Metabolic Syndrome in Children and Adolescents(Papers for cerebrating the Forty Aniversary of the Department of Pediatrics, Tokyo Women\u27s Medical University Center East)

The prevalence of obesity in Japanese school-children has risen to approximately 10%, more than doubling, in the past 30 years. This extraordinary change in obesity prevalence may be due to drastic life style changes in Japan. The term "metabolic syndrome" was proposed, to describe the pathophysiologic state with high risk factors of atherosclerosis inducing cardiovascular disease and stroke, by the World Health Organization (WHO) in 1999. Metabolic syndrome consists of visceral obesity, insulin resistance, impaired glucose tolerance, hypertension and dyslipidemia. Recently, adipose tissues have been reported to produce various hormones (adipocytokines) which induce insulin resistance, hypertension, and other metabolic dysfunctions. The risk factors for atherosclerosis are known to arise in childhood in accordance with visceral obesity and to affect the onset of cardiovascular disease in later life. Different definitions and diagnostic criteria for metabolic syndrome have been proposed by several academic associations including the WHO, NCEP, IDF and the committee of Japan medical organizations. The metabolic syndrome in children and adolescents has recently been studied in Japan as well as worldwide. Reports referring to the history, pathophysiology, definition, and diagnostic criteria for metabolic syndrome in children and adolescence as well as in adults are introduced and discussed in this review.東京女子医科大学東医療センター小児科開局40周年記念論文