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Children
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State-of-Art in Metabolic Syndrome in Childhood
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State-of-Art in Metabolic Syndrome in Childhood

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

Deadline for manuscript submissions: closed (1 July 2023) | Viewed by 5747

Special Issue Editors

Dr. Giulio Frontino

E-Mail Website
Guest Editor
Department of Pediatrics, Ospedale San Raffaele Scientific Institute, 20132 Milano, MI, Italy
Interests: diabetes; primary care; insulin; metabolic diseases; pediatric endocrinology; diabetology; diabetic ketoacidosis; hypoglycemia; metabolic syndrome; blood glucose self-monitoring
Special Issues, Collections and Topics in MDPI journals
Dr. Maurizio Delvecchio

E-Mail Website
Co-Guest Editor
Department of Biomedical Sciences and Human Oncology, Ospedale Pediatrico Giovanni XXIII, 70126 Bari, BA, Italy
Interests: diabetes; primary care; insulin; metabolic diseases; pediatric endocrinology; diabetology; diabetic ketoacidosis; hypoglycemia; metabolic syndrome; blood glucose self-monitoring
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

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 crucia lfor early risk stratification. Several sets of diagnostic criteria have been proposed in the past, but 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 paper 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 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-analysis, review original 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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

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

Published Papers (4 papers)

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Research

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12 pages, 509 KiB  
Article
Atherogenic Index of Plasma (AIP) and Its Association with Fatty Liver in Obese Adolescents
by Hüseyin Dağ, Fatih İncirkuş and Okan Dikker
Children 2023, 10(4), 641; https://doi.org/10.3390/children10040641 - 29 Mar 2023
Cited by 4 | Viewed by 1334
Abstract
Background: The atherogenic index of plasma (AIP) is the base-10 logarithmic conversion of the triglyceride to high-density lipoprotein cholesterol ratio [AIP = log10 (triglyceride/HDL cholesterol)]. Some studies have found a link between low serum vitamin D levels, AIP, and fatty liver. This study [...] Read more.
Background: The atherogenic index of plasma (AIP) is the base-10 logarithmic conversion of the triglyceride to high-density lipoprotein cholesterol ratio [AIP = log10 (triglyceride/HDL cholesterol)]. Some studies have found a link between low serum vitamin D levels, AIP, and fatty liver. This study was conducted to evaluate the relationship between AIP levels, fatty liver, and vitamin D levels in obese adolescents aged 10–17 years. Methods: This study included 136 adolescents, including 83 obese and 53 healthy controls, in the age range of 10–17 years. Thirty-nine of the obese adolescents had fatty livers. Those with ultrasonography grades 2 or 3 of fat were in the fatty liver group. The AIP value was calculated as the logarithmic conversion of the ratio (triglyceride/HDL cholesterol) at the base of 10. Vitamin D and other laboratory tests were analyzed biochemically. Statistical evaluations were made with the SPSS program. Results: The AIP, body mass index (BMI), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin averages of obese adolescents with fatty liver were significantly higher than those of obese adolescents without fatty liver and the healthy control group (p < 0.05). Again, the mean AIP of obese patients without fatty liver was pointedly higher than that of the healthy control group (p < 0.05). There was a positive, moderate relationship between AIP and BMI, AIP and HOMA-IR, and AIP and insulin levels (p < 0.05), whereas there was a negative, moderate (37.3%) relationship between AIP and vitamin D (p = 0.019). Conclusion: AIP levels were higher in obese adolescents, and this increase was higher in obese adolescents with fatty liver in this study. Moreover, we detected a negative correlation between AIP and vitamin D levels and a positive correlation with BMI, insulin resistance, and insulin levels. Based on our data, we concluded that AIP can be a useful predictor of fatty liver in obese adolescents. Full article
(This article belongs to the Special Issue State-of-Art in Metabolic Syndrome in Childhood)
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11 pages, 616 KiB  
Article
Is Metabolic Syndrome Useful for Identifying Youths with Obesity at Risk for NAFLD?
by Procolo Di Bonito, Anna Di Sessa, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Giuseppina Rosaria Umano, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni and Giuliana Valerio
Children 2023, 10(2), 233; https://doi.org/10.3390/children10020233 - 28 Jan 2023
Viewed by 1226
Abstract
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs [...] Read more.
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDFm) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6–17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIIIm) was performed. The prevalence of MetS-IDFm was 27.8% and 28.9% by MetS-ATPIIIm. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30–5.60) (p = 0.008) for high WC, 1.68 (1.25–2.26)(p = 0.001) for MetS, 1.54 (1.12–2.11)(p = 0.007) for low HDL-Cholesterol, 1.49 (1.04–2.13)(p = 0.032) for high triglycerides and 1.37 (1.03–1.82)(p = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDFm and frequency of NAFLD compared to Mets-ATPIIIm definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD. Full article
(This article belongs to the Special Issue State-of-Art in Metabolic Syndrome in Childhood)
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Review

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31 pages, 713 KiB  
Review
Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity
by Malgorzata Wasniewska, Giorgia Pepe, Tommaso Aversa, Simonetta Bellone, Luisa de Sanctis, Procolo Di Bonito, Maria Felicia Faienza, Nicola Improda, Maria Rosaria Licenziati, Claudio Maffeis, Alice Maguolo, Giuseppina Patti, Barbara Predieri, Mariacarolina Salerno, Stefano Stagi, Maria Elisabeth Street, Giuliana Valerio, Domenico Corica and Valeria Calcaterra
Children 2023, 10(4), 735; https://doi.org/10.3390/children10040735 - 17 Apr 2023
Cited by 4 | Viewed by 2593
Abstract
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative [...] Read more.
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity. Full article
(This article belongs to the Special Issue State-of-Art in Metabolic Syndrome in Childhood)
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20 pages, 820 KiB  
Review
From Metabolic Syndrome to Type 2 Diabetes in Youth
by Dario Iafusco, Roberto Franceschi, Alice Maguolo, Salvatore Guercio Nuzio, Antonino Crinò, Maurizio Delvecchio, Lorenzo Iughetti, Claudio Maffeis, Valeria Calcaterra and Melania Manco
Children 2023, 10(3), 516; https://doi.org/10.3390/children10030516 - 05 Mar 2023
Cited by 4 | Viewed by 2876
Abstract
In the frame of metabolic syndrome, type 2 diabetes emerges along a continuum of the risk from the clustering of all its components, namely visceral obesity, high blood pressure and lipids, and impaired glucose homeostasis. Insulin resistance is the hallmark common to all [...] Read more.
In the frame of metabolic syndrome, type 2 diabetes emerges along a continuum of the risk from the clustering of all its components, namely visceral obesity, high blood pressure and lipids, and impaired glucose homeostasis. Insulin resistance is the hallmark common to all the components and, in theory, is a reversible condition. Nevertheless, the load that this condition can exert on the β-cell function at the pubertal transition is such as to determine its rapid and irreversible deterioration leading to plain diabetes. The aim of this review is to highlight, in the context of metabolic syndrome, age-specific risk factors that lead to type 2 diabetes onset in youth; resume age specific screening and diagnostic criteria; and anticipate potential for treatment. Visceral obesity and altered lipid metabolism are robust grounds for the development of the disease. Genetic differences in susceptibility to hampered β-cell function in the setting of obesity and insulin resistance largely explain why some adolescents with obesity do develop diabetes at a young age and some others do not. Lifestyle intervention with a healthy diet and physical activity remains the pillar of the type 2 diabetes treatment in youth. As to the pharmacological management, metformin and insulin have failed to rescue β-cell function and to ensure long-lasting glycemic control in youth. A new era might start with the approval for use in pediatric age of drugs largely prescribed in adults, such as dipeptidyl peptidase-4 and sodium-dependent glucose transport inhibitors, and of new weight-lowering drugs in the pipeline such as single and multiple agonists of the glucagon-like peptide 1 receptor. The latter drugs can have tremendous impact on the natural history of the disease. By treating diabetes, they will reduce the burden of all the metabolic abnormalities belonging to the syndrome while causing a tremendous weight loss hitherto never seen before. Full article
(This article belongs to the Special Issue State-of-Art in Metabolic Syndrome in Childhood)
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