title: An update on the assessment and management of metabolic syndrome, a growing medical emergency in paediatric populations.
abstract: In the last decades the increasing rate of obesity in children and adolescents worldwide has led to the onset in paediatric age of metabolic syndrome, a disease commonly associated to adulthood. Central obesity, dyslipidaemia, hyperglycaemia, and hypertension are typical features of metabolic syndrome that seem to hesitate often in type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and many other clinical conditions. Thus preventing and curing metabolic syndrome in paediatric patients is becoming an urgent need for public health. While diagnostic criteria and therapy of metabolic syndrome in adults are very well defined, there is no consensus on the definition of metabolic syndrome in children and adolescents as well as on healing approaches. The aim of this review is to describe the recent advances on the pathogenesis and clinical outcomes of paediatric metabolic syndrome. We then detail the therapeutic strategies (i.e. dietary regimens, physical exercise, nutraceuticals, and medications) employed to manage the disease. Finally, we analyse the safety profile of the drugs used in children and adolescents by performing a retrospective review of paediatric adverse reactions reported in the FDA's Adverse Event Reporting System database.
authors.affiliation: Department of Paediatrics, V. Buzzi Hospital, Università degli Studi di Milano, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mameli
authors.affiliation: Department of Paediatrics, V. Buzzi Hospital, Università degli Studi di Milano, Milano, Italy.
authors.forename: Gian Vincenzo
authors.initials: GV
authors.lastname: Zuccotti
authors.affiliation: Department of Biomedical and Clinical Sciences "Luigi Sacco" (DIBIC), Università degli Studi di Milano, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Carnovale
authors.affiliation: Department of Paediatrics, V. Buzzi Hospital, Università degli Studi di Milano, Milano, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Galli
authors.affiliation: Department of Paediatrics, V. Buzzi Hospital, Università degli Studi di Milano, Milano, Italy.
authors.forename: Pilar
authors.initials: P
authors.lastname: Nannini
authors.affiliation: Department of Biomedical and Clinical Sciences "Luigi Sacco" (DIBIC), Università degli Studi di Milano, Italy; Department for Innovation in Biological, Agro-Food and Forest Systems (DIBAF), Università degli Studi della Tuscia, Viterbo, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Cervia
authors.affiliation: Department of Biomedical and Clinical Sciences "Luigi Sacco" (DIBIC), Università degli Studi di Milano, Italy. Electronic address: cristiana.perrotta@unimi.it.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Perrotta
mesh_terms: D000818:Animals; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000150:complications; D008019:Life Style; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications; D009765:Obesity / Q000150:complications
keywords: ADRs; Lifestyle interventions; Metabolic syndrome; Paediatrics; Pharmacotherapy; Symptoms and diagnosis of metabolic syndrome