Prevalence of obesity is high worldwide, some find it pandemic. This disease is known to be one of the so called “lifestyle diseases” and it was fathered mostly upon adolescence and adults.
However, incidence of obesity in children is growing fast and the burden of its complications must be considered not only from medical but also socioeconomic point of view.
Obesity increases the risk of other diseases of affluence, such as: hypertension, dyslipidemia, glucose intolerance at the same time being a well known risk factor of CVD and MetS. 23–26.
Many authors reported that children with BMI over 75th centile have higher morbidity and mortality of DM2 and CVD in adulthood. 27–30. Thus, quality and expectancy of life certainly is and will be affected by obesity.
Metabolic syndrome became an epitome of obesity’s complications with high impact on human’s well-being.
Apart from various definitions of MetS in children, apparently not all teens with obesity develop metabolic syndrome or not even one of its components. Which of the obese children (in fact whole obese population) are especially predisposed to MetS is still not fully understood. Yet, knowing the risk factors of metabolic syndrome would allow to prevent the latter or at least minimise its prevalence and consequences.
In our study 12.9% of obese children 9–12 years old, participating in „6-10-14“ for health” had metabolic syndrome diagnosed − 10.9% of girls and 14.6% of boys. These results are similar to other publications. 31. It seems that prevalence of obesity and metabolic syndrome in children is more or less the same all over the world.
According to Abdullah et al. young age at the onset of obesity as well as time period it lasts are essential factors of MetS in adolescence. 32 Clearly, appropriate prophylaxis should be undertaken as soon as possible to stop his process..
Our main aim was to identify children who were at highest risk of developing MetS. Recognition of predisposing agents, which can be modified, may be crucial, since it is our deep believe that undertaking no prevention will lead to MetS eventually.
The results show that obese children with metabolic syndrome characterize with poor physical performance, bad nutrition habits and glucose intolerance with insulin resistance. Similarly to Mazur et.al., we also found that pathological WhtR predisposes to both MetS and syndrome’s certain components. 33
In our study, we found that boys with low body mass at birth had more often MetS. Obviously this fact is irreversible, nevertheless it is known that metabolic programming, which begins in fetal life is going on after birth too. There is slight opportunity to influence this process by means of “healthy” lifestyle of pregnant woman and can be achieved by education of not only doctors and health providers but also mothers. Promoting exclusively breastfeeding with recommended weaning time presents to be easy way to influence metabolic programming and weight gain in fist 2–3 years of life.
Both or either parent’s obesity - especially father’s - might depict genetic predisposition to excess body mass in a child, but, on the other hand, illustrates family’s lifestyle. It is already known, that obese children more often skip breakfast. 34. Contrary to some authors, we found that omitting dinner is related to metabolic syndrome or to components of metabolic syndrome too. This feeding pattern fits in modern model of life, characterized additionally with little physical activity and much sedentary time (at school, work and home). Similar observations have already been published.35
Obviously, there is not much we can do about genetics. However, if genetic predisposition runs in the family it stands for a red flag and preventive measurements should be undertaken in order to alleviate unavoidable consequences of obesity and MetS.
Such, sound knowledge and education on energy balance (via proper diet and physical activity) as driving force against obesity should be promoted. Changes implemented for child’s prevention will cover beneficially whole family.
To our knowledge this is the first study on “factors” predisposing to metabolic syndrome” in obese children and teenagers, carried out in such a large, unanimous population (age, residency).
Taking into account genetic predisposition and environmental influences we tried to indicate modifiable risk factors
The results of our study could be used as warning signals for subjects who are genetically predisposed to obesity. In these children certain preventive measures should be undertaken.