Although there is debate surrounding the definition of metabolic X syndrome in pediatrics and there are few long-term studies of outcomes in children with metabolic syndrome, pediatric metabolic syndrome needs to be on the radar of all pediatricians interested in ensuring a healthy adult life for their patients.
Testing glycated hemoglobin (HbA1c) appears to predict children’s diabetes risk as well as fasting plasma glucose and 2-hour postload plasma glucose, according to a study on more than 2000 American Indian children.
In the city of Chicago, there’s a 95-year-old retired pathologist and professor with a wry smile on his face. More than 50 years ago, Joseph Kraft, MD, identified that many tinnitus patients were in fact pre-diabetic.1 Back then this was a leaner America, and far fewer citizens had diabetes. Of course, much has radically changed.
PCOS is likely underdiagnosed, especially in adolescent patients. It is challenging to make a diagnosis during the 1–2 years following menarche because normal pubertal changes can mimic features of PCOS.
Insulin resistance can be described as a decrease in sensitivity or a decreased biological response to insulin. No single etiological explanation has been described for insulin resistance because of the unique associations with cardiovascular risk, obesity, hypertension, and dyslipidemia. Research has shown that the pathogenesis of insulin resistance results from either lipid accumulation, the contribution of systemic inflammation, or through genetic mutations involving autoantibodies to the insulin receptor.