Metabolic syndrome in children and adolescents
The concept of metabolic syndrome means a symptomatic complex of hormonal, metabolic and psychosomatic disorders. Their basis is abdominal( central) obesity, complicated by insulin resistance and hyperinsulinemia. Treatment consists in obligatory change of a way of life of the patient.
The prevalence of the usual metabolic syndrome among people over 30 in developed countries ranges from 10 to almost 30%.Exact data on the prevalence of this dangerous syndrome among adolescents and young children are almost absent, limited only by scant information about the frequent occurrence of its main manifestation - obesity. To date, according to domestic and foreign statistics, the prevalence of obesity in children of secondary and senior school age is about 17%.
Symptoms of the metabolic syndrome
Internal disorders in the body, combined with the medical framework of the metabolic syndrome, can for a long time be asymptomatic. Most often they begin to form already in adolescence, before the clinical diagnosis of diabetes mellitus, arterial hypertension and multiple vascular lesions. The earliest manifestations of congenital metabolic syndrome are dyslipidemia and arterial vascular hypertension. But only in rare cases all components of this syndrome are noted simultaneously. What kind of phenotype it will manifest, directly depends on the interaction of environmental factors and genetics in ontogeny.
Metabolic and clinical signs( markers) are combined in a metabolic syndrome, which can be considered in its framework only in the presence of insulin resistance. All the components of the metabolic syndrome are long-established risk factors for cardiovascular diseases:
- obesity( the deposition of excess fat in the abdominal cavity, in the anterior abdominal wall, on the trunk, neck and even on the face - a more rare android type of obesity);
- insulin resistance( insensitivity of cells of the body to insulin);
- type 2 diabetes mellitus;
- chronic or acute arterial hypertension;
- hyperandrogenia in girls;
- disruption of normal hemostasis( reduced fibrinolytic activity of the blood);
Treatment of the metabolic syndrome
In children and adolescents, the complex treatment of this syndrome involves a complete lifestyle change, the associated treatment of obesity, carbohydrate metabolism pathologies, hypertension and dyslipidemia. The goal of any doctor in this case is to generate a stable motivation in the patient, helping him to follow recommendations on nutrition, normalized physical activity, and clear medication. A true attitude to success enables the patient to more easily cope with the deprivations that a change in the habitual way of life will require. This change provides: the speedy normalization of the regime and the ration of the child, the optimization of its physical load, complex psychotherapy, problem-oriented training programs and rigid self-control.
Health groups by the degree of the metabolic syndrome
In children and adolescents - carriers of the metabolic syndrome, the health group depends on the severity of the markers of the disease. It can be a III, IV or V group. At high arterial pressure it is necessary to release the sick child not only from the current transfer examinations, but also from the final exams - to the matriculation certificate. This is usually decided by a special commission on the application of parents of a sick schoolboy.
At III-IV degree of obesity, complicated by stable arterial hypertension, type 2 diabetes mellitus is given a delay from conscription into the army. In the case of a lower degree of obesity, the problem of delay is decided individually, taking into account the state of hemodynamics, sensitivity to glucose, various stresses and stresses. In each of the cases, during the call, a medical examination is carried out in the department of endocrinology with the involvement of doctors: a cardiologist, a neurologist and an ophthalmologist.