Screening for metabolic syndrome in children needs to change, says US report

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Chronic health problems such as type 2 diabetes could be prevented through proper identification of risk factors in children, a US report suggests.
The American Academy of Pediatrics have called for greater efforts to prevent and treat obesity in children, which can lead to metabolic abnormalities, type 2 diabetes and metabolic syndrome.
They say clinical screening for metabolic syndrome in children should focus on cardiometabolic risk factors, such as obesity, high blood sugar and high blood pressure. Currently in the US pediatricians define metabolic syndrome as a specific cluster of at least three of five diagnostic criteria.
Co-author Sarah Armstrong, MD, of Duke University, told MedPage Today: “Rather than worrying about how to diagnose metabolic syndrome, we should consider each risk factor individually and treat as its own problem, and recognise that some clusters of risk factors commonly occur together, and should be treated seriously as they are accompanied by high risk for future illness.”
The report noted that over 40 different definitions of metabolic syndrome exist in the US, which can lead to confusion in pediatric health departments.
To address this, the researchers propose annual obesity screenings for all children with higher BMI and elevated blood pressure. Glucose abnormalities, dyslipidemia (unbalanced cholesterol) and sleep apnea should also be screened for, among other health markers.
The authors acknowledged “there are no easy solutions” in screening for known obesity risks, but adopting these measures could help pediatricians ensure obesity doesn’t lead to further complications.
“Metabolic health in childhood lays the foundation for lifelong metabolic health in adulthood. Pediatricians can help improve lifelong health by identifying children who are at greater risk for heart disease and diabetes earlier in life,” added co-author Elizabeth Goodman, MD, of Harvard Medical School.
The report has been published online in the journal Pediatrics.