Metabolic syndrome in children and adolescents: Problems in definition, and ethnicity-related determinants

Childhood obesity is increasing worldwide thus increasing the likelihood of the metabolic syndrome (MS) in children. There is increasing realization that a there is a strong need to evolve a definition of MS in children to define future risk for development of diabetes and cardiovascular diseases. Although there are several determinants of the MS in childhood, obesity, regional excess of adipose tissue and body fat patterning are important. Body fat distribution varies with ethnicity, and this may account for some of the observed differences in the MS and its variables among various ethnic groups. Excess adiposity and thick truncal subcutaneous fat may predispose Asian Indian children to develop insulin resistance. These ethnic differences must be considered for evaluation and management of the MS in children and adolescents. Finally, in Asian Indians, early and aggressive management of obesity and the MS is warranted.