The concept of metabolic syndrome (MetS) as a cluster of cardiovascular risk factors (obesity, altered glucose metabolism, dyslipidemia, and hypertension) has been around for more than 30 years. It is considered to be the result of complex interactions between centrally located fat, insulin resistance, subclinical inflammation, and other factors in genetically predisposed individuals. MetS diagnosis in adults has been linked to increased risk for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). However, MetS in children and adolescents remains a controversial issue despite the extensive research in the field. It is still uncertain which definition should be used for its diagnosis in this age group, what is the clinical significance of such a diagnosis, and how reliably it can predict the future risk of developing CVD and T2D. Even if a child is diagnosed with MetS, management includes addressing each of the syndrome's components individually with weight loss and lifestyle modifications as the basic approach. Co-morbid conditions, such as nonalcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome should also be considered. It seems that MetS in children and adolescents should be used clinically as a conceptual framework for the identification of risk factors clustered around obesity and insulin resistance rather than a syndrome that needs to be diagnosed by measuring absolute “all-or-none” criteria.

中文翻译：

---

儿童和青少年代谢综合征：是否有普遍接受的定义？有关系吗？

代谢综合征 (MetS) 作为一组心血管危险因素（肥胖、糖代谢异常、血脂异常和高血压）的概念已经存在 30 多年。它被认为是遗传易感个体中位于中心的脂肪、胰岛素抵抗、亚临床炎症和其他因素之间复杂相互作用的结果。成人 MetS 诊断与心血管疾病 (CVD) 和 2 型糖尿病 (T2D) 的风险增加有关。然而，尽管在该领域进行了广泛的研究，但儿童和青少年的 MetS 仍然是一个有争议的问题。目前仍不确定在这个年龄组中应该使用哪种定义进行诊断，这种诊断的临床意义是什么，以及它预测未来发生 CVD 和 T2D 的风险的可靠性如何。即使孩子被诊断出患有 MetS，管理也包括单独解决每个综合征的组成部分，以减轻体重和改变生活方式作为基本方法。还应考虑合并症，如非酒精性脂肪肝、阻塞性睡眠呼吸暂停和多囊卵巢综合征。似乎儿童和青少年的 MetS 应该在临床上用作识别围绕肥胖和胰岛素抵抗的风险因素的概念框架，而不是需要通过测量绝对的“全有或全无”标准来诊断的综合征。还应考虑非酒精性脂肪肝、阻塞性睡眠呼吸暂停和多囊卵巢综合征等。似乎儿童和青少年的 MetS 应该在临床上用作识别围绕肥胖和胰岛素抵抗的风险因素的概念框架，而不是需要通过测量绝对的“全有或全无”标准来诊断的综合征。还应考虑非酒精性脂肪肝、阻塞性睡眠呼吸暂停和多囊卵巢综合征等。似乎儿童和青少年的 MetS 应该在临床上用作识别围绕肥胖和胰岛素抵抗的风险因素的概念框架，而不是需要通过测量绝对的“全有或全无”标准来诊断的综合征。