Metabolic syndrome as a factor in the development of type 2 diabetes mellitus in children.

Abstract

Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia , and abdominal obesity) that occur in obese children. Metabolic syndrome is difficult to define because of its heterogeneous classification and reliance on rigid cutoff values to assess disorders with non-Gaussian distributions. Defining the syndrome is even more challenging in children because of racial and pubertal differences and the absence of cardiovascular events. Lipid partitioning between specific fat depots is associated with insulin resistance, which may lead to mitochondrial overload and dysfunctional subcellular energy utilization and contribute to the various elements of metabolic syndrome. Multiple environmental factors, particularly the typical Western diet, cause mitochondrial overload, while other changes in Western society, such as stress and sleep deprivation, increase insulin resistance and food intake. They lead to an unfavorable biochemical phenotype, including the development of altered glucose metabolism and early atherogenesis in childhood and early adulthood. The increasing prevalence of obesity among children and adolescents is one of the most alarming public health problems facing the world today.