Metabolic Syndrome in Children: What You Should Know

01 January, 2020
Metabolic syndrome in children is one of the most serious complications derived from childhood obesity. Learn more about it in this article. 

Metabolic syndrome in children (MS) is one of the afflictions that can occur in obese children. The prevalence of this syndrome has been increasing as obesity and being overweight is more common in children and adolescents. It’s a growing problem in recent years and pediatricians are very concerned about it.

What is the metabolic syndrome in children?

The metabolic syndrome is also known as insulin resistance syndrome or syndrome X. It’s a set of risk factors that increase the likelihood of suffering from certain diseases early on; such as various cardiovascular diseases or type 2 diabetes.

Experts point out five characteristic elements of this syndrome:

  1. Obesity of central or abdominal predominance.
  2. Hypertension.
  3. Hypertriglyceridemia.
  4. Hyperglycemia.
  5. A decrease in HDL cholesterol.

Currently, there are different criteria when diagnosing it; however, there’s no consensus to apply it in pediatric ages. 

According to Emilio Garcia Garcia, from the Pediatric Endocrinology Unit of the Virgen del Rocio Hospital (Seville), the Panel of Experts of the US National Cholesterol Education Program (ATP III) defines MS in adolescents (after puberty) when they meet 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 alterations in carbohydrate metabolism; such as altered baseline glycemia, glycemia greater than 100 mg/dl, hydrocarbon intolerance, glycemia greater than 140 mg/dl two hours after oral glucose overload).

Furthermore, this organization doesn’t define criteria for prepubertal children.

In 2007, The International Diabetes Federation (IDF) published criteria for MS in children between the ages of 10 to 16. It always requires the presence of abdominal obesity in addition to two of the other four parameters.

Metabolic Syndrome in Children: What You Should Know

What causes metabolic syndrome in children?

The relationship between the five characteristic elements of MS (abdominal obesity, triglycerides, HDL cholesterol, blood pressure, and blood glucose) and the role of insulin resistance (IR) aren’t entirely clear. However, experts believe that IR can be the main cause responsible for the syndrome.

Insulin resistance is the situation in which the insulin hormone’s actions are hindered. Hence, it can’t get glucose to the peripheral tissues of the body or slow down the release of glucose from the liver.

Among the exogenous factors that influence glucose uptake carried out by an individual’s tissues we find:

  • Being overweight or obese.
  • Rapid weight gain, both prenatal and postnatal. 
  • Physical activity.
  • The diet.
  • Psychosocial stress, lack of sleep, and depression
  • Chronic use of certain medications.

In contrast, these are some of the endogenous factors:

  • Race.
  • Puberty.
  • The 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 commonly used are baseline insulinemia and the HOMA index.

Consequences of metabolic syndrome on future health

Childhood metabolic syndrome increases the risk of certain diseases in adulthood, such as:

  • Alteration 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’s essential to follow healthy lifestyle habits. This surely includes a balanced diet and physical exercise. 

Above all, experts recommend intervening from the first year of life with actions aimed at preventing MS; such as exclusive breastfeeding (at least during the first six months of life).

Regarding overweight children, it’s best to start with these lifestyle changes from the moment they become overweight; without waiting for them to be obese. It’s advisable to intervene in all those children over two years old, even if they’re of normal weight.

Metabolic Syndrome in Children: What You Should Know

These are some of the safety measures that experts certainly recommend to prevent MS:

  • Changes in physical activity. Moderate sedentary activities while increasing physical exercise. 
  • Reduce the intake of saturated fats, trans unsaturated fats, and cholesterol.
  • Decrease the intake of simple carbohydrates (refined sugars).
  • Increase the intake of fruits, vegetables, and cereals.
  • Caloric restriction in cases of excess weight (always under the control of a pediatrician).

Once the metabolic syndrome is diagnosed, there are different pharmacological treatments depending on the element to be treated; this includes obesity, blood pressure, blood glucose, HDL cholesterol, and also triglycerides. Nonetheless, a proper and healthy diet and physical exercise are the fundamental pillars to control MS.

Remember to take your son or daughter to all the checkups with your pediatrician and to also consult all the doubts that may arise with your healthcare professional.

  • García García E. (2015). Obesidad y síndrome metabólico en pediatría. En AEPap ed. Curso de Actualización Pediatría 2015. Madrid: Lúa Ediciones 3.0; p. 71-84.
  • Güemes-Hidalgo M., Muñoz-Calvo M.T. (2015). Síndrome metabólico. Pediatr Integral; XIX (6): 428-435.