Metabolic syndrome: identifying the risk factors.

OBJECTIVES To discuss the metabolic syndrome and identify its risk factors, including in the pediatric age group. SOURCES Indexed review articles. SUMMARY OF THE FINDINGS The metabolic syndrome is characterized by insulin resistance and the presence of risk factors for cardiovascular diseases and diabetes mellitus type 2. Consensus has not yet been reached on its diagnostic criteria. This review presents diagnostic criteria defined by the American Heart Association (US National Cholesterol Education Program), the American Association of Clinical Endocrinologists, the World Health Organization and the International Diabetes Federation and discusses the possibilities of applying them to children. Pathophysiologic features of the syndrome are also covered, principally those related to the perinatal period and childhood. CONCLUSIONS The metabolic syndrome is being diagnosed with ever greater frequency, principally during adolescence. Lifestyle changes, such as to diet and level of physical activity are fundamental to prevention. Treatment with medication and, in extreme cases, with surgery should also be considered, depending on severity and age.