Metabolic Syndrome: A Construct with Limited Relevance to Children

The prevalence of obesity in youth has increased dramatically over the last 3 decades. Similar to adults, obese children often display clusterings of risk factors associated with heightened risk for future cardiovascular disease. In adults, this clustering is commonly referred to as the metabolic syndrome and is used to identify individuals at high risk for premature cardiovascular disease and diabetes. Conversely, the relevance of a pediatric metabolic syndrome diagnosis to predict future adult cardiovascular outcomes is less clear. Many pediatric definitions of the metabolic syndrome have been proposed, yet no consensus has been adopted due to inconsistent study results, lack of translational relevance of childhood classifications to future disease, and instability of the criteria used for various definitions. Given absence of substantial evidence for using a dichotomous metabolic syndrome diagnosis over individual cardiometabolic risk factors, clinicians and experts must proceed with caution when diagnosing metabolic syndrome to guide treatments recommendations.