Metabolic syndrome in youth: chimera or useful concept?

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors associated with an increased risk for the development of cardiovascular diseases and type 2 diabetes. The prevalence of the MetS is not particularly high in the overall pediatric population (3 %-4 %) but it is as high as 30 %-50 % among overweight youth. Several definitions of the MetS have been used, thus, generating confusion and difficulties in defining the true prevalence of this syndrome. The recent definition of the International Diabetes Federation has tried to standardize the diagnostic criteria. However, there are still some concerns about use of cut-offs values and dichotomous variables, and some debate as to whether a continuous cardiometabolic risk score could be more appropriate for the pediatric population. Although there are some studies that have shown the association between childhood and adolescent MetS with long-term outcomes, further prospective studies are needed to clarify the true value of diagnosing MetS in youth.