Not just a problem for adults or even the elderly. The metabolic syndrome has now become one of the diseases that even pediatricians must deal with: the fault of the epidemic of obesit infantile, which in our country, according to the latest data from the Istituto Superiore di Sanit, now concerns 10 percent of children of school age. The syndrome closely associated with obesity, which has greatly increased in recent decades. A realistic estimate? Today, one in four obese children or adolescents suffers from metabolic syndrome, observes Claudio Maffeis, professor of pediatrics at the University of Verona and president of the Italian Society of Pediatric Endocrinology and Diabetology. In the case of children and young people, however, there is no clear definition as for adults and therefore the diagnosis becomes even more complicated.
The wide biological variability between a child, a boy and an adolescent, but also the pubertal development at different ages in the two sexes and the modifications of the body and metabolism that this entails, prevent us from having a definition that can work from zero to eighteen. ‘years, Maffeis points out. In general, however, it can be diagnosed if there is abdominal obesity and at least two altered parameters including blood sugar, triglycerides, HDL cholesterol and blood pressure. The abundant waist in short, it remains the ‘cornerstone’ for noticing the metabolic syndrome even in the very young: If the ratio between the waist circumference and the height exceeds 0.5, the child or adolescent has at least three times the risk of having metabolic alterations compared to a peer in which the ratio is lower than 0.5. And the probability grows as the ratio increases, says Maffeis.
How it is measured
In short, to get a first indication, a tape measure is enough, then a blood test is useful for the glycemia and the lipid profile, measure blood pressure and do an ultrasound of the liver: about 60 percent of very young obese people have fatty liver disease, an accumulation of fat in the liver tissue that further complicates the clinical picture. Because having the metabolic syndrome from the first years of life, if it is not resolved, means living with it for a long time with consequences that can be serious, as adds Stefano Stagi, endocrinologist pediatrician at the Meyer University Pediatric Hospital of Florence: In the United States, where the ‘childhood obesity has started to spread earlier, we see people with type 2 diabetes or hypertension as early as their twenties, with enormous health care costs and a considerable impact on quality and life expectancy. We must not neglect an excess of weight as a child, even before the health assessment of the eight years in which obesity is specifically assessed: at eight years old it happens to see obese children for some time.
Metabolic syndrome can be prevented with a healthy lifestyle, but it must above all be treated if it is diagnosed: The goal is to control obesity and manage individual complications, but to do so, a team of specialized pediatricians is needed, explains Maffeis. Only by involving in a dedicated team other figures besides the pediatrician, such as dietician and psychologist, can the various aspects of the problem be addressed and have a greater chance of success.