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Diagnosis of metabolic syndrome in children
Last reviewed: 06.07.2025
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Diagnostic criteria for metabolic syndrome
- Mandatory (large) markers (criteria):
- abdominal-visceral (central) obesity;
- insulin resistance and hyperinsulinemia or impaired carbohydrate metabolism (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes mellitus).
- Additional markers (criteria):
- dyslipidemia (increased concentration of LDL and triglycerides, decreased level of HDL), early atherosclerosis;
- arterial hypertension, remodeling of the heart and blood vessels;
- hemostasis disorders (fibrinogen, ITAP 1, etc.);
- hyperuricemia;
- microalbuminuria;
- hyperandrogenism (in girls);
- other hormonal-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. Incomplete (subclinical) forms of metabolic syndrome can be discussed in the presence of central obesity, insulin resistance and hyperinsulinemia, as well as when no more than one additional metabolic marker is registered (dyslipidemia, hyperuricemia, microalbuminuria, etc.).
Complete forms of metabolic syndrome. Diagnosis of four or more markers, including two mandatory ones, indicates complete (complicated) forms of metabolic syndrome. Detection of clinical markers of metabolic syndrome (type 2 diabetes mellitus, arterial hypertension, etc.), along with mandatory criteria, also indicates a complicated form.
The identification of subclinical (uncomplicated) forms of 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 pre-clinical diagnosis, timely correction and prevention.
The identification of anxiety-depressive syndrome as one of the criteria of metabolic syndrome is due to its higher (1.5-2 times) frequency of registration in patients with metabolic syndrome, the similarity of the pathogenetic mechanisms of the influence of depression and hyperinsulinemia on the cardiovascular system, as well as the need for timely correction of these psychopathological disorders.
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