Metabolic syndrome in children: current issues and South Asian perspective.
OBJECTIVE
The objective of this review is to discuss definition, determinants, and management issues of the metabolic syndrome in children with a focus on South Asians.


METHODS
The literature search was done using the PubMed search engine (National Library of Medicine, Bethesda, MD, USA). Manual searches for other important references and medical databases were also done.


RESULTS
There is a need for an integrated definition of the metabolic syndrome in children and adolescents, taking cognizance of the ethnic-specific variations. Obesity and body fat patterning are important determinants of insulin resistance and the metabolic syndrome in children and ethnic variations in these parameters are seen. Excess body fat and thicker truncal subcutaneous fat are important predisposing factors for development of insulin resistance in South Asian children. Because the metabolic syndrome tracks into adulthood, its manifestations need to be recognized early for prevention of diabetes and coronary heart disease. Therapeutic lifestyle changes, maintenance of high levels of physical activity and normal weight are most important strategies; pharmacologic therapy for individual components of the metabolic syndrome is occasionally needed.


CONCLUSIONS
The metabolic syndrome in children is an important clinical marker of diabetes and coronary heart disease in adults. In view of the rapid increase in the metabolic syndrome in most populations, high-risk screening and effective public-intervention educational programs are urgently needed.
Misra
Anoop
A
Department of Diabetes and Metabolic Diseases, Fortis Hospital, Vasant Kunj, New Delhi, India. anoopmisra@metabolicresearchindia.com
Khurana
Lokesh
L
Vikram
Naval K
NK
Goel
Ashish
A
Wasir
Jasjeet S
JS
D000293:Adolescent; D044466:Asian People / Q000235:genetics*; D001823:Body Composition / Q000502:physiology*; D002648:Child; D005006:Ethnicity; D020022:Genetic Predisposition to Disease; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000208:ethnology* / Q000235:genetics; D009765:Obesity / Q000150:complications* / Q000208:ethnology / Q000378:metabolism; D015995:Prevalence