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Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging...
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Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging Perspectives

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Endocrinology and Clinical Metabolic Research".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 5252

Special Issue Editors

Dr. Teofana Otilia Bizerea-Moga

E-Mail Website
Guest Editor
Department XI: Pediatrics, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
Interests: nutritional and metabolic diseases in childhood; obesity; metabolic syndrome; insulin resistance; clinical endocrinology; oxidative stress; selenium
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Wieland Kiess

E-Mail Website
Guest Editor
Department of Pediatrics, Faculty of Medicine, University of Leipzig, 04109 Leipzig, Germany
Interests: children's health; clinical endocrinology; growth; puberty; obesity; diabetes

Special Issue Information

Dear Colleagues,

Metabolic syndrome in children represents a nuanced continuum intricately woven by various contributing factors, beginning with fetal programming. The prenatal environment plays a pivotal role in shaping metabolic trajectories, impacting organ development and programming metabolic pathways. Genetic predispositions add an additional layer of complexity, influencing susceptibility to metabolic dysregulation. The interplay between specific gene variants may contribute to altered lipid metabolism, insulin resistance, and other hallmarks of metabolic syndrome. Oxidative stress, which is characterized by an imbalance between reactive oxygen species and antioxidant defenses, has emerged as a key mechanistic link. Increased oxidative stress can disrupt cellular function and contribute to the development of insulin resistance and inflammation. Moreover, environmental risk factors, encompassing lifestyle, dietary habits, and exposure to pollutants, further modulate the trajectory of metabolic health in children. Investigating these intricate relationships provides a comprehensive understanding of the origins and progression of metabolic syndrome in pediatric populations, offering valuable insights for targeted interventions and early-life prevention strategies.

Dr. Teofana Otilia Bizerea-Moga
Prof. Dr. Wieland Kiess
Guest Editors

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Keywords

  • metabolic syndrome in children
  • childhood obesity
  • hypertension
  • glucose tolerance
  • insulin resistance
  • nutritional status
  • metabolomics
  • oxidative stress
  • trace elements—selenium

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Related Special Issue

Published Papers (4 papers)

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Research

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16 pages, 876 KiB  
Article
Associations Between Birth Characteristics, Weaning Practices, and the Metabolic Syndrome in Children: A Descriptive Study
by Teofana Otilia Bizerea-Moga, Tudor Voicu Moga, Ramona Stroescu, Lazar Chisavu, Otilia Mărginean and Flavia Chisavu
Metabolites 2025, 15(3), 148; https://doi.org/10.3390/metabo15030148 - 22 Feb 2025
Viewed by 563
Abstract
Background: Childhood obesity has seen an important rise in recent decades, in both the pediatric and adult populations. Excess weight can cause various health complications, such as the metabolic syndrome (MetS), a cluster of medical conditions linked to adverse cardiometabolic outcomes. Although MetS [...] Read more.
Background: Childhood obesity has seen an important rise in recent decades, in both the pediatric and adult populations. Excess weight can cause various health complications, such as the metabolic syndrome (MetS), a cluster of medical conditions linked to adverse cardiometabolic outcomes. Although MetS may be attributed mainly to adults, early life factors, such as birth characteristics and feeding practices, may influence its development in obese children. Aim: This study aims to investigate the relationships between birth metrics, early feeding practices, and the prevalence of MetS and its components among obese children. Methods: A retrospective observational study was conducted on 800 obese patients aged 0–18 years, admitted to the “Louis Țurcanu” Children’s Clinical and Emergency Hospital in Timișoara, Romania, from 1 January 2013 to 31 December 2023. Patients were divided according to gestational age: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: Type 2 diabetes (18.2%), hypercholesterolemia (24.6%), IR (41.3%), and MetS (39.2%) were more prevalent among oSGA patients included in the study. These patients were breastfed for longer periods but weaned at a younger age. oLGA patients had the highest BMI values (28.4 ± 4.2) and, in this study group, hypertriglyceridemia (29.4%), arterial hypertension (26.8%), and lower HDL-C (41.7 ± 6.3 mg/dL) were more prevalent. The incidence of MetS increased with age (12.6 ± 3.1 years). Among these patients, IR (52.3%) was more prevalent. The introduction of flour-based energy-dense foods before six months was more frequent in MetS patients, but not statistically significant. Logistic regression showed oSGA patients had a 4.49-fold higher MetS risk (p < 0.001). Older age at diagnosis increased the risk of developing MetS by 37%, a diagnosis of impaired glucose tolerance by 19-fold, and a family history of diabetes by 2.7-fold. ROC analysis showed strong predictability (AUC = 0.905, sensitivity = 82%, specificity = 88%). Conclusions: Obese children born SGA had a higher risk for developing MetS. The incidence of MetS and its components increases with age among obese patients. Monitoring growth patterns and dietary habits in early life is paramount to mitigate future metabolic complications Full article
(This article belongs to the Special Issue Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging Perspectives)
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14 pages, 444 KiB  
Article
Association of Initial Muscle Fitness with Weight Loss and Metabolically Healthy Status in Children and Adolescents with Obesity: A Retrospective Study
by Wenya Shang, Jiaqi Kong, Mengxue Zhang, Tao Chen, Linlin Zhao, Kun Wang and Qin Yang
Metabolites 2024, 14(9), 468; https://doi.org/10.3390/metabo14090468 - 24 Aug 2024
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Abstract
This retrospective study aimed to investigate the association of initial muscular fitness (MF) with weight loss and metabolic health status in 282 children and adolescents with obesity during 3 to 4 weeks of diet- and exercise-based interventions. Metabolically healthy obesity (MHO) definitions established [...] Read more.
This retrospective study aimed to investigate the association of initial muscular fitness (MF) with weight loss and metabolic health status in 282 children and adolescents with obesity during 3 to 4 weeks of diet- and exercise-based interventions. Metabolically healthy obesity (MHO) definitions established in 2023 and MF standards based on the 2021 Chinese children’s grip strength grading were applied. The proportion of metabolically unhealthy obesity (MUO) was higher in the high MF group than in their low MF counterparts at baseline. After the intervention, neither group transitioned from MUO to MHO due to the high frequency of low HDL-C. High MF females showed a higher percentage of high systolic blood pressure (SBP) than low MF females before and after intervention. High MF males exhibited greater improvements in waist circumference, hip circumference, waist-hip ratio, triglycerides, total cholesterol, and LDL-C than low MF males. The benefits of weight loss and blood lipids obtained by males are more evident than those obtained by females under the same MF level. Thus, attention should be paid to females during weight loss regardless of MF levels. Precision therapy should prioritize the management of blood pressure and avoid excessive reduction in HDL-C levels to sustain metabolic health. Full article
(This article belongs to the Special Issue Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging Perspectives)
12 pages, 957 KiB  
Article
Effects of Different Physical Training Protocols on Metabolic Syndrome Indicators and the Activity of Butyrylcholinesterase in Adolescents: A Randomized Clinical Trial
by Giuliano Roberto da Silva, Gerusa Dias Siqueira Vilela Terra, David Michel de Oliveira, Eduardo Vignoto Fernandes, Emerson José Zechin, Arthur Rizzi Soares, Dalton Muller Pessoa-Filho and Cassiano Merussi Neiva
Metabolites 2024, 14(8), 422; https://doi.org/10.3390/metabo14080422 - 31 Jul 2024
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Abstract
Metabolic syndrome (MS) increases the risk of cardiovascular disease and affects children and adolescents. Butyrylcholinesterase (BChE) is an enzyme associated with obesity. The aim of this study was to investigate the effects of different physical training protocols on MS indicators and their relationship [...] Read more.
Metabolic syndrome (MS) increases the risk of cardiovascular disease and affects children and adolescents. Butyrylcholinesterase (BChE) is an enzyme associated with obesity. The aim of this study was to investigate the effects of different physical training protocols on MS indicators and their relationship with BChE activity. This randomized clinical trial included 80 adolescents randomly assigned to 4 groups (CG: Control Group; ATG: Aerobic Training Group; STG: Strength Training Group; and CTG: Concurrent Training Group). The EFC, lipid profile, glycemia, waist circumference, and blood pressure were analyzed. With the exception of the CG, all the groups underwent training protocols for 12 consecutive weeks, 4 times a week, as follows: (ATG: 75% of heart rate on an electric treadmill; STG: 85% of 1 maximum repetition; CTG: 20 min of aerobic training at the same intensity as the ATG, and 20 min of resistance training in the same way as the STG). The training reduced MS-related biomarkers, such as the lipid profile, glycemia, waist circumference, and blood pressure. STG reduced BChE activity. The training methods led to improvements in the majority of the MS indicators. In addition, aerobic training significantly reduced BChE activity after a 12-week training protocol. The results suggest that different types of exercise can benefit MS. Full article
(This article belongs to the Special Issue Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging Perspectives)
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Review

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17 pages, 665 KiB  
Review
Metabolic Syndrome Spectrum in Children with Classic Congenital Adrenal Hyperplasia—A Comprehensive Review
by Sanja Panic Zaric, Tatjana Milenkovic, Sladjana Todorovic, Katarina Mitrovic, Dimitrije Cvetkovic, Maja Cehic, Jelena Vekic, Katja Dumic and Rade Vukovic
Metabolites 2025, 15(2), 89; https://doi.org/10.3390/metabo15020089 - 2 Feb 2025
Cited by 1 | Viewed by 956
Abstract
Children with a classic form of congenital adrenal hyperplasia (CCAH) have a potentially increased risk of unfavorable cardiometabolic events due to the interplay of corticosteroid treatment, hyperandrogenism, and other factors. Although readily recognized in adults, these aspects are frequently overlooked in children and [...] Read more.
Children with a classic form of congenital adrenal hyperplasia (CCAH) have a potentially increased risk of unfavorable cardiometabolic events due to the interplay of corticosteroid treatment, hyperandrogenism, and other factors. Although readily recognized in adults, these aspects are frequently overlooked in children and youth with CCAH; Aim: To review the evidence available from studies regarding cardiometabolic health outcomes in CCAH patients; Methods: A review of the literature was performed following PRISMA guidelines, including studies published between 2000 and 2024. We included studies reporting cardiometabolic outcomes in children and adolescents (<18 years) with CCAH. Where pediatric data were sparse, additional data were obtained from studies with older adolescents and young adults (15–25 years). Cardiometabolic outcomes included risk factors, such as obesity, insulin resistance, lipids, blood pressure, and vascular markers; Results: Twenty-five studies were analyzed. The prevalence of obesity was found to be higher in children with CCAH, as well as of increased visceral adiposity. Higher indices of insulin resistance were also a frequent finding in children with CCAH. CCAH patients had higher systolic blood pressure and more frequently loss of nocturnal blood pressure dipping, particularly among salt-wasting subtypes and in younger children. Subclinical atherosclerosis was indicated by increased carotid intima–media thickness, elevated hs-CRP, and impaired endothelial function. Other findings suggested changes in lipid profiles, particularly decreased HDL-c and increased triglycerides, although the findings were less consistent; Conclusions: Compared with the general pediatric population, children with CCAH were found to have an increase in multiple cardiometabolic risk factors. It is therefore vital to monitor these risk factors in pediatric CCAH, as well as tailoring treatment with cardiometabolic health in mind, to achieve better long-term cardiovascular and metabolic outcomes. Future research should focus on longitudinal studies of cardiometabolic outcomes and innovative therapeutic approaches to reduce these risks in patients with CCAH. Full article
(This article belongs to the Special Issue Obesity and Metabolic Syndrome in Children: Insights, Interventions and Emerging Perspectives)
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