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Sarah Bussler, Melanie Penke, Gunter Flemming, Yasir S. Elhassan, Jürgen Kratzsch, Elena Sergeyev, Tobias Lipek, Mandy Vogel, Ulrike Spielau, Antje Körner, Tommaso de Giorgis, Wieland Kiess. Novel Insights in the Metabolic Syndrome in Childhood and Adolescence. Horm Res Paediatr. 2017 Aug 28.

Background

Metabolic syndrome (MetS) is recognized as an escalating major health risk in adults as well as in children and adolescents. Its prevalence ranges from 6 to 39% depending on the applied definition criteria. To date, there is no consensus on a MetS definition for children and adolescents. However, most authors agree on essential components such as glucose intolerance, central obesity, hypertension, and dyslipidemia; each representing a risk for cardiovascular disease.
Recently, associations between MetS and non-alcoholic fatty liver disease, hyperuricemia, and sleep disturbances have emerged. Biomarkers like adipocytokines are a subject of current research as they are implicated in the pathogenesis of the MetS. Epigenetics and gestational programming, especially
the role of microRNA, comprise a novel, rapidly developing and promising research focus on the topic of MetS. MicroRNAs are increasingly valued for potential roles in the diagnosis, stratification, and therapeutics of MetS. Early detection of risk factors, screening for metabolic disturbances, and the identification of new therapies are major aims to reduce morbidity and mortality related to MetS. Dietary modification and physical activity are currently the only adopted treatment approaches. Pharmacological therapies and bariatric surgery are still contradictory and, therefore, are only
recommended in selected high-risk cases.

Introduction

During the last 20 years, the proportion of overweight and obese children and adolescents has significantly increased across most countries. Although the prevalence
of obesity at a young age has stabilized or even slightly declined in some countries, the number of adolescents with obesity is still increasing [1]. In 2006, the German Children and Adolescent Health Survey (KIGGS) estimated that 15% of all children and adolescents between the ages of 3 and 17 years were overweight, and 6.3% were obese. More recent studies confirm the same trend

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