liver.
Among the exogenous factors that influence the uptake of glucose by the tissues of an individual we find:
- Overweight and obesity.
- Rapid weight gain, both prenatal and postnatal.
- Physical activity.
- The diet.
- Psychosocial stress, lack of sleep and depression.
- Chronic use of certain medications.
Among the endogenous factors we find:
- The race.
- Puberty.
- Genetic predisposition to IR (family history).
- Certain syndromes, such as Turner syndrome.
There are different tests to measure and study insulin resistance, although the most widely used are basal insulinemia and the HOMA index.
Consequences of metabolic syndrome on future health
Infant metabolic syndrome increases the risk of certain diseases in adulthood, such as:
- Alterations in carbohydrate metabolism: type 2 diabetes …
- Cardiovascular diseases : cerebrovascular, peripheral vascular and coronary diseases.
- Cancer: colon, breast, endometrium, liver …
What can I do to prevent it?
To prevent metabolic syndrome in children, it is essential to follow healthy lifestyle habits, with a balanced diet and physical exercise.
Experts recommend intervening from the first year of life with actions aimed at preventing MS, such as exclusive feeding with breastfeeding (at least during the first six months of life).
In overweight children, they recommend starting with lifestyle changes from the moment they appear, without waiting until they are obese. It is recommended to intervene in all those children older than two years, even if they have a normal weight.
These are some of the actions recommended by experts to prevent MS:
- Changes in physical activity Moderate sedentary activities and increase physical exercise.
- Reduce your intake of saturated fats, “trans” unsaturated fats, and cholesterol.
- Decrease your intake of simple carbohydrates (refined sugars).
- Increase your intake of fruits, vegetables, and grains.
- Caloric restriction in cases of excess weight (always controlled by a pediatrician).
Once the metabolic syndrome is diagnosed, there are different pharmacological treatments depending on the element to be treated (obesity, blood pressure, blood glucose, HDL cholesterol or triglycerides). Although an adequate and healthy diet and physical exercise are the fundamental pillars to control MS.
Remember to go with your son or daughter to all the check-ups with your pediatrician and consult all the doubts that may arise with your trusted health professional.
