State of the Art in Metabolic Syndrome in Childhood: 2nd Edition

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Endocrinology & Diabetes".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 1422

Special Issue Editors


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Guest Editor
Department of Pediatrics, Ospedale San Raffaele Scientific Institute, 20132 Milano, Italy
Interests: diabetes; primary care; insulin; metabolic diseases; pediatric endocrinology; diabetology; diabetic ketoacidosis; hypoglycemia; metabolic syndrome; blood glucose self-monitoring
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Dear Colleagues,

Childhood obesity has more than doubled in prevalence in the last 30 years, with up to 39 percent of obese children and adolescents manifesting signs and symptoms of metabolic syndrome (MeS), depending on the classification used. This is all the more concerning given that obesity was responsible for around 4 million deaths worldwide in 2015, nearly 70% of which were caused by cardiovascular disease.  There is still currently no standardized definition of MeS in children, although consensus diagnostic criteria are crucial for early risk stratification. Several sets of diagnostic criteria have been proposed in the past, but the recent literature suggests the inclusion of other additional features, as many affected children already have one or more cardiovascular risk factors or metabolic abnormalities, such as dyslipidemia, impaired glucose tolerance, type 2 diabetes, hyperuricemia, arterial hypertension, NAFDL, hyperuricemia, and sleep and psychological disorders (such as depression and attention deficit disorder). Current therapeutic options, including pharmacotherapy and bariatric surgery, are limited at this age. Consequently, lifestyle modification remains the most effective (and only way in most children and adolescents) to prevent or treat childhood obesity and MeS. However, preventive or therapeutic treatments should be initiated before overt manifestations of MeS using consistent and internationally established criteria. The goal of this review is to provide a concise and critical summary of our current understanding of metabolic syndrome in children and adolescents, as well as to address present and future treatment perspectives.

Contributions from different professions are welcome, and all types of papers will be taken into consideration for publication. This Special Issue aims to collect high-quality research papers that address novel issues related to metabolic syndrome. We would like this Special Issue to provide clinicians and researchers with interesting options for improving their clinical practice and that could also be the basis for future research projects.

The incidence of obesity and metabolic syndrome has dramatically increased over the last few decades. In parallel, the number of papers on this topic has increased, and many studies concerning their treatment, genetic predisposition, and even diagnosis and clinical findings are ongoing. Despite the growing body of research, the only effective treatment is weight loss. Some drugs have been proposed for this purpose, but they have not yet significantly changed the prognosis for these patients.

Meta-analyses, original review papers, position statements, and interesting case reports that could be relevant for readers will be welcomed. We encourage contacting the Guest Editors regarding the submission of different kinds of papers.

Dr. Giulio Frontino
Dr. Maurizio Delvecchio
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • metabolic syndrome
  • childhood and adolescent obesity
  • type 2 diabetes
  • NAFLD
  • dyslipidemia
  • insulin resistance

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Published Papers (1 paper)

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Research

10 pages, 648 KiB  
Article
Severe Obesity Defined by Percentiles of WHO and Cardiometabolic Risk in Youth with Obesity
by Giuliana Valerio, Procolo Di Bonito, Anna Di Sessa, Giada Ballarin, Valeria Calcaterra, Domenico Corica, Maria Felicia Faienza, Francesca Franco, Maria Rosaria Licenziati, Claudio Maffeis, Giulio Maltoni, Emanuele Miraglia del Giudice, Anita Morandi, Enza Mozzillo and Malgorzata Wasniewska
Children 2024, 11(11), 1345; https://doi.org/10.3390/children11111345 - 1 Nov 2024
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Abstract
Background/Objectives: The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); Methods: In this [...] Read more.
Background/Objectives: The pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); Methods: In this multicentric study, data were retrieved for 3727 youths (1937 boys; 2225 children, 1502 adolescents). OB was defined as BMI > 97th percentile (BMI97th), severe OB was defined as BMI > 99th percentile (BMI99th), BMI ≥ 120% of the 97th percentile (120% BMI97th), or BMI Z-score > 3 (WHO tables), or BMI ≥ the International Obesity Task Force (IOTF) value crossing a BMI of 35 kg/m2 at the age of 18 (IOTF35). The continuous CMR Z-score (sum of residual standardized for age and sex of waist-to-height ratio, systolic and diastolic blood pressure, triglycerides, and HDL-cholesterol x −1) and the cluster of at least two CMR factors (hypertension, high triglycerides, low HDL-cholesterol, and high waist-to-height ratio) were calculated. Results: Continuous CMR Z-score was significantly higher both in children or adolescents with severe OB defined by 120% BMI97th compared to BMI99th (p < 0.0001), while it was lower only in adolescents with severe OB defined by 120% BMI97th compared to BMI Z-score >3 (p < 0.0001). Compared to 120% BMI97th, BMI Z-score > 3 and IOTF35 had higher specificity, but lower sensitivity in identifying children and adolescents with clustered CMR factors. Conclusions: The definition of severe OB based on 120% BMI97th is superior to BMI99th but it is inferior to BMI Z score > 3 as far as the association between severe OB and CMR factors is concerned. Pediatricians should take into consideration the implication of the use of different BMI metrics in those countries that recommend the WHO system. WHO BMI Z-score > 3 and IOTF35 can be used interchangeably to predict cardiometabolic risk. Full article
(This article belongs to the Special Issue State of the Art in Metabolic Syndrome in Childhood: 2nd Edition)
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