OBJECTIVETo compare and evaluate clinical applications of two definitions of metabolic syndrome in children and adolescents, which was developed by Pediatric Academy of Chinese Medical Association in 2012 (Chinese definition) and by International Diabetes Federation in 2007 (IDF definition), respectively.

METHODS593 obese children and adolescents aged 10 ≊16 y from July 2006 to December 2012 were enrolled in the study. The diagnostic concordance of two definitions for metabolic syndrome and individual components was estimated, and their sensitivity and specificity for detecting insulin resistance and early macrovascular complications were compared.

RESULTSThe concordance between two definitions for diagnosing metabolic syndrome was good (kappa=0.626); as for detecting the individual components, the Kappa concordance index were 1.000, 0.803, 0.780, 0.734 and 0.594 for hypertriglyceridemia, hyperglycemia, cholesterol abnormality and hypertension, respectively. The incidence of insulin resistance and early macrovascular complications, detected by the two definitions, were both increased with increasing number of abnormal components. The sensitivity and specificity for detecting insulin resistance in children with metabolic syndrome were 54.5% and 65.7% by Chinese definition, and 36.1% and 83.1% by IDF definition; while the sensitivity and specificity for detecting early macrovascular complications were 58.3% and 55.8% by Chinese definition, and 37.3% and 70.8% by IDF definition. After adjusting for age and sex, compared to the obese children and adolescents without metabolic syndrome, the odds ratios of insulin resistance and early macrovascular complications were 2.166 (P<0.001) and 1.771(P=0.008) for children with metabolic syndrome diagnosed by Chinese definition, and the odds ratio of insulin resistance and early macrovascular complications were 2.618 (P<0.001) and 1.357 (P=0.190) by IDF definition.

CONCLUSIONThe concordance between Chinese and IDF definitions for diagnosing metabolic syndrome in Chinese obese children and adolescents is good. Compared to IDF definition, Chinese definition is more sensitive for hypertension, hyperglycemia and hypercholesterolemia, thus it can more effectively detect insulin resistance and early macrovascular complication.

Adolescent ; Child ; Female ; Humans ; Insulin Resistance ; Male ; Metabolic Syndrome ; classification ; complications ; diagnosis ; Obesity ; complications ; Sensitivity and Specificity

INTRODUCTIONTo review the definitions of the metabolic syndrome according to various expert groups and assess their relevance to clinical practice.

MATERIALS AND METHODSMedline searches were conducted to identify studies which addressed: (i) the utility of the metabolic syndrome compared to multivariable predictive functions for the identification of individuals at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), (ii) the importance and definition of obesity in the definition of the metabolic syndrome and (iii) the impact of lifestyle and pharmacological interventions designed to reduce the risk of cardiovascular disease in those with and without the metabolic syndrome.

RESULTSAlthough inferior to multivariable risk scores in predicting T2DM and CVD, the metabolic syndrome represents a simple clinical tool, particularly for the prediction of T2DM. Obesity is not a critical component of the metabolic syndrome for identifying those at increased risk of CVD but may be important for predicting T2DM. If anything, pharmacological therapy, especially lipid lowering is as, if not more, effective in those with the metabolic syndrome than in those without.

CONCLUSIONSAlthough the metabolic syndrome appears to have limited utility for the identification of individuals at increased risk of T2DM or CVD, the diagnosis of the metabolic syndrome presents an opportunity to rationalise health services to deliver coordinated care to those with metabolic syndrome.

Cardiovascular Diseases ; etiology ; Diabetes Mellitus, Type 2 ; etiology ; Humans ; Metabolic Syndrome ; complications ; diagnosis ; Obesity ; complications

Asymmetric septal hypertrophy with systolic anterior motion of the mitral valve is frequently a phenotypic, but not pathognomonic, expression of genetic hypertrophic cardiomyopathy (HCM) with or without obstruction. It can, however, be associated nonspecifically with other forms of increased left ventricular (LV) afterload. We herein report the case of a young man with obesity cardiomyopathy and heart failure who presented with asymmetric septal hypertrophy and marked LV hypertrophy, and endomyocardial biopsy ruled out genetic HCM.
Adult ; Cardiomyopathy, Hypertrophic, Familial ; Diagnosis, Differential ; Echocardiography ; Humans ; Hypertrophy, Left Ventricular ; complications ; diagnosis ; Male ; Obesity, Morbid ; complications

Autonomic Nervous System Diseases ; diagnosis ; etiology ; Child ; Female ; Humans ; Hypothalamic Diseases ; diagnosis ; etiology ; Hypoventilation ; diagnosis ; etiology ; Obesity ; complications ; psychology

INTRODUCTIONThe incidence of childhood obesity is rising across the globe, and obesity related co-morbidities are increasing concomitantly in the paediatric population.

MATERIALS AND METHODSPubMed search for research and review papers on complications of childhood obesity was performed.

RESULTSThe consequences of childhood obesity can be broadly classified into medical and psychosocial consequences. Medical consequences include metabolic complications such as diabetes mellitus, hypertension, dyslipidaemia and non-alcoholic fatty liver disease, and mechanical problems such as obstructive sleep apnoea syndrome and orthopaedic disorders. Psychological and social consequences are prevalent but often overlooked. Local data on these complications were also discussed.

CONCLUSIONChildhood obesity is associated with significant morbidities, which not only have immediate impact on the health of the obese children, but also significantly increase the risk of morbidities in adulthood.

Adolescent ; Body Mass Index ; Child ; Comorbidity ; Humans ; Obesity ; complications ; diagnosis ; epidemiology ; Young Adult

Abnormalities, Multiple ; diagnosis ; Child ; Diabetes Mellitus, Type 2 ; complications ; Female ; Hearing Loss, Sensorineural ; complications ; Humans ; Obesity ; complications ; Prognosis ; Retinitis Pigmentosa ; complications ; Skin ; pathology ; Syndrome

No abstract available.
Carotid Arteries/pathology/ultrasonography ; Carotid Artery Diseases/diagnosis/*etiology ; Diabetes Mellitus, Type 2/complications/diagnosis ; Fatty Liver/*complications/diagnosis/ultrasonography ; Humans ; Metabolic Syndrome X/complications/diagnosis ; Obesity/complications/diagnosis ; Risk Factors

No abstract availble.
Adenoma/diagnosis/epidemiology/*etiology ; Anticipation, Genetic ; Colonic Neoplasms/diagnosis/epidemiology/*etiology ; Humans ; *Insulin Resistance ; Obesity/*complications/epidemiology ; Risk Factors

OBJECTIVEThe incidences of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are very high in obese children, and insulin resistance may be the key point linking them together. Debates still remain as to whether NAFLD could be a component of MS. Some researchers reported that NAFLD was a composition of MS, while the others stated that NAFLD was an independent predicting factor of MS. Here we analyzed the prevalence of NAFLD and MS in 308 obese children who came to our endocrinology department from June 2003 to September 2006, and we also evaluated the relationship between NAFLD and MS in this group of obese children.

METHODTotally 308 obese children aged from 9 to 14 years with mean age of (10.7 +/- 2.6) years were enrolled. Two hundred and thirty one were males, and 77 were females. Body mass index (BMI), waist circumference (WC), biochemical indicators, liver B-mode ultrasound examination, oral glucose tolerance test (OGTT) and insulin releasing test were performed for all of the cases. The incidences of NAFLD including simple nonalcoholic fatty liver (SNAFL) and nonalcoholic steatohepatitis (NASH) as well as MS were calculated. Three subgroups were selected according to the diagnostic criteria: Group 1: OCWLD (obese children without liver disorder), Group 2: SNAFL and Group 3: NASH. The prevalence of MS, components of MS, free insulin, whole body insulin sensitivity index (WBISI), homeostasis model of insulin resistance (HOMA(IR)) were compared among these three subgroups.

RESULT(1) Among all the obese children, the prevalence of NAFLD, SNAFL, NASH and MS was 65.9% (203), 45.5% (140), 20.5% (63) and 24.7% (76) respectively. Among all the MS children, the prevalence of NAFLD was 84.2% (64/76). The prevalence of MS was 29.3% (41/140) in SNAFL group and 36.5% (23/63) in NASH group, which was significantly higher than that of OCWLD group 11.4% (12/105) (P < 0.05), but no significant difference was found between SNAFL group and NASH group (P > 0.05). Moreover, there were significantly higher incidences in NASH group concerning every component of MS (hypertension, hyperlipidemia, hyperglycemia) compared with that of OCWLD group. The incidence of hypertension in SNAFL was significantly higher than that of OCWLD group. And the incidence of hyperlipidemia was markedly increased in NASH group compared with SNAFL group. NAFLD group had higher free insulin and more severe IR compared with that of OCWLD group. When OCWLD developed to SNAFL and NASH, free insulin and IR deteriorated calculated by HOMA-IR and WBISI. However there was no significant difference between NAFLD and MS children concerning free insulin and IR.

CONCLUSIONThe prevalence of NAFLD and MS hits high in obese children. The prevalence of NAFLD was very high among children with MS and NAFLD and MS shared the common mechanism of IR. The higher prevalence of MS and higher frequencies of MS components were tightly associated with the development of NAFLD and severity of IR.

Adolescent ; Child ; Fatty Liver ; diagnosis ; epidemiology ; etiology ; metabolism ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Obesity ; complications ; epidemiology ; Prevalence

Female ; Gastrectomy ; Humans ; Hyperpigmentation ; diagnosis ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; Obesity ; surgery ; Peripheral Nervous System Diseases ; diagnosis ; Postoperative Complications ; diagnostic imaging ; Pruritus ; diagnosis ; Weight Gain ; Weight Loss