The metabolic syndrome in pediatrics: do we have a reliable definition? A systematic review.

Objective: Metabolic syndrome is a cluster of cardio-metabolic risk facto rs associated with an increased risk of cardiovascular disease and type 2 diabetes. In the last two dec ades, several definitions of metabolic syndrome have been proposed for the pediatric population; all of them agree on the defining components but differ in the suggested criteria for diagnosis. This review aims to analyze the current diagnostic criteria of metabolic syndrome in pediatrics with reference to their feasibility and reliability in clinical practice. Methods: The systematic research was conducted from January 2003 to Jun e 2020 through MEDLINE via PubMed, Cochrane Library and EMBASE databases. Results: After the selection phase, a total of 15 studies (182 screened) met the inclusion criteria and are reported in the present review. Twelve studies were cross-sectional, two we re longitudinal and one was a consensus report. The sample population consisted of multiethnic group or single ethn ic group, including Turkish, European, Asian and Hispanic subjects. Conclusions: To date, there is not a univocal, internationally accepted ped iatric definition of metabolic syndrome, which guarantees a high sensitivity and stability of the diagno sis. The definition proposed by IDF results the most straightforward and easy to use in clinical practice, having the unquestionable advantage of requiring measurements quickly accessible in clinical practice, without the adoption of multiple reference tables. Further research is needed to validate a new version of such definition which includes the dia gnostic cut-off points recently suggested by published guidelines. [ABSTRACT FROM AUTHOR]