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Diagnosis of metabolic syndrome in children
Last reviewed: 23.04.2024
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Criteria for diagnosis of metabolic syndrome
- Mandatory (large) markers (criteria):
- abdominal-visceral (central) obesity;
- insulin resistance and hyperinsulinemia or violation of carbohydrate metabolism (impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus).
- Additional markers (criteria):
- dyslipidemia (increased LDL and triglyceride concentrations, lower HDL cholesterol), early atherosclerosis;
- arterial hypertension, cardiac and vascular remodeling;
- disorders of hemostasis (fibrinogen, ITAP 1, etc.);
- hyperuricemia;
- microalbuminuria;
- hyperandrogenia (in girls);
- other hormone-metabolic markers of cardiovascular risk (hyperhomocysteinemia, C-reactive protein and others) may correspond to the "platinum standard" for determining additional metabolic factors;
- anxiety-depressive state.
Incomplete forms of metabolic syndrome. About incomplete (subclinical) forms of the metabolic syndrome can be said in the presence of central obesity, insulin resistance and hyperinsulinemia, and also at registration of not more than one additional metabolic marker (dyslipidemia, hyperuricemia, microalbuminuria, etc.).
Complete forms of metabolic syndrome. Diagnosis of four markers or more, including two mandatory markers, indicates complete (complicated) forms of the metabolic syndrome. Identification of clinical markers of metabolic syndrome (type 2 diabetes mellitus, arterial hypertension, etc.), along with mandatory criteria, also indicates a complicated form.
The isolation of subclinical (uncomplicated) forms of the metabolic syndrome is advisable in children and adolescents due to the high frequency of their registration in this age period, as well as the possibility of early donor diagnosis, timely correction and prevention.
The isolation of the anxiety-depressive syndrome as one of the criteria of the metabolic syndrome is due to the higher frequency of its registration in patients with a metabolic syndrome, the similarity of the pathogenetic mechanisms of the influence of depression and hyperinsulinemia on the cardiovascular system, and the need for timely correction of the data psychopathological disorders.
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