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Children
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Metabolic Syndrome in Childhood Obesity
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Metabolic Syndrome in Childhood Obesity

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Endocrinology & Diabetes".

Deadline for manuscript submissions: closed (30 December 2025) | Viewed by 12108

Special Issue Editors

Dr. Cristina Pederiva

E-Mail Website
Guest Editor
Clinical Service for Dyslipidemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy
Interests: nutrition; lipid metabolism disorders; cardiovascular prevention in pediatric age; metabolic diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Giuseppe Banderali

E-Mail Website
Guest Editor
Clinical Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo-San Paolo University Hospital, 20142 Milan, Italy
Interests: pediatric; dietary interventions; familial hypercholesterolemia; dyslipidemia; nutraceuticals
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obesity represents one of today’s greatest public health challenges and has important implications in both the short and long term even in pediatric patients. Our aim here is to delve into the metabolic aspects of obesity in children and adolescents with a focus on alterations in lipid profiles, glucose metabolism, hepatic involvement (MAFLD), and all the clinical and biochemical features of so-called metabolic syndrome that we can now identify and treat in children.

In this Special Issue, we welcome original research articles, reviews, and short papers on metabolic syndrome and obesity in children related to diagnostic and treatment modalities related to lifestyle changes, dietary–nutritional interventions, and pharmacological treatments that could be used as early as adolescence.

Dr. Cristina Pederiva
Dr. Giuseppe Banderali
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • metabolic syndrome
  • dyslipidemia
  • glucose metabolism
  • dietary intervention
  • pediatric obesity

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Published Papers (5 papers)

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Research

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9 pages, 321 KB  
Article
Usefulness of Non-High-Density Lipoprotein Cholesterol for Screening Dyslipidemia in Children and Adolescents with Overweight or Obesity: A Single-Center Retrospective Study
by Hyo-Kyoung Nam, Eungu Kang, Kee-Hyoung Lee and Young-Jun Rhie
Children 2025, 12(11), 1518; https://doi.org/10.3390/children12111518 - 10 Nov 2025
Viewed by 764
Abstract
Background/Objectives: Non-high-density lipoprotein (non-HDL) cholesterol provides a practical alternative for assessing dyslipidemia, with the advantage of not requiring fasting. The aim of this study was to evaluate the utility of non-HDL cholesterol measured in random (non-fasting) samples for screening dyslipidemia in children and [...] Read more.
Background/Objectives: Non-high-density lipoprotein (non-HDL) cholesterol provides a practical alternative for assessing dyslipidemia, with the advantage of not requiring fasting. The aim of this study was to evaluate the utility of non-HDL cholesterol measured in random (non-fasting) samples for screening dyslipidemia in children and adolescents with overweight or obesity. Methods: We retrospectively analyzed 751 children and adolescents (268 boys and 483 girls) aged 2 to 19 years with overweight or obesity. They underwent lipid profile evaluation without fasting. Dyslipidemia was defined as the presence of one or more of the following: total cholesterol ≥ 200 mg/dL, triglycerides ≥ 100 mg/dL (ages 0–9) or ≥130 mg/dL (ages 10–19), low-density lipoprotein (LDL) cholesterol ≥ 130 mg/dL, and HDL cholesterol < 40 mg/dL. A cutoff value of ≥145 mg/dL was used for non-HDL cholesterol. The sensitivity and specificity of non-HDL cholesterol were compared with those of fasting-state data from the Korean National Health and Nutrition Examination Survey. Results: Dyslipidemia was identified in 52.6% of children and adolescents with overweight or obesity. Non-HDL cholesterol ≥ 145 mg/dL was observed in 18.7% of boys and 17.0% of girls, and dyslipidemia was observed in 94.0% and 85.4% of boys and girls with high non-HDL cholesterol, respectively. Non-HDL cholesterol demonstrated excellent performance in detecting elevated measured LDL cholesterol, with a sensitivity and specificity of 100% and 92.0%, respectively, for boys and 97.8% and 91.3%, respectively, for girls. When stratified by age, non-HDL cholesterol showed sensitivity comparable to or higher than that of total cholesterol for both boys and girls. The sensitivity of non-HDL cholesterol in random samples was significantly higher than that of non-HDL cholesterol in fasting-state samples from boys (100% vs. 94.3%, p = 0.010), with a similar trend shown by girls (92.9% vs. 92.3%, p = 0.510). Conclusions: Non-HDL cholesterol measurement may be a reliable and practical tool for dyslipidemia screening in children and adolescents with overweight or obesity. Its applicability in non-fasting conditions makes it a convenient tool for routine clinical use. Full article
(This article belongs to the Special Issue Metabolic Syndrome in Childhood Obesity)
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14 pages, 845 KB  
Article
The Effect of GnRH Analogs on Body Mass Index in Girls with Central Precocious Puberty: A Single-Center Retrospective Study with a Literature Review
by Ignazio Cammisa, Elena Malavolta, Federica Arzilli, Giulia Rotunno, Donato Rigante and Clelia Cipolla
Children 2025, 12(3), 336; https://doi.org/10.3390/children12030336 - 7 Mar 2025
Cited by 4 | Viewed by 4700
Abstract
Background/Objectives: Central precocious puberty (CPP) is defined by the premature onset of secondary sexual characteristics prior to the age of 8 and 9 years in girls and boys, respectively. The administration of GnRH analogs (GnRH-a) has become a cornerstone in the management of [...] Read more.
Background/Objectives: Central precocious puberty (CPP) is defined by the premature onset of secondary sexual characteristics prior to the age of 8 and 9 years in girls and boys, respectively. The administration of GnRH analogs (GnRH-a) has become a cornerstone in the management of CPP, but effects on metabolic processes, particularly body mass index (BMI), remain a subject of ongoing investigation. This study aimed to investigate the relationship between GnRH-a treatment and BMI changes in a cohort of Italian children with CPP. Methods: We conducted a retrospective cohort study of 34 girls with idiopathic CPP, all treated with GnRH-a. Anthropometric parameters including BMI were collected at three time points: baseline, one year after treatment, and one year after treatment cessation. A comprehensive review of the medical literature concerning GnRH-a and BMI was performed. Results: Statistical analysis using the Wilcoxon and McNemar tests revealed a significant increase in BMI-for-age z-scores after one year of GnRH-a, with a slight increase also observed one year post-treatment of CPP. These findings suggest that GnRH-a treatment contributes to an increase in BMI, particularly in CPP children with a normal weight at baseline, although the overall impact on the progression of obesity remains minimal. A review of the existing literature supports the notion that changes in BMI during GnRH-a treatment are influenced by various factors, including baseline BMI, gender, and metabolic processes. Conclusions: Despite our findings suggesting the potential impact of GnRH-a on BMI, further longitudinal studies are necessary to fully understand the long-term metabolic consequences of GnRH-a therapy in children with CPP. Full article
(This article belongs to the Special Issue Metabolic Syndrome in Childhood Obesity)
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10 pages, 1183 KB  
Article
Diagnosis and Screening Strategies for Detection of Familial Hypercholesterolaemia in Children and Adolescents in Italy: A Survey from the LIPIGEN Paediatric Group
by Cristina Pederiva, Federica Galimberti, Manuela Casula, Giuseppe Banderali, Guglielmo Beccuti, Vanessa Bianconi, Giacomo Biasucci, Marta Biolo, Marco Bucci, Paola Sabrina Buonuomo, Paolo Calabrò, Stefano Carugo, Angelo Baldassare Cefalù, Nadia Citroni, Nicholas Cocomello, Sergio D’Addato, Simona Gatti, Simonetta Genovesi, Ornella Guardamagna, Gabriella Iannuzzo, Lorenzo Iughetti, Giuseppe Mandraffino, Lorenzo Maroni, Ilenia Minicocci, Giuliana Mombelli, Tiziana Montalcini, Sara Moriglia, Sandro Muntoni, Fabio Nascimbeni, Angelina Passaro, Fabio Pellegatta, Livia Pisciotta, Elena Sani, Francesco Sbrana, Roberto Scicali, Patrizia Suppressa, José Pablo Werba, Maria Grazia Zenti, Marcello Arca, Maurizio Averna, Sebastiano Calandra, Alberico Luigi Catapano, Patrizia Tarugi and Maria Elena Capraadd Show full author list remove Hide full author list
Children 2025, 12(3), 288; https://doi.org/10.3390/children12030288 - 26 Feb 2025
Cited by 2 | Viewed by 1776
Abstract
Background: Awareness, diagnosis, and treatment of familial hypercholesterolemia (FH) starting from childhood are a cornerstone of cardiovascular disease prevention. The LIPIGEN Paediatric Group, a network of specialised centres for the diagnosis and management of familial genetic dyslipidemia, is an active part of this [...] Read more.
Background: Awareness, diagnosis, and treatment of familial hypercholesterolemia (FH) starting from childhood are a cornerstone of cardiovascular disease prevention. The LIPIGEN Paediatric Group, a network of specialised centres for the diagnosis and management of familial genetic dyslipidemia, is an active part of this mission. Materials and Methods: This is the second exploratory survey organised within the LIPIGEN (LIpid transPort disorders Italian GEnetic Network) paediatric centres. A digital questionnaire consisting of 16 questions was proposed to the principal investigators of 35 LIPIGEN centres in September 2023. We analysed the main FH screening strategies implemented in Italy, which are the referral characteristics to the lipid clinics and clinical and biochemical criteria considered to diagnose FH in paediatric patients. Results: Centres frequently reported conducting cascade screening (88.6%) and reverse screening (57.1%), whereas 28.6% of respondents indicated using selective screening and only 5.7% reported employing child–parent screening. We documented a detailed biochemical characterisation of paediatric patients (62.9% of respondents usually perform full lipoprotein profile and 80% determine lipoprotein(a) for each patient) and a high percentage of genetic analysis (82.9%). We have also highlighted a quite low awareness of FH as a genetic condition involving paediatric patients among primary care paediatricians and general practitioners. Conclusions: The results of our survey show that specialised lipid centres usually have good diagnostic competence when dealing with paediatric patients with hypercholesterolemia. However, FH awareness and the importance of early diagnosis and treatment initiation in childhood still need to be further improved. Full article
(This article belongs to the Special Issue Metabolic Syndrome in Childhood Obesity)
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9 pages, 265 KB  
Article
Neck Circumference as a Valuable Tool to Identify the Risk of Metabolic Syndrome in Mexican Children
by Evelyn Valencia-Sosa, Guillermo Julián González-Pérez, Clío Chávez-Palencia, María Guadalupe Vega-López and Enrique Romero-Velarde
Children 2024, 11(8), 908; https://doi.org/10.3390/children11080908 - 27 Jul 2024
Cited by 3 | Viewed by 3148
Abstract
Background/Objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was [...] Read more.
Background/Objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI). Methods: A cross-sectional study was carried out with a sample of 286 children 6–9 years old who attended six public primary schools in Jalisco, Mexico. Pearson’s correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index. Results: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11–65.74). Conclusions: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC. Full article
(This article belongs to the Special Issue Metabolic Syndrome in Childhood Obesity)

Other

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18 pages, 2166 KB  
Protocol
Formative Evaluation of an Early Family-Centred Prevention Programme for Childhood Overweight and Obesity (FruehstArt): A Study Protocol
by Katharina Ruettger, Verena Fluegel, Anna Hagemeier, Kerstin D. Rosenberger, Martin Hellmich, Christine Joisten, Laura Mause, Nadine Scholten, Julia Glaubach, Miriam Hehn, Ida Bernhard, Marcus Redaèlli, Dusan Simic, Adrienne Alayli, Stephanie Stock and Kevin Dadaczynski
Children 2025, 12(12), 1613; https://doi.org/10.3390/children12121613 - 26 Nov 2025
Viewed by 746
Abstract
Background: Early childhood obesity is an urgent public health challenge, with long-term health risks. The 12-month fruehstArt intervention aims to improve healthcare for 3 to 6-year-olds with overweight and obesity in Germany through a family-centred approach, including home-based counselling with coaches, paediatric consultations, [...] Read more.
Background: Early childhood obesity is an urgent public health challenge, with long-term health risks. The 12-month fruehstArt intervention aims to improve healthcare for 3 to 6-year-olds with overweight and obesity in Germany through a family-centred approach, including home-based counselling with coaches, paediatric consultations, and a supportive web application for both German- and Turkish-speaking families. This process evaluation will examine the barriers and enabling factors critical for successful implementation, identify necessary adaptations to the intervention, and assess its quality and acceptability among families, coaches, and paediatricians. Methods: This formative evaluation will use a mixed-methods approach including qualitative and quantitative data. Semi-structured interviews will be conducted with parents, coaches, and paediatricians at two different time points. Interviews will be analysed using qualitative content analysis. An Implementation Quality Index assessing the four dimensions of dosage, adherence, quality of delivery, and participant responsiveness will be developed, based on data collected from coaches carrying out the home-based counselling and participating parents of the intervention group. Linear mixed models for repeated measures will be used to analyse the relationship between data of the Implementation Quality Index and the primary and secondary outcomes of the effectiveness evaluation. Conclusions: The formative evaluation of the fruehstArt intervention is expected to identify important determinants of the implementation and provide valuable insights for future strategies to improve implementation. By identifying barriers and facilitators to participation, this study aims to pave the way for an effective dissemination of the intervention and ultimately contribute to improved health outcomes for children. Full article
(This article belongs to the Special Issue Metabolic Syndrome in Childhood Obesity)
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