Abstract

ARJONA-VILLICANA, Ruy David; GOMEZ-DIAZ, Rita Angélica  and  AGUILAR-SALINAS, Carlos Alberto. Controversies in diagnosis of the metabolic syndrome in pediatric population. Bol. Med. Hosp. Infant. Mex. [online]. 2008, vol.65, n.6, pp.488-501. ISSN 1665-1146.

The metabolic syndrome is a clinical concept which incorporates the phenotypic expression of intra-abdominal fat and insulin resistance under a single diagnosis. The main end points of the metabolic syndrome are well known, namely type 2 diabetes mellitus and atherosclerosis. The prevalence of the metabolic syndrome has increased in all western societies. Simultaneously, there has been a reduction in diagnosis age, probably related to the increase in prevalence of childhood obesity. However, diagnosis of the metabolic syndrome in pediatric patients has been an area of controversy. There has been little evidence connecting the known components of the metabolic syndrome in adults with either cardiovascular or metabolic end points in children and adolescents. Different definitions with distinct thresholds and components have resulted in confusion regarding diagnosis and treatment in this population. In addition, cut-off points for the components of the metabolic syndrome come from populations from developed countries; they are frequently not adjusted for populations in developing countries. Both situations complicate the possibility of obtaining accurate epidemiological data to evaluate the metabolic syndrome in the pediatric population. In this document, we discuss the strengths and weaknesses of diagnostic criteria for the metabolic syndrome when applied to children and adolescents.

Keywords : Metabolic, syndrome, disease; triglycerides; cholesterol; lipoproteins, HDL; blood glucose.