Metabolic syndrome in youth - A fresh look at an old problem

The clustering of cardiometabolic risk factors, commonly referred to as metabolic syndrome (MetS), has become increasingly prevalent among youth <18 years of age. Although its definition in this population is often debated, as in adults MetS is typically characterized by central obesity, high blood pressure, dyslipidemia (elevated triglycerides and low high density lipoprotein cholesterol), and glucose dysregulation, with insulin resistance as the common link. MetS frequently originates in childhood, tracks into adulthood, and is associated with comorbidities such as fatty liver disease and polycystic ovarian syndrome. Furthermore, it significantly increases the risk of developing type 2 diabetes and cardiovascular disease later in life. In this article, we discuss MetS, its components, associated comorbidities, evaluation, and management strategies in the era of recent medications now approved for use in pediatrics. While short-term use of weight loss medications, such as glucagon-like peptide-1 receptor agonists, has been shown to be effective, the safety and long-term benefits have not been determined.