Metabolic Syndrome in Pediatrics: The Role of Lipid Partitioning

The ever growing prevalence of childhood obesity is being accompanied by an increase in the pediatric population of diseases once believed to be exclusive of the adulthood such as the metabolic syndrome (MS). The MS has been defined as the link between insulin resistance, hypertension, dyslipidemia, impaired glucose tolerance and other metabolic abnormalities associated with an increased risk of atherosclerotic cardiovascular diseases in adults. In the past years it however became clear that a subgroup of obese patients is metabolically healthy with insulin sensitivity similar to healthy lean individuals, and lower liver fat content than the majority of metabolically ‘unhealthy’ obese patients. Recent studies investigating lipid partitioning among specific fat depots revealed that protection against ectopic fat deposition in liver, muscle and heart, as well as protection against adipose tissue dysfunction and inflammation, seem to be contributing to the healthy obese phenotype.