Metabolic Syndrome

As a parent, you know that life is full of cause-and-effect scenarios: If you don’t go to work, then you can’t pay the bills. If you ignore that sound the car is making, then you could end up on the side of the road with engine trouble.

不幸的是，这个概念往往有点难以掌握。他们倾向于生活在现在，并不思考长期后果。通常，这效果很好，因为您在那里提供支持，必要时是安全网。

But when it comes to your kids’ health, there are some long-term consequences you may not even realize they’re up against. One of the best examples of this is a condition calledmetabolic syndrome.

关于代谢综合征

Not to be confused with metabolicdisease(which occurs when hormones and other chemicals in the body fail to interact properly), metabolicsyndrome描述了一组风险因素，让孩子们在心脏病道路上type 2 diabetes.

Kids with metabolic syndrome have at least three of these risk factors:

• excessive belly fat
• 高血压（高血压）
• abnormal levels of blood fats (lipids), includingcholesteroland triglycerides
• 高血糖(high blood sugar)

你可能会感到惊讶地知道这些是孩子们可以拥有的问题。毕竟，高血压和高胆固醇通常是老年人的怨恨。

Not so anymore. Thanks to the rising obesity epidemic in young people, kids and teensare获得这些条件 - 他们比以往任何时候都早于以往任何时候。一些估计说，近十几岁的近1岁 - 超过三分之一的青少年 - 具有代谢综合征。对375名第二年级和三年级的研究发现5％具有代谢综合征，45％有一个或两个风险因素。

This is something parents should know about, especially because they can take steps to lessen their kids’ chances of developing metabolic syndrome or the risk factors that lead to it.

Causes

Because it’s a precursor to heart disease and type 2 diabetes, metabolic syndrome (also called dysmetabolic syndrome or syndrome X) is brought on by the same problems that cause those diseases. So, having a diet that’s high in calories and low in nutrients and consuming lots of fast food and sweetened beverages can put kids at risk.

Playing video games for most of the day or sitting in front of the computer and not getting enough (or any) exercise also can increase a child’s chance of developing factors like obesity, high LDL (“bad”) cholesterol, hypertension, and high blood sugar that define metabolic syndrome.

发展病情的风险似乎是青春期周围最高的。这可能是因为身体脂肪，血压和脂质都受到荷尔蒙的影响，这些激素带来了青春期的许多变化。

Kids who have a family history of heart disease or diabetes are at greater risk for metabolic syndrome. But, as with many things in life, the lifestyle habits a child adopts can push things in one direction or another. So kids who are active, fit, and eat a lot of fruits and vegetables may drastically decrease their chances of developing metabolic syndrome — even if a close relative already has it.

Effects

Metabolic syndrome itself often has no noticeable symptoms early on. But when its risk factors are left to snowball for too long, major changes may start to develop in the body, such as:

• 动脉硬化。This happens when cholesterol hardens and begins to build up in the walls of arteries, causing blockages that can lead to high blood pressure, heart attack, and stroke.
• Poor kidney function.The kidneys become less able to filter toxins out of the blood, which can also increase the risk of high blood pressure, heart attack, or stroke.
• Insulin resistance.当身体的细胞不响应胰岛素（有助于调节血液中的糖的激素）时，就会发生这种情况，这可能导致高血糖水平和糖尿病。
• 多囊卵巢综合征。Thought to be related to insulin resistance, this disorder involves the release of extra male hormones by the ovaries, which can lead to abnormal menstrual bleeding, excessive hair growth, acne, and fertility problems. It is also associated with an increased risk for obesity, hypertension, and — in the long-term — diabetes, heart disease, and cancer.
• Acanthosis nigricans.A skin disorder that causes thick, dark, velvet-like patches of skin around the neck, armpits, groin, between the fingers and toes, or on the elbows and knees.

Diagnosis

For a diagnosis of metabolic syndrome, a child must have at least three of the four risk factors. The most common risk factors in teens are hypertension and high LDL cholesterol. However, even when just one risk factor is present, a doctor will likely check for the others. This is especially true if a child is overweight, has a family member with type 2 diabetes, or has acanthosis nigricans.

这些考试和测试可以帮助医生诊断代谢综合症：

• Body mass index (BMI)和腰部测量。通过计算一个人的体重指数,并检查extra weight around the middle, doctors can judge if these problems are likely to have a negative effect on health. A waist measurement at or above the 90th percentile for a child’s age and sex would be considered a risk factor.
• Blood pressure.血压是血液施加血管壁的力作为心脏泵。当这种力量处于或高于儿童年龄和性别的90百分位数时，它被认为是一个危险因素。
• Blood tests, including:
  • Lipid profile. This test measures the levels of fats in the blood. Having low levels of good cholesterol (HDL) and high levels of bad cholesterol (LDL) or triglycerides would be considered a risk factor.
  • Fasting glucose. The fasting blood glucose test measures the amount of glucose in the blood after an 8-hour fast. After several hours without eating, a healthy person’s blood glucose level should not be higher than a certain level. A glucose level higher than this could be a risk factor.
  • Insulin. A blood insulin test may also be performed in some cases as part of a check for insulin resistance.

Diagnosing metabolic syndrome in kids and teens can be a little bit like trying to hit a moving target. That’s because as kids’ bodies change and grow, the cutoff numbers for many of these tests change too. To standardize some of this information, doctors use special charts (a lot like growth charts) to plot where a child’s numbers fall according to his or her age, sex, weight, and height. This also helps them follow the child’s progression over time.

Treating Risk Factors

If your child is diagnosed with metabolic syndrome, it does not necessarily mean that he or she will develop heart disease or diabetes, but the chances are increased — especially if the risk factors involved aren’t improved or eliminated.

对于一些孩子来说，生活方式的变化可能足以降低严重疾病的风险。医生可能会推荐：

• Dropping excess pounds.If your child is overweight, even a moderate amount of weight loss can translate to big improvements in blood pressure, blood lipid levels, and the body’s ability to use insulin.
• Getting moreexercise.By taking just one of those hours spent in front of a screen each day and spending it on something that gets the blood flowing, kids can dramatically improve their blood pressure, cholesterol, and sensitivity to the effects of insulin.
• Eating mindfully.A child who learns to see food as fuel and not emotional compensation can start to make better choices at mealtime — for example, selecting complex instead of simple carbs (such as whole-grain instead of white bread, and brown rice instead of white); increasing fiber intake with more beans, fruits, and vegetables; choosing “healthy” fats like olive oil and nuts; and avoiding too many empty calories from soda and sweets.
• Fibersupplements.If your child might not be getting enough fiber through food, a fiber supplement may provide an added boost to help reduce the amount of LDL cholesterol in the blood.
• Notsmoking.No surprise here — it’s just about the worst thing people can do to their heart and lungs. Either alone or in combination with metabolic syndrome risk factors, smoking greatly increases your child’s risk for developing heart disease.

When lifestyle changes aren’t enough, a child may be prescribed medications to treat individual risk factors. So, kids with high blood pressure might be put on antihypertension drugs. Others with high LDL cholesterol might be prescribed statins or other lipid-lowering drugs. Children with high blood sugar, who are on the brink of developing diabetes, may be given medication to decrease insulin resistance.

Although weight-loss drugs that are helpful to adults are still investigational in children, some kids who are morbidly obese (double or more the healthy weight for kids their sex, age, and height) might benefit from these medications.

尽管bariatric surgeryfor weight loss is not yet approved by the U.S. Food and Drug Administration (FDA) in kids, some teens with morbid obesity or those who are obese and have developed heart disease or diabetes may be candidates for the procedure.

Changing Course

这是一个伟大的事情，孩子可以了解原因和效果：他们有能力积极影响许多健康结果。享受权利和留下活跃是两种方式，他们可以帮助明天健康。

Of course, it’s easier for kids to make better choices if they see their parents doing the same. So make a plan to help your entire family choose a new, healthier direction. After all, getting a late start on the right path beats staying on the wrong one.

Reviewed by:史蒂文Dowshen，MD
Date reviewed: September 2013