Pediatric Gastroenterology, Hepatology & Nutrition

  • 제23권3호
  • /
  • Pages.189-230
  • /
  • 2020
  • /
  • 2234-8646(pISSN)
  • /
  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
권호 표지
DOI QR코드

DOI QR Code

Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome

  • Wang, Helen H. (Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine) ;
  • Lee, Dong Ki (Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Liu, Min (Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine) ;
  • Portincasa, Piero (Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School) ;
  • Wang, David Q.H. (Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine)
  • 투고 : 2020.02.11
  • 심사 : 2020.04.21
  • 발행 : 2020.05.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.

키워드

참고문헌

  1. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005;365:1415-28. https://doi.org/10.1016/S0140-6736(05)66378-7
  2. Samson SL, Garber AJ. Metabolic syndrome. Endocrinol Metab Clin North Am 2014;43:1-23. https://doi.org/10.1016/j.ecl.2013.09.009
  3. Dommermuth R, Ewing K. Metabolic syndrome: systems thinking in heart disease. Prim Care 2018;45:109-29. https://doi.org/10.1016/j.pop.2017.10.003
  4. Sperling LS, Mechanick JI, Neeland IJ, Herrick CJ, Despres JP, Ndumele CE, et al. The cardiometabolic health alliance: working toward a new care model for the metabolic syndrome. J Am Coll Cardiol 2015;66:1050-67. https://doi.org/10.1016/j.jacc.2015.06.1328
  5. D'Adamo E, Marcovecchio ML, Giannini C, Capanna R, Impicciatore M, Chiarelli F, et al. The possible role of liver steatosis in defining metabolic syndrome in prepubertal children. Metabolism 2010;59:671-6. https://doi.org/10.1016/j.metabol.2009.09.012
  6. Grundy SM. Cholesterol gallstones: a fellow traveler with metabolic syndrome? Am J Clin Nutr 2004;80:1-2. https://doi.org/10.1093/ajcn/80.1.1
  7. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006;444:881-7. https://doi.org/10.1038/nature05488
  8. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007;49:403-14. https://doi.org/10.1016/j.jacc.2006.09.032
  9. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008;28:629-36. https://doi.org/10.1161/ATVBAHA.107.151092
  10. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113-32. https://doi.org/10.1016/j.jacc.2010.05.034
  11. Grundy SM. Overnutrition, ectopic lipid and the metabolic syndrome. J Investig Med 2016;64:1082-6. https://doi.org/10.1136/jim-2016-000155
  12. Esser N, Legrand-Poels S, Piette J, Scheen AJ, Paquot N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Res Clin Pract 2014;105:141-50. https://doi.org/10.1016/j.diabres.2014.04.006
  13. Esser N, Paquot N, Scheen AJ. Anti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease. Expert Opin Investig Drugs 2015;24:283-307. https://doi.org/10.1517/13543784.2015.974804
  14. Stenholm S, Koster A, Alley DE, Visser M, Maggio M, Harris TB, et al. Adipocytokines and the metabolic syndrome among older persons with and without obesity: the InCHIANTI study. Clin Endocrinol (Oxf) 2010;73:55-65. https://doi.org/10.1111/j.1365-2265.2009.03742.x
  15. Kim LJ, Nalls MA, Eiriksdottir G, Sigurdsson S, Launer LJ, Koster A, et al. Associations of visceral and liver fat with the metabolic syndrome across the spectrum of obesity: the AGES-Reykjavik study. Obesity (Silver Spring) 2011;19:1265-71. https://doi.org/10.1038/oby.2010.291
  16. Koster A, Stenholm S, Alley DE, Kim LJ, Simonsick EM, Kanaya AM, et al. Body fat distribution and inflammation among obese older adults with and without metabolic syndrome. Obesity (Silver Spring) 2010;18:2354-61. https://doi.org/10.1038/oby.2010.86
  17. Despres JP, Lemieux I, Bergeron J, Pibarot P, Mathieu P, Larose E, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol 2008;28:1039-49. https://doi.org/10.1161/ATVBAHA.107.159228
  18. Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 2006;119:812-9. https://doi.org/10.1016/j.amjmed.2006.02.031
  19. Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ, Pio JR, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004;110:1245-50. https://doi.org/10.1161/01.CIR.0000140677.20606.0E
  20. Rutter MK, Meigs JB, Sullivan LM, D'Agostino RB Sr, Wilson PW. Insulin resistance, the metabolic syndrome, and incident cardiovascular events in the Framingham Offspring Study. Diabetes 2005;54:3252-7. https://doi.org/10.2337/diabetes.54.11.3252
  21. Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 2005;112:3066-72. https://doi.org/10.1161/CIRCULATIONAHA.105.539528
  22. Kathiresan S, Otvos JD, Sullivan LM, Keyes MJ, Schaefer EJ, Wilson PW, et al. Increased small low-density lipoprotein particle number: a prominent feature of the metabolic syndrome in the Framingham Heart Study. Circulation 2006;113:20-9. https://doi.org/10.1161/CIRCULATIONAHA.105.567107
  23. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356-9. https://doi.org/10.1001/jama.287.3.356
  24. Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163:427-36. https://doi.org/10.1001/archinte.163.4.427
  25. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006. Natl Health Stat Report 2009;(13):1-7.
  26. McCullough AJ. Epidemiology of the metabolic syndrome in the USA. J Dig Dis 2011;12:333-40. https://doi.org/10.1111/j.1751-2980.2010.00469.x
  27. Beltran-Sanchez H, Harhay MO, Harhay MM, McElligott S. Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999-2010. J Am Coll Cardiol 2013;62:697-703. https://doi.org/10.1016/j.jacc.2013.05.064
  28. Shin D, Kongpakpaisarn K, Bohra C. Trends in the prevalence of metabolic syndrome and its components in the United States 2007-2014. Int J Cardiol 2018;259:216-9. https://doi.org/10.1016/j.ijcard.2018.01.139
  29. Cheung BM, Ong KL, Man YB, Wong LY, Lau CP, Lam KS. Prevalence of the metabolic syndrome in the United States National Health and Nutrition Examination Survey 1999-2002 according to different defining criteria. J Clin Hypertens (Greenwich) 2006;8:562-70. https://doi.org/10.1111/j.1524-6175.2006.05414.x
  30. Kastorini CM, Panagiotakos DB, Georgousopoulou EN, Laskaris A, Skourlis N, Zana A, et al. Metabolic syndrome and 10-year cardiovascular disease incidence: the ATTICA study. Nutr Metab Cardiovasc Dis 2016;26:223-31. https://doi.org/10.1016/j.numecd.2015.12.010
  31. Pucci G, Alcidi R, Tap L, Battista F, Mattace-Raso F, Schillaci G. Sex- and gender-related prevalence, cardiovascular risk and therapeutic approach in metabolic syndrome: a review of the literature. Pharmacol Res 2017;120:34-42. https://doi.org/10.1016/j.phrs.2017.03.008
  32. Vishram JK, Borglykke A, Andreasen AH, Jeppesen J, Ibsen H, Jorgensen T, et al. Impact of age and gender on the prevalence and prognostic importance of the metabolic syndrome and its components in Europeans. The MORGAM prospective cohort project. PLoS One 2014;9:e107294. https://doi.org/10.1371/journal.pone.0107294
  33. Xi B, He D, Hu Y, Zhou D. Prevalence of metabolic syndrome and its influencing factors among the Chinese adults: the China Health and Nutrition Survey in 2009. Prev Med 2013;57:867-71. https://doi.org/10.1016/j.ypmed.2013.09.023
  34. Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, et al. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 2005;365:1398-405. https://doi.org/10.1016/S0140-6736(05)66375-1
  35. Cheng TO. Prevalence of metabolic syndrome in Chinese adults has been underestimated by using US-Based National Cholesterol Education Programs Adult Treatment Panel III and World Health Organization criteria. Am J Cardiol 2006;98:422-3. https://doi.org/10.1016/j.amjcard.2006.01.018
  36. He Y, Li Y, Bai G, Zhang J, Fang Y, Zhao L, et al. Prevalence of metabolic syndrome and individual metabolic abnormalities in China, 2002-2012. Asia Pac J Clin Nutr 2019;28:621-33.
  37. Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and risk factors for metabolic syndrome in Asian Indians: a community study from urban Eastern India. J Cardiovasc Dis Res 2012;3:204-11. https://doi.org/10.4103/0975-3583.98895
  38. Katulanda P, Ranasinghe P, Jayawardana R, Sheriff R, Matthews DR. Metabolic syndrome among Sri Lankan adults: prevalence, patterns and correlates. Diabetol Metab Syndr 2012;4:24. https://doi.org/10.1186/1758-5996-4-24
  39. Lee SR, Cha MJ, Kang DY, Oh KC, Shin DH, Lee HY. Increased prevalence of metabolic syndrome among hypertensive population: ten years' trend of the Korean National Health and Nutrition Examination Survey. Int J Cardiol 2013;166:633-9. https://doi.org/10.1016/j.ijcard.2011.11.095
  40. Lee SE, Han K, Kang YM, Kim SO, Cho YK, Ko KS, et al. Trends in the prevalence of metabolic syndrome and its components in South Korea: findings from the Korean National Health Insurance Service Database (2009-2013). PLoS One 2018;13:e0194490. https://doi.org/10.1371/journal.pone.0194490
  41. Huh JH, Kang DR, Jang JY, Shin JH, Kim JY, Choi S, et al. Metabolic syndrome epidemic among Korean adults: Korean survey of Cardiometabolic Syndrome (2018). Atherosclerosis 2018;277:47-52. https://doi.org/10.1016/j.atherosclerosis.2018.08.003
  42. Genser L, Casella Mariolo JR, Castagneto-Gissey L, Panagiotopoulos S, Rubino F. Obesity, type 2 diabetes, and the metabolic syndrome: pathophysiologic relationships and guidelines for surgical intervention. Surg Clin North Am 2016;96:681-701. https://doi.org/10.1016/j.suc.2016.03.013
  43. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome. Lancet 2005;366:1921-2; author reply 1923-4. https://doi.org/10.1016/S0140-6736(05)67778-1
  44. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2005;48:1684-99. https://doi.org/10.1007/s00125-005-1876-2
  45. Ekelund U, Ward HA, Norat T, Luan J, May AM, Weiderpass E, et al. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Am J Clin Nutr 2015;101:613-21. https://doi.org/10.3945/ajcn.114.100065
  46. Emili A, Abushomar H, Nair K. Treating metabolic syndrome: lifestyle change or medication? Can Fam Physician 2007;53:1203-5.
  47. Young DR, Hivert MF, Alhassan S, Camhi SM, Ferguson JF, Katzmarzyk PT, et al. Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the American Heart Association. Circulation 2016;134:e262-79. https://doi.org/10.1161/CIRCULATIONAHA.116.023081
  48. Bozkurt B, Aguilar D, Deswal A, Dunbar SB, Francis GS, Horwich T, et al. Contributory risk and management of comorbidities of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement from the American Heart Association. Circulation 2016;134:e535-78.
  49. Rader DJ. Effect of insulin resistance, dyslipidemia, and intra-abdominal adiposity on the development of cardiovascular disease and diabetes mellitus. Am J Med 2007;120(3 Suppl 1):S12-8. https://doi.org/10.1016/j.amjmed.2006.05.029
  50. Bamba V, Rader DJ. Obesity and atherogenic dyslipidemia. Gastroenterology 2007;132:2181-90. https://doi.org/10.1053/j.gastro.2007.03.056
  51. Haffner SM. Abdominal adiposity and cardiometabolic risk: do we have all the answers? Am J Med 2007;120(9 Suppl 1):S10-6; discussion S16-7. https://doi.org/10.1016/j.amjmed.2007.06.006
  52. Bodhini D, Mohan V. Mediators of insulin resistance & cardiometabolic risk: newer insights. Indian J Med Res 2018;148:127-9. https://doi.org/10.4103/ijmr.IJMR_969_18
  53. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001;50:1844-50. https://doi.org/10.2337/diabetes.50.8.1844
  54. Neuschwander-Tetri BA. Fatty liver and the metabolic syndrome. Curr Opin Gastroenterol 2007;23:193-8. https://doi.org/10.1097/MOG.0b013e32801421a9
  55. Neuschwander-Tetri BA. Nonalcoholic steatohepatitis and the metabolic syndrome. Am J Med Sci 2005;330:326-35. https://doi.org/10.1097/00000441-200512000-00011
  56. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346:1221-31. https://doi.org/10.1056/NEJMra011775
  57. Wang DQ, Portincasa P, Neuschwander-Tetri BA. Steatosis in the liver. Compr Physiol 2013;3:1493-532.
  58. Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 2003;37:1202-19. https://doi.org/10.1053/jhep.2003.50193
  59. Banini BA, Sanyal AJ. Current and future pharmacologic treatment of nonalcoholic steatohepatitis. Curr Opin Gastroenterol 2017;33:134-41. https://doi.org/10.1097/MOG.0000000000000356
  60. American Heart Association. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Executive summary. Cardiol Rev 2005;13:322-7. https://doi.org/10.1097/01.crd.0000380842.14048.7e
  61. Cruz ML, Goran MI. The metabolic syndrome in children and adolescents. Curr Diab Rep 2004;4:53-62. https://doi.org/10.1007/s11892-004-0012-x
  62. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821
  63. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110:2494-7. https://doi.org/10.1161/01.CIR.0000145117.40114.C7
  64. Bokor S, Frelut ML, Vania A, Hadjiathanasiou CG, Anastasakou M, Malecka-Tendera E, et al. Prevalence of metabolic syndrome in European obese children. Int J Pediatr Obes 2008;3 Suppl 2:3-8.
  65. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-74. https://doi.org/10.1056/NEJMoa031049
  66. Park J, Hilmers DC, Mendoza JA, Stuff JE, Liu Y, Nicklas TA. Prevalence of metabolic syndrome and obesity in adolescents aged 12 to 19 years: comparison between the United States and Korea. J Korean Med Sci 2010;25:75-82. https://doi.org/10.3346/jkms.2010.25.1.75
  67. Park MJ, Boston BA, Oh M, Jee SH. Prevalence and trends of metabolic syndrome among Korean adolescents: from the Korean NHANES survey, 1998-2005. J Pediatr 2009;155:529-34. https://doi.org/10.1016/j.jpeds.2009.03.063
  68. Friend A, Craig L, Turner S. The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord 2013;11:71-80. https://doi.org/10.1089/met.2012.0122
  69. Higgins V, Adeli K. Pediatric metabolic syndrome: pathophysiology and laboratory assessment. EJIFCC 2017;28:25-42.
  70. Goodman E, Daniels SR, Morrison JA, Huang B, Dolan LM. Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents. J Pediatr 2004;145:445-51. https://doi.org/10.1016/j.jpeds.2004.04.059
  71. Cook S. The metabolic syndrome: antecedent of adult cardiovascular disease in pediatrics. J Pediatr 2004;145:427-30. https://doi.org/10.1016/j.jpeds.2004.07.021
  72. Agirbasli M, Tanrikulu AM, Berenson GS. Metabolic syndrome: bridging the gap from childhood to adulthood. Cardiovasc Ther 2016;34:30-6. https://doi.org/10.1111/1755-5922.12165
  73. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  74. Grundy SM. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 2006;47:1093-100. https://doi.org/10.1016/j.jacc.2005.11.046
  75. Grundy SM. A constellation of complications: the metabolic syndrome. Clin Cornerstone 2005;7:36-45. https://doi.org/10.1016/S1098-3597(05)80066-3
  76. Grundy SM. Metabolic syndrome scientific statement by the American Heart Association and the National Heart, Lung, and Blood Institute. Arterioscler Thromb Vasc Biol 2005;25:2243-4. https://doi.org/10.1161/01.ATV.0000189155.75833.c7
  77. Grundy SM. Point: the metabolic syndrome still lives. Clin Chem 2005;51:1352-4. https://doi.org/10.1373/clinchem.2005.050989
  78. Kylin E. Studien ueber das Hypertonie-Hyperglyka "mie-Hyperurika" miesyndrom. Zentralblatt fuer Innere Medizin 1923;44:105-27.
  79. Phillips GB. Sex hormones, risk factors and cardiovascular disease. Am J Med 1978;65:7-11. https://doi.org/10.1016/0002-9343(78)90685-X
  80. Albrink MJ, Krauss RM, Lindgrem FT, von der Groeben J, Pan S, Wood PD. Intercorrelations among plasma high density lipoprotein, obesity and triglycerides in a normal population. Lipids 1980;15:668-76. https://doi.org/10.1007/BF02534017
  81. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607. https://doi.org/10.2337/diab.37.12.1595
  82. Cheal KL, Abbasi F, Lamendola C, McLaughlin T, Reaven GM, Ford ES. Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome. Diabetes 2004;53:1195-200. https://doi.org/10.2337/diabetes.53.5.1195
  83. Kim SH, Reaven GM. The metabolic syndrome: one step forward, two steps back. Diab Vasc Dis Res 2004;1:68-75. https://doi.org/10.3132/dvdr.2004.010
  84. Reaven G. The metabolic syndrome or the insulin resistance syndrome? Different names, different concepts, and different goals. Endocrinol Metab Clin North Am 2004;33:283-303. https://doi.org/10.1016/j.ecl.2004.03.002
  85. Reaven GM. Insulin resistance, cardiovascular disease, and the metabolic syndrome: how well do the emperor's clothes fit? Diabetes Care 2004;27:1011-2. https://doi.org/10.2337/diacare.27.4.1011
  86. Grundy SM. Metabolic syndrome update. Trends Cardiovasc Med 2016;26:364-73. https://doi.org/10.1016/j.tcm.2015.10.004
  87. Salazar MR, Carbajal HA, Espeche WG, Dulbecco CA, Aizpurua M, Marillet AG, et al. Relationships among insulin resistance, obesity, diagnosis of the metabolic syndrome and cardio-metabolic risk. Diab Vasc Dis Res 2011;8:109-16. https://doi.org/10.1177/1479164111403170
  88. Simmons RK, Alberti KG, Gale EA, Colagiuri S, Tuomilehto J, Qiao Q, et al. The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation. Diabetologia 2010;53:600-5. https://doi.org/10.1007/s00125-009-1620-4
  89. Reaven GM. Insulin resistance: the link between obesity and cardiovascular disease. Med Clin North Am 2011;95:875-92. https://doi.org/10.1016/j.mcna.2011.06.002
  90. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539-53. https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
  91. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442-3. https://doi.org/10.1046/j.1464-5491.1999.00059.x
  92. Balkau B, Eschwege E. Insulin resistance: an independent risk factor for cardiovascular disease? Diabetes Obes Metab 1999;1 Suppl 1:S23-31.
  93. Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97. https://doi.org/10.1001/jama.285.19.2486
  94. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006;23:469-80. https://doi.org/10.1111/j.1464-5491.2006.01858.x
  95. Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet 2005;366:1059-62. https://doi.org/10.1016/S0140-6736(05)67402-8
  96. Assmann G, Guerra R, Fox G, Cullen P, Schulte H, Willett D, et al. Harmonizing the definition of the metabolic syndrome: comparison of the criteria of the Adult Treatment Panel III and the International Diabetes Federation in United States American and European populations. Am J Cardiol 2007;99:541-8. https://doi.org/10.1016/j.amjcard.2006.08.045
  97. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
  98. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 2007;8:299-306. https://doi.org/10.1111/j.1399-5448.2007.00271.x
  99. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet 2007;369:2059-61. https://doi.org/10.1016/S0140-6736(07)60958-1
  100. Ahrens W, Moreno LA, Marild S, Molnar D, Siani A, De Henauw S, et al. Metabolic syndrome in young children: definitions and results of the IDEFICS study. Int J Obes (Lond) 2014;38 Suppl 2:S4-14. https://doi.org/10.1038/ijo.2014.130
  101. Koebnick C, Smith N, Coleman KJ, Getahun D, Reynolds K, Quinn VP, et al. Prevalence of extreme obesity in a multiethnic cohort of children and adolescents. J Pediatr 2010;157:26-31.e2. https://doi.org/10.1016/j.jpeds.2010.01.025
  102. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002;360:473-82. https://doi.org/10.1016/S0140-6736(02)09678-2
  103. Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 2013;128:1689-712. https://doi.org/10.1161/CIR.0b013e3182a5cfb3
  104. Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA 2016;315:2292-9. https://doi.org/10.1001/jama.2016.6361
  105. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA 2018;319:1723-5. https://doi.org/10.1001/jama.2018.3060
  106. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA 2010;303:242-9. https://doi.org/10.1001/jama.2009.2012
  107. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 2004;291:2847-50. https://doi.org/10.1001/jama.291.23.2847
  108. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 2012;307:483-90. https://doi.org/10.1001/jama.2012.40
  109. Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004;27:1798-811. https://doi.org/10.2337/diacare.27.7.1798
  110. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999-2012. https://doi.org/10.1161/01.CIR.0000161369.71722.10
  111. Dietz WH, Robinson TN. Clinical practice. Overweight children and adolescents. N Engl J Med 2005;352:2100-9. https://doi.org/10.1056/NEJMcp043052
  112. Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003-2012. JAMA 2015;313:1973-4. https://doi.org/10.1001/jama.2015.4260
  113. Arai H, Yamamoto A, Matsuzawa Y, Saito Y, Yamada N, Oikawa S, et al. Prevalence of metabolic syndrome in the general Japanese population in 2000. J Atheroscler Thromb 2006;13:202-8. https://doi.org/10.5551/jat.13.202
  114. Saito I, Mori M, Shibata H, Hirose H, Tsujioka M, Kawabe H. Prevalence of metabolic syndrome in young men in Japan. J Atheroscler Thromb 2007;14:27-30. https://doi.org/10.5551/jat.14.27
  115. Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988-2012. Prev Chronic Dis 2017;14:E24.
  116. Adams RJ, Appleton S, Wilson DH, Taylor AW, Dal Grande E, Chittleborough C, et al. Population comparison of two clinical approaches to the metabolic syndrome: implications of the new International Diabetes Federation consensus definition. Diabetes Care 2005;28:2777-9. https://doi.org/10.2337/diacare.28.11.2777
  117. Athyros VG, Ganotakis ES, Elisaf M, Mikhailidis DP. The prevalence of the metabolic syndrome using the National Cholesterol Educational Program and International Diabetes Federation definitions. Curr Med Res Opin 2005;21:1157-9. https://doi.org/10.1185/030079905X53333
  118. Guerrero-Romero F, Rodriguez-Moran M. Concordance between the 2005 International Diabetes Federation definition for diagnosing metabolic syndrome with the National Cholesterol Education Program Adult Treatment Panel III and the World Health Organization definitions. Diabetes Care 2005;28:2588-9. https://doi.org/10.2337/diacare.28.10.2588
  119. Cornier MA, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR, et al. The metabolic syndrome. Endocr Rev 2008;29:777-822. https://doi.org/10.1210/er.2008-0024
  120. Lovre D, Mauvais-Jarvis F. Trends in prevalence of the metabolic syndrome. JAMA 2015;314:950. https://doi.org/10.1001/jama.2015.8625
  121. Marchesini G, Forlani G, Cerrelli F, Manini R, Natale S, Baraldi L, et al. WHO and ATPIII proposals for the definition of the metabolic syndrome in patients with Type 2 diabetes. Diabet Med 2004;21:383-7. https://doi.org/10.1111/j.1464-5491.2004.01115.x
  122. Hu G, Lindstrom J, Jousilahti P, Peltonen M, Sjoberg L, Kaaja R, et al. The increasing prevalence of metabolic syndrome among Finnish men and women over a decade. J Clin Endocrinol Metab 2008;93:832-6. https://doi.org/10.1210/jc.2007-1883
  123. Ilanne-Parikka P, Eriksson JG, Lindstrom J, Hamalainen H, Keinanen-Kiukaanniemi S, Laakso M, et al. Prevalence of the metabolic syndrome and its components: findings from a Finnish general population sample and the Diabetes Prevention Study cohort. Diabetes Care 2004;27:2135-40. https://doi.org/10.2337/diacare.27.9.2135
  124. Reinehr T, de Sousa G, Toschke AM, Andler W. Comparison of metabolic syndrome prevalence using eight different definitions: a critical approach. Arch Dis Child 2007;92:1067-72. https://doi.org/10.1136/adc.2006.104588
  125. Jorgensen ME, Bjerregaard P, Gyntelberg F, Borch-Johnsen K; Greenland Population Study. Prevalence of the metabolic syndrome among the Inuit in Greenland. A comparison between two proposed definitions. Diabet Med 2004;21:1237-42. https://doi.org/10.1111/j.1464-5491.2004.01294.x
  126. Csaszar A, Kekes E, Abel T, Papp R, Kiss I, Balogh S. Prevalence of metabolic syndrome estimated by International Diabetes Federation criteria in a Hungarian population. Blood Press 2006;15:101-6. https://doi.org/10.1080/08037050600772284
  127. Liu J, Hanley AJ, Young TK, Harris SB, Zinman B. Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada. Int J Obes (Lond) 2006;30:669-76. https://doi.org/10.1038/sj.ijo.0803179
  128. Al-Qahtani DA, Imtiaz ML, Saad OS, Hussein NM. AComparison of the prevalence of metabolic syndrome in Saudi adult females using two definitions. Metab Syndr Relat Disord 2006;4:204-14. https://doi.org/10.1089/met.2006.4.204
  129. Balasubramanyam A, Rao S, Misra R, Sekhar RV, Ballantyne CM. Prevalence of metabolic syndrome and associated risk factors in Asian Indians. J Immigr Minor Health 2008;10:313-23. https://doi.org/10.1007/s10903-007-9092-4
  130. Baracco R, Mohanna S, Seclen S. A comparison of the prevalence of metabolic syndrome and its components in high and low altitude populations in peru. Metab Syndr Relat Disord 2007;5:55-62. https://doi.org/10.1089/met.2006.0019
  131. Alexander CM, Landsman PB, Grundy SM. The influence of age and body mass index on the metabolic syndrome and its components. Diabetes Obes Metab 2008;10:246-50. https://doi.org/10.1111/j.1463-1326.2006.00695.x
  132. Basit A, Shera AS. Prevalence of metabolic syndrome in Pakistan. Metab Syndr Relat Disord 2008;6:171-5. https://doi.org/10.1089/met.2008.0005
  133. Bee YT Jr, Haresh KK, Rajibans S. Prevalence of metabolic syndrome among Malaysians using the International Diabetes Federation, National Cholesterol Education Program and modified World Health Organization definitions. Malays J Nutr 2008;14:65-77.
  134. Caceres M, Teran CG, Rodriguez S, Medina M. Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity. BMC Pediatr 2008;8:31. https://doi.org/10.1186/1471-2431-8-31
  135. Calcaterra V, Klersy C, Muratori T, Telli S, Caramagna C, Scaglia F, et al. Prevalence of metabolic syndrome (MS) in children and adolescents with varying degrees of obesity. Clin Endocrinol (Oxf) 2008;68:868-72. https://doi.org/10.1111/j.1365-2265.2007.03115.x
  136. Bener A, Zirie M, Musallam M, Khader YS, Al-Hamaq AO. Prevalence of metabolic syndrome according to Adult Treatment Panel III and International Diabetes Federation criteria: a population-based study. Metab Syndr Relat Disord 2009;7:221-9. https://doi.org/10.1089/met.2008.0077
  137. Bindraban NR, van Valkengoed IG, Mairuhu G, Koster RW, Holleman F, Hoekstra JB, et al. A new tool, a better tool? Prevalence and performance of the International Diabetes Federation and the National Cholesterol Education Program criteria for metabolic syndrome in different ethnic groups. Eur J Epidemiol 2008;23:37-44. https://doi.org/10.1007/s10654-007-9200-8
  138. Caranti DA, Lazzer S, Damaso AR, Agosti F, Zennaro R, de Mello MT, et al. Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study. Int J Clin Pract 2008;62:1526-32. https://doi.org/10.1111/j.1742-1241.2008.01826.x
  139. Chien KL, Lee BC, Hsu HC, Lin HJ, Chen MF, Lee YT. Prevalence, agreement and classification of various metabolic syndrome criteria among ethnic Chinese: a report on the hospital-based health diagnosis of the adult population. Atherosclerosis 2008;196:764-71. https://doi.org/10.1016/j.atherosclerosis.2007.01.006
  140. Churilla JR, Fitzhugh EC, Thompson DL. The metabolic syndrome: how definition impacts the prevalence and risk in U.S. adults: 1999-2004 NHANES. Metab Syndr Relat Disord 2007;5:331-42. https://doi.org/10.1089/met.2007.0010
  141. Dhanaraj E, Bhansali A, Jaggi S, Dutra P, Jain S, Tiwari P, et al. Prevalence and predictors of metabolic syndrome in non-obese Asian Indians with newly detected type 2 diabetes mellitus. J Indian Med Assoc 2008;106:366-8, 370-2.
  142. Ekelund U, Anderssen S, Andersen LB, Riddoch CJ, Sardinha LB, Luan J, et al. Prevalence and correlates of the metabolic syndrome in a population-based sample of European youth. Am J Clin Nutr 2009;89:90-6. https://doi.org/10.3945/ajcn.2008.26649
  143. Erem C, Hacihasanoglu A, Deger O, Topbas M, Hosver I, Ersoz HO, et al. Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study. Endocrine 2008;33:9-20. https://doi.org/10.1007/s12020-008-9044-3
  144. Fiuza M, Cortez-Dias N, Martins S, Belo A; VALSIM study investigators. Metabolic syndrome in Portugal: prevalence and implications for cardiovascular risk--results from the VALSIM Study English, Portuguese. Rev Port Cardiol 2008;27:1495-529.
  145. Malik M, Razig SA. The prevalence of the metabolic syndrome among the multiethnic population of the United Arab Emirates: a report of a national survey. Metab Syndr Relat Disord 2008;6:177-86. https://doi.org/10.1089/met.2008.0006
  146. Martinez MA, Puig JG, Mora M, Aragon R, O'Dogherty P, Anton JL, et al. Metabolic syndrome: prevalence, associated factors, and C-reactive protein: the MADRIC (MADrid RIesgo Cardiovascular) Study. Metabolism 2008;57:1232-40. https://doi.org/10.1016/j.metabol.2008.04.017
  147. Matei C, Pop I, Jurcut R, Suceveanu M, Predescu D, Nechita E, et al. ROmanian multicentric study of the prevalence of metabolic syndrome--ROMES. Hellenic J Cardiol 2008;49:303-9.
  148. Sen Y, Kandemir N, Alikasifoglu A, Gonc N, Ozon A. Prevalence and risk factors of metabolic syndrome in obese children and adolescents: the role of the severity of obesity. Eur J Pediatr 2008;167:1183-9. https://doi.org/10.1007/s00431-007-0658-x
  149. Seo SJ, Lee HY, Lee SW. The prevalence of the metabolic syndrome in Korean children and adolescents: comparisons of the criteria of Cook et al., Cruz and Goran, and ferranti et al. Yonsei Med J 2008;49:563-72. https://doi.org/10.3349/ymj.2008.49.4.563
  150. Shimajiri Y, Tsunoda K, Furuta M, Kadoya Y, Yamada S, Nanjo K, et al. Prevalence of metabolic syndrome in Japanese type 2 diabetic patients and its significance for chronic vascular complications. Diabetes Res Clin Pract 2008;79:310-7. https://doi.org/10.1016/j.diabres.2007.08.026
  151. Yoneda M, Yamane K, Jitsuiki K, Nakanishi S, Kamei N, Watanabe H, et al. Prevalence of metabolic syndrome compared between native Japanese and Japanese-Americans. Diabetes Res Clin Pract 2008;79:518-22. https://doi.org/10.1016/j.diabres.2007.10.012
  152. Halley Castillo E, Borges G, Talavera JO, Orozco R, Vargas-Aleman C, Huitron-Bravo G, et al. Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations. J Adolesc Health 2007;40:521-6. https://doi.org/10.1016/j.jadohealth.2006.12.015
  153. Xu H, Li Y, Liu A, Zhang Q, Hu X, Fang H, et al. Prevalence of the metabolic syndrome among children from six cities of China. BMC Public Health 2012;12:13. https://doi.org/10.1186/1471-2458-12-13
  154. Lucove JC, Kaufman JS, James SA. Association between adult and childhood socioeconomic status and prevalence of the metabolic syndrome in African Americans: the Pitt County Study. Am J Public Health 2007;97:234-6. https://doi.org/10.2105/AJPH.2006.087429
  155. Chen W, Srinivasan SR, Berenson GS. Path analysis of metabolic syndrome components in black versus white children, adolescents, and adults: the Bogalusa Heart Study. Ann Epidemiol 2008;18:85-91. https://doi.org/10.1016/j.annepidem.2007.07.090
  156. Harville EW, Srinivasan S, Chen W, Berenson GS. Is the metabolic syndrome a "small baby" syndrome?: the bogalusa heart study. Metab Syndr Relat Disord 2012;10:413-21. https://doi.org/10.1089/met.2012.0031
  157. Frontini MG, Srinivasan SR, Berenson GS. Longitudinal changes in risk variables underlying metabolic Syndrome X from childhood to young adulthood in female subjects with a history of early menarche: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 2003;27:1398-404. https://doi.org/10.1038/sj.ijo.0802422
  158. Zhang H, Zhang T, Li S, Li Y, Hussain A, Fernandez C, et al. Long-term impact of childhood adiposity on adult metabolic syndrome is modified by insulin resistance: the Bogalusa Heart study. Sci Rep 2015;5:17885. https://doi.org/10.1038/srep17885
  159. Chen W, Srinivasan SR, Li S, Xu J, Berenson GS. Metabolic syndrome variables at low levels in childhood are beneficially associated with adulthood cardiovascular risk: the Bogalusa Heart Study. Diabetes Care 2005;28:126-31. https://doi.org/10.2337/diacare.28.1.126
  160. Magnussen CG, Koskinen J, Chen W, Thomson R, Schmidt MD, Srinivasan SR, et al. Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 diabetes mellitus but is no better than body mass index alone: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Circulation 2010;122:1604-11. https://doi.org/10.1161/CIRCULATIONAHA.110.940809
  161. Nguyen QM, Srinivasan SR, Xu JH, Chen W, Berenson GS. Changes in risk variables of metabolic syndrome since childhood in pre-diabetic and type 2 diabetic subjects: the Bogalusa Heart Study. Diabetes Care 2008;31:2044-9. https://doi.org/10.2337/dc08-0898
  162. Srinivasan SR, Myers L, Berenson GS. Changes in metabolic syndrome variables since childhood in prehypertensive and hypertensive subjects: the Bogalusa Heart Study. Hypertension 2006;48:33-9. https://doi.org/10.1161/01.HYP.0000226410.11198.f4
  163. Wang J, Zhu Y, Cai L, Jing J, Chen Y, Mai J, et al. Metabolic syndrome and its associated early-life factors in children and adolescents: a cross-sectional study in Guangzhou, China. Public Health Nutr 2016;19:1147-54. https://doi.org/10.1017/S1368980015002542
  164. Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, et al. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet 2003;362:951-7. https://doi.org/10.1016/S0140-6736(03)14364-4
  165. DuBose KD, Stewart EE, Charbonneau SR, Mayo MS, Donnelly JE. Prevalence of the metabolic syndrome in elementary school children. Acta Paediatr 2006;95:1005-11. https://doi.org/10.1080/08035250600570553
  166. Invitti C, Maffeis C, Gilardini L, Pontiggia B, Mazzilli G, Girola A, et al. Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors. Int J Obes (Lond) 2006;30:627-33. https://doi.org/10.1038/sj.ijo.0803151
  167. Kaler SN, Ralph-Campbell K, Pohar S, King M, Laboucan CR, Toth EL. High rates of the metabolic syndrome in a First Nations Community in western Canada: prevalence and determinants in adults and children. Int J Circumpolar Health 2006;65:389-402. https://doi.org/10.3402/ijch.v65i5.18139
  168. Kim S, So WY. Prevalence of metabolic syndrome among Korean adolescents according to the National Cholesterol Education Program, Adult Treatment Panel III and International Diabetes Federation. Nutrients 2016;8:E588. https://doi.org/10.3390/nu8100588
  169. Molnar D. The prevalence of the metabolic syndrome and type 2 diabetes mellitus in children and adolescents. Int J Obes Relat Metab Disord 2004;28 Suppl 3:S70-4. https://doi.org/10.1038/sj.ijo.0802811
  170. Papoutsakis C, Yannakoulia M, Ntalla I, Dedoussis GV. Metabolic syndrome in a Mediterranean pediatric cohort: prevalence using International Diabetes Federation-derived criteria and associations with adiponectin and leptin. Metabolism 2012;61:140-5. https://doi.org/10.1016/j.metabol.2011.06.006
  171. Agredo-Zuniga RA, Aguilar-de Plata C, Suarez-Ortegon MF. Waist:height ratio, waist circumference and metabolic syndrome abnormalities in Colombian schooled adolescents: a multivariate analysis considering located adiposity. Br J Nutr 2015;114:700-5. https://doi.org/10.1017/S0007114515002275
  172. Bitsori M, Linardakis M, Tabakaki M, Kafatos A. Waist circumference as a screening tool for the identification of adolescents with the metabolic syndrome phenotype. Int J Pediatr Obes 2009;4:325-31. https://doi.org/10.3109/17477160902914597
  173. Choi DH, Hur YI, Kang JH, Kim K, Cho YG, Hong SM, et al. Usefulness of the waist circumference-to-height ratio in screening for obesity and metabolic syndrome among Korean children and adolescents: Korea National Health and Nutrition Examination Survey, 2010-2014. Nutrients 2017;9:E256. https://doi.org/10.3390/nu9030256
  174. Hirschler V, Aranda C, Calcagno ML, Maccalini G, Jadzinsky M. Can waist circumference identify children with the metabolic syndrome? Arch Pediatr Adolesc Med 2005;159:740-4. https://doi.org/10.1001/archpedi.159.8.740
  175. McCarthy HD. Body fat measurements in children as predictors for the metabolic syndrome: focus on waist circumference. Proc Nutr Soc 2006;65:385-92. https://doi.org/10.1017/S0029665106005143
  176. Wu XY, Hu CL, Wan YH, Su PY, Xing C, Qi XY, et al. Higher waist-to-height ratio and waist circumference are predictive of metabolic syndrome and elevated serum alanine aminotransferase in adolescents and young adults in mainland China. Public Health 2012;126:135-42. https://doi.org/10.1016/j.puhe.2011.11.001
  177. Spolidoro JV, Pitrez Filho ML, Vargas LT, Santana JC, Pitrez E, Hauschild JA, et al. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clin Nutr 2013;32:93-7. https://doi.org/10.1016/j.clnu.2012.05.020
  178. Arimura ST, Moura BM, Pimentel GD, Silva ME, Sousa MV. Waist circumference is better associated with high density lipoprotein (HDL-c) than with body mass index (BMI) in adults with metabolic syndrome. Nutr Hosp 2011;26:1328-32.
  179. Zanchetti A, Hennig M, Baurecht H, Tang R, Cuspidi C, Carugo S, et al. Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima-media thickness. J Hypertens 2007;25:2463-70. https://doi.org/10.1097/HJH.0b013e3282f063d5
  180. Cardinal TR, Vigo A, Duncan BB, Matos SM, da Fonseca MJ, Barreto SM, et al. Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Brazilian adults: baseline analyses of the Longitudinal Study of Adult Health (ELSA-Brasil). Diabetol Metab Syndr 2018;10:49. https://doi.org/10.1186/s13098-018-0347-0
  181. Lee WY, Park JS, Noh SY, Rhee EJ, Kim SW, Zimmet PZ. Prevalence of the metabolic syndrome among 40,698 Korean metropolitan subjects. Diabetes Res Clin Pract 2004;65:143-9. https://doi.org/10.1016/j.diabres.2003.12.007
  182. Miccoli R, Bianchi C, Odoguardi L, Penno G, Caricato F, Giovannitti MG, et al. Prevalence of the metabolic syndrome among Italian adults according to ATP III definition. Nutr Metab Cardiovasc Dis 2005;15:250-4. https://doi.org/10.1016/j.numecd.2004.09.002
  183. Ali O, Cerjak D, Kent JW, James R, Blangero J, Zhang Y. Obesity, central adiposity and cardiometabolic risk factors in children and adolescents: a family-based study. Pediatr Obes 2014;9:e58-62. https://doi.org/10.1111/j.2047-6310.2014.218.x
  184. Xi B, Zong X, Kelishadi R, Litwin M, Hong YM, Poh BK, et al. International waist circumference percentile cutoffs for central obesity in children and adolescents aged 6 to 18 years. J Clin Endocrinol Metab 2020;105:dgz195. https://doi.org/10.1210/clinem/dgaa195
  185. Mladenova S, Andreenko E. Prevalence of underweight, overweight, general and central obesity among 8-15-years old Bulgarian children and adolescents (Smolyan region, 2012-2014). Nutr Hosp 2015;31:2419-27.
  186. Hosseini M, Kelishadi R, Yousefifard M, Qorbani M, Bazargani B, Heshmat R, et al. Height-adjusted percentiles evaluated central obesity in children and adolescents more effectively than just waist circumference. Acta Paediatr 2017;106:112-9. https://doi.org/10.1111/apa.13622
  187. Ejtahed HS, Kelishadi R, Qorbani M, Motlagh ME, Hasani-Ranjbar S, Angoorani P, et al. Utility of waist circumference-to-height ratio as a screening tool for generalized and central obesity among Iranian children and adolescents: the CASPIAN-V study. Pediatr Diabetes 2019;20:530-7.
  188. Fernandez JR, Bohan Brown M, Lopez-Alarcon M, Dawson JA, Guo F, Redden DT, et al. Changes in pediatric waist circumference percentiles despite reported pediatric weight stabilization in the United States. Pediatr Obes 2017;12:347-55. https://doi.org/10.1111/ijpo.12150
  189. Fernandez JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004;145:439-44. https://doi.org/10.1016/j.jpeds.2004.06.044
  190. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006;148:188-94. https://doi.org/10.1016/j.jpeds.2005.10.001
  191. Maffeis C, Corciulo N, Livieri C, Rabbone I, Trifiro G, Falorni A, et al. Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls. Eur J Clin Nutr 2003;57:566-72. https://doi.org/10.1038/sj.ejcn.1601573
  192. Maffeis C, Grezzani A, Pietrobelli A, Provera S, Tato L. Does waist circumference predict fat gain in children? Int J Obes Relat Metab Disord 2001;25:978-83. https://doi.org/10.1038/sj.ijo.0801641
  193. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L. Waist circumference and cardiovascular risk factors in prepubertal children. Obes Res 2001;9:179-87. https://doi.org/10.1038/oby.2001.19
  194. Lee S, Bacha F, Arslanian SA. Waist circumference, blood pressure, and lipid components of the metabolic syndrome. J Pediatr 2006;149:809-16. https://doi.org/10.1016/j.jpeds.2006.08.075
  195. Cameron AJ, Magliano DJ, Zimmet PZ, Welborn T, Shaw JE. The metabolic syndrome in Australia: prevalence using four definitions. Diabetes Res Clin Pract 2007;77:471-8. https://doi.org/10.1016/j.diabres.2007.02.002
  196. de Simone G, Devereux RB, Chinali M, Best LG, Lee ET, Galloway JM, et al. Prognostic impact of metabolic syndrome by different definitions in a population with high prevalence of obesity and diabetes: the Strong Heart Study. Diabetes Care 2007;30:1851-6. https://doi.org/10.2337/dc06-2152
  197. Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA. Age-specific prevalence of the metabolic syndrome defined by the International Diabetes Federation and the National Cholesterol Education Program: the Norwegian HUNT 2 study. BMC Public Health 2007;7:220. https://doi.org/10.1186/1471-2458-7-220
  198. Zabetian A, Hadaegh F, Azizi F. Prevalence of metabolic syndrome in Iranian adult population, concordance between the IDF with the ATPIII and the WHO definitions. Diabetes Res Clin Pract 2007;77:251-7. https://doi.org/10.1016/j.diabres.2006.12.001
  199. Pirkola J, Tammelin T, Bloigu A, Pouta A, Laitinen J, Ruokonen A, et al. Prevalence of metabolic syndrome at age 16 using the International Diabetes Federation paediatric definition. Arch Dis Child 2008;93:945-51. https://doi.org/10.1136/adc.2007.132951
  200. Brown TM, Vaidya D, Rogers WJ, Waters DD, Howard BV, Tardif JC, et al. Does prevalence of the metabolic syndrome in women with coronary artery disease differ by the ATP III and IDF criteria? J Womens Health (Larchmt) 2008;17:841-7. https://doi.org/10.1089/jwh.2007.0536
  201. Caprio S, Weiss R. The metabolic phenotype of pre-diabetes in obese youth. Nutr Metab Cardiovasc Dis 2004;14:270-5. https://doi.org/10.1016/S0939-4753(04)80054-1
  202. Cook S, Auinger P, Huang TT. Growth curves for cardio-metabolic risk factors in children and adolescents. J Pediatr 2009;155:S6.e15-26. https://doi.org/10.1016/j.jpeds.2008.12.047
  203. Cook S, Auinger P, Li C, Ford ES. Metabolic syndrome rates in United States adolescents, from the National Health and Nutrition Examination Survey, 1999-2002. J Pediatr 2008;152:165-70. https://doi.org/10.1016/j.jpeds.2007.06.004
  204. Gower BA, Nagy TR, Goran MI. Visceral fat, insulin sensitivity, and lipids in prepubertal children. Diabetes 1999;48:1515-21. https://doi.org/10.2337/diabetes.48.8.1515
  205. Gower BA, Nagy TR, Trowbridge CA, Dezenberg C, Goran MI. Fat distribution and insulin response in prepubertal African American and white children. Am J Clin Nutr 1998;67:821-7. https://doi.org/10.1093/ajcn/67.5.821
  206. Cruz ML, Huang TT, Johnson MS, Gower BA, Goran MI. Insulin sensitivity and blood pressure in black and white children. Hypertension 2002;40:18-22. https://doi.org/10.1161/01.HYP.0000019972.37690.EF
  207. Ball GD, Huang TT, Gower BA, Cruz ML, Shaibi GQ, Weigensberg MJ, et al. Longitudinal changes in insulin sensitivity, insulin secretion, and beta-cell function during puberty. J Pediatr 2006;148:16-22. https://doi.org/10.1016/j.jpeds.2005.08.059
  208. Goran MI, Bergman RN, Gower BA. Influence of total vs. visceral fat on insulin action and secretion in African American and white children. Obes Res 2001;9:423-31. https://doi.org/10.1038/oby.2001.56
  209. Arslanian S, Suprasongsin C, Janosky JE. Insulin secretion and sensitivity in black versus white prepubertal healthy children. J Clin Endocrinol Metab 1997;82:1923-7. https://doi.org/10.1210/jcem.82.6.4002
  210. Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care 2006;29:1891-6. https://doi.org/10.2337/dc06-0310
  211. Linder B, Imperatore G. Research updates on type 2 diabetes children. NASN Sch Nurse 2013;28:138-40. https://doi.org/10.1177/1942602X13479402
  212. Bell RA, Mayer-Davis EJ, Beyer JW, D'Agostino RB Jr, Lawrence JM, Linder B, et al. Diabetes in non-Hispanic white youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care 2009;32 Suppl 2:S102-11. https://doi.org/10.2337/dc09-S202
  213. Bobo N, Evert A, Gallivan J, Imperatore G, Kelly J, Linder B, et al. An update on type 2 diabetes in youth from the National Diabetes Education Program. Pediatrics 2004;114:259-63. https://doi.org/10.1542/peds.114.1.259
  214. Bosevski M, Borozanov V, Gucev F, Bosevska G, Tosev S, Georgievska-Ismail L. Prevalence of metabolic syndrome components in the type 2 diabetic population who presented coronary artery disease. Prilozi 2007;28:161-9.
  215. Machado-Rodrigues AM, Leite N, Coelho-e-Silva MJ, Martins RA, Valente-dos-Santos J, Mascarenhas LP, et al. Independent association of clustered metabolic risk factors with cardiorespiratory fitness in youth aged 11-17 years. Ann Hum Biol 2014;41:271-6. https://doi.org/10.3109/03014460.2013.856471
  216. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002;288:1728-32. https://doi.org/10.1001/jama.288.14.1728
  217. Ogden CL, Troiano RP, Briefel RR, Kuczmarski RJ, Flegal KM, Johnson CL. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics 1997;99:E1.
  218. Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology 2007;132:2087-102. https://doi.org/10.1053/j.gastro.2007.03.052
  219. Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998;101(3 Pt 2):497-504.
  220. Flegal KM. The effects of age categorization on estimates of overweight prevalence for children. Int J Obes Relat Metab Disord 2000;24:1636-41. https://doi.org/10.1038/sj.ijo.0801441
  221. Whitaker RC, Pepe MS, Wright JA, Seidel KD, Dietz WH. Early adiposity rebound and the risk of adult obesity. Pediatrics 1998;101:E5.
  222. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869-73. https://doi.org/10.1056/NEJM199709253371301
  223. Sun SS, Liang R, Huang TT, Daniels SR, Arslanian S, Liu K, et al. Childhood obesity predicts adult metabolic syndrome: the Fels Longitudinal Study. J Pediatr 2008;152:191-200. https://doi.org/10.1016/j.jpeds.2007.07.055
  224. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992;327:1350-5. https://doi.org/10.1056/NEJM199211053271904
  225. Steinberger J, Daniels SR; American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young); American Heart Association Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 2003;107:1448-53. https://doi.org/10.1161/01.CIR.0000060923.07573.F2
  226. Nadeau KJ, Maahs DM, Daniels SR, Eckel RH. Childhood obesity and cardiovascular disease: links and prevention strategies. Nat Rev Cardiol 2011;8:513-25. https://doi.org/10.1038/nrcardio.2011.86
  227. Smith SC Jr, Clark LT, Cooper RS, Daniels SR, Kumanyika SK, Ofili E, et al. Discovering the full spectrum of cardiovascular disease: Minority Health Summit 2003: report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group. Circulation 2005;111:e134-9.
  228. Janssen I, Katzmarzyk PT, Ross R. Duration of overweight and metabolic health risk in American men and women. Ann Epidemiol 2004;14:585-91. https://doi.org/10.1016/j.annepidem.2004.01.007
  229. St-Onge MP, Janssen I, Heymsfield SB. Metabolic syndrome in normal-weight Americans: new definition of the metabolically obese, normal-weight individual. Diabetes Care 2004;27:2222-8. https://doi.org/10.2337/diacare.27.9.2222
  230. Sumner AE, Luercio MF, Frempong BA, Ricks M, Sen S, Kushner H, et al. Validity of the reduced-sample insulin modified frequently-sampled intravenous glucose tolerance test using the nonlinear regression approach. Metabolism 2009;58:220-5. https://doi.org/10.1016/j.metabol.2008.09.017
  231. Mayer-Davis EJ, D'Agostino R Jr, Karter AJ, Haffner SM, Rewers MJ, Saad M, et al. Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA 1998;279:669-74. https://doi.org/10.1001/jama.279.9.669
  232. Srinivasan SR, Bao W, Wattigney WA, Berenson GS. Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996;45:235-40. https://doi.org/10.1016/S0026-0495(96)90060-8
  233. Maffeis C, Moghetti P, Grezzani A, Clementi M, Gaudino R, Tato L. Insulin resistance and the persistence of obesity from childhood into adulthood. J Clin Endocrinol Metab 2002;87:71-6. https://doi.org/10.1210/jcem.87.1.8130
  234. Thivel D, Malina RM, Isacco L, Aucouturier J, Meyer M, Duche P. Metabolic syndrome in obese children and adolescents: dichotomous or continuous? Metab Syndr Relat Disord 2009;7:549-55. https://doi.org/10.1089/met.2008.0085
  235. Katzmarzyk PT, Perusse L, Malina RM, Bergeron J, Despres JP, Bouchard C. Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: the Quebec Family Study. J Clin Epidemiol 2001;54:190-5. https://doi.org/10.1016/S0895-4356(00)00315-2
  236. Parsons TJ, Power C, Logan S, Summerbell CD. Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999;23 Suppl 8:S1-107.
  237. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med 1993;22:167-77. https://doi.org/10.1006/pmed.1993.1014
  238. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101(3 Pt 2):518-25.
  239. Faienza MF, Chiarito M, Molina-Molina E, Shanmugam H, Lammert F, Krawczyk M, et al. Childhood obesity, cardiovascular and liver health: a growing epidemic with age. World J Pediatr 2020. doi: 10.1007/s12519-020-00341-9. Epub ahead of print.
  240. Faienza MF, Wang DQ, Fruhbeck G, Garruti G, Portincasa P. The dangerous link between childhood and adulthood predictors of obesity and metabolic syndrome. Intern Emerg Med 2016;11:175-82. https://doi.org/10.1007/s11739-015-1382-6
  241. Nolan PB, Carrick-Ranson G, Stinear JW, Reading SA, Dalleck LC. Prevalence of metabolic syndrome and metabolic syndrome components in young adults: a pooled analysis. Prev Med Rep 2017;7:211-5. https://doi.org/10.1016/j.pmedr.2017.07.004
  242. Parsons TJ, Manor O, Power C. Television viewing and obesity: a prospective study in the 1958 British birth cohort. Eur J Clin Nutr 2008;62:1355-63. https://doi.org/10.1038/sj.ejcn.1602884
  243. Freedman DS, Ogden CL, Flegal KM, Khan LK, Serdula MK, Dietz WH. Childhood overweight and family income. MedGenMed 2007;9:26.
  244. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013;93:359-404. https://doi.org/10.1152/physrev.00033.2011
  245. Michaud A, Laforest S, Pelletier M, Nadeau M, Simard S, Daris M, et al. Abdominal adipocyte populations in women with visceral obesity. Eur J Endocrinol 2016;174:227-39. https://doi.org/10.1530/EJE-15-0822
  246. Sniderman AD, Bhopal R, Prabhakaran D, Sarrafzadegan N, Tchernof A. Why might South Asians be so susceptible to central obesity and its atherogenic consequences? The adipose tissue overflow hypothesis. Int J Epidemiol 2007;36:220-5. https://doi.org/10.1093/ije/dyl245
  247. Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA 1990;263:2893-8. https://doi.org/10.1001/jama.1990.03440210043030
  248. Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gomez-Gerique JA, et al. Central adiposity determines prevalence differences of the metabolic syndrome. Obes Res 2003;11:1480-7. https://doi.org/10.1038/oby.2003.198
  249. Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation 2000;101:975-80. https://doi.org/10.1161/01.CIR.101.9.975
  250. Abbasi F, Brown BW Jr, Lamendola C, McLaughlin T, Reaven GM. Relationship between obesity, insulin resistance, and coronary heart disease risk. J Am Coll Cardiol 2002;40:937-43. https://doi.org/10.1016/S0735-1097(02)02051-X
  251. Wagh A, Stone NJ. Treatment of metabolic syndrome. Expert Rev Cardiovasc Ther 2004;2:213-28. https://doi.org/10.1586/14779072.2.2.213
  252. Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects), Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. Lancet 2014;383:970-83. https://doi.org/10.1016/S0140-6736(13)61836-X
  253. Bassi N, Karagodin I, Wang S, Vassallo P, Priyanath A, Massaro E, et al. Lifestyle modification for metabolic syndrome: a systematic review. Am J Med 2014;127:1242.e1-10.
  254. Grundy SM. Drug therapy of the metabolic syndrome: minimizing the emerging crisis in polypharmacy. Nat Rev Drug Discov 2006;5:295-309. https://doi.org/10.1038/nrd2005
  255. DePaula AL, Macedo AL, Rassi N, Vencio S, Machado CA, Mota BR, et al. Laparoscopic treatment of metabolic syndrome in patients with type 2 diabetes mellitus. Surg Endosc 2008;22:2670-8. https://doi.org/10.1007/s00464-008-9808-0
  256. Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, et al. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008. Circulation 2013;127:1493-502, 1502.e1-8. https://doi.org/10.1161/CIRCULATIONAHA.113.001470
  257. Wang HH, Portincasa P, Mendez-Sanchez N, Uribe M, Wang DQ. Effect of ezetimibe on the prevention and dissolution of cholesterol gallstones. Gastroenterology 2008;134:2101-10. https://doi.org/10.1053/j.gastro.2008.03.011
  258. Conlon MA, Bird AR. The impact of diet and lifestyle on gut microbiota and human health. Nutrients 2014;7:17-44. https://doi.org/10.3390/nu7010017
  259. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 2005;81:341-54. https://doi.org/10.1093/ajcn.81.2.341
  260. Geleijnse JM, Kok FJ, Grobbee DE. Impact of dietary and lifestyle factors on the prevalence of hypertension in Western populations. Eur J Public Health 2004;14:235-9. https://doi.org/10.1093/eurpub/14.3.235
  261. Pacifico L, Anania C, Martino F, Poggiogalle E, Chiarelli F, Arca M, et al. Management of metabolic syndrome in children and adolescents. Nutr Metab Cardiovasc Dis 2011;21:455-66. https://doi.org/10.1016/j.numecd.2011.01.011
  262. Reinehr T, Kleber M, Toschke AM. Lifestyle intervention in obese children is associated with a decrease of the metabolic syndrome prevalence. Atherosclerosis 2009;207:174-80. https://doi.org/10.1016/j.atherosclerosis.2009.03.041
  263. Chen AK, Roberts CK, Barnard RJ. Effect of a short-term diet and exercise intervention on metabolic syndrome in overweight children. Metabolism 2006;55:871-8. https://doi.org/10.1016/j.metabol.2006.03.001
  264. Roberts CK, Chen AK, Barnard RJ. Effect of a short-term diet and exercise intervention in youth on atherosclerotic risk factors. Atherosclerosis 2007;191:98-106. https://doi.org/10.1016/j.atherosclerosis.2006.09.011
  265. Pasanisi F, Contaldo F, de Simone G, Mancini M. Benefits of sustained moderate weight loss in obesity. Nutr Metab Cardiovasc Dis 2001;11:401-6.
  266. Van Gaal LF, Wauters MA, De Leeuw IH. The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997;21 Suppl 1:S5-9.
  267. Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, et al. Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med 2001;134:1-11. https://doi.org/10.7326/0003-4819-134-1-200101020-00007
  268. Case CC, Jones PH, Nelson K, O'Brian Smith E, Ballantyne CM. Impact of weight loss on the metabolic syndrome. Diabetes Obes Metab 2002;4:407-14. https://doi.org/10.1046/j.1463-1326.2002.00236.x
  269. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-404. https://doi.org/10.1056/NEJMoa1014296
  270. Ilanne-Parikka P, Eriksson JG, Lindstrom J, Peltonen M, Aunola S, Hamalainen H, et al. Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabetes Care 2008;31:805-7. https://doi.org/10.2337/dc07-1117
  271. Forman D, Bulwer BE. Cardiovascular disease: optimal approaches to risk factor modification of diet and lifestyle. Curr Treat Options Cardiovasc Med 2006;8:47-57. https://doi.org/10.1007/s11936-006-0025-7
  272. Stevens VJ, Corrigan SA, Obarzanek E, Bernauer E, Cook NR, Hebert P, et al. Weight loss intervention in phase 1 of the Trials of Hypertension Prevention. The TOHP Collaborative Research Group. Arch Intern Med 1993;153:849-58. https://doi.org/10.1001/archinte.1993.00410070039006
  273. Aucott L, Poobalan A, Smith WC, Avenell A, Jung R, Broom J. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes: a systematic review. Hypertension 2005;45:1035-41. https://doi.org/10.1161/01.HYP.0000165680.59733.d4
  274. Curioni CC, Lourenco PM. Long-term weight loss after diet and exercise: a systematic review. Int J Obes (Lond) 2005;29:1168-74. https://doi.org/10.1038/sj.ijo.0803015
  275. Norris SL, Zhang X, Avenell A, Gregg E, Bowman B, Serdula M, et al. Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis. Am J Med 2004;117:762-74. https://doi.org/10.1016/j.amjmed.2004.05.024
  276. Hofso D, Nordstrand N, Johnson LK, Karlsen TI, Hager H, Jenssen T, et al. Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 2010;163:735-45. https://doi.org/10.1530/EJE-10-0514
  277. Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 2006;29:2102-7. https://doi.org/10.2337/dc06-0560
  278. McAuley KA, Williams SM, Mann JI, Goulding A, Chisholm A, Wilson N, et al. Intensive lifestyle changes are necessary to improve insulin sensitivity: a randomized controlled trial. Diabetes Care 2002;25:445-52. https://doi.org/10.2337/diacare.25.3.445
  279. Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet 2015;115:1447-63. https://doi.org/10.1016/j.jand.2015.02.031
  280. Grundy SM. Atherogenic dyslipidemia associated with metabolic syndrome and insulin resistance. Clin Cornerstone 2006;8 Suppl 1:S21-7. https://doi.org/10.1016/S1098-3597(06)80005-0
  281. Wyszynski DF, Waterworth DM, Barter PJ, Cohen J, Kesaniemi YA, Mahley RW, et al. Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project). Am J Cardiol 2005;95:194-8. https://doi.org/10.1016/j.amjcard.2004.08.091
  282. Grundy SM. Cardiovascular and metabolic risk factors: how can we improve outcomes in the high-risk patient? Am J Med 2007;120(9 Suppl 1):S3-8, discussion S9. https://doi.org/10.1016/j.amjmed.2007.06.005
  283. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. J Am Coll Cardiol 2004;44:720-32. https://doi.org/10.1016/j.jacc.2004.07.001
  284. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. A summary of implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Arterioscler Thromb Vasc Biol 2004;24:1329-30. https://doi.org/10.1161/01.ATV.0000139012.45265.e0
  285. See R, Lindsey JB, Patel MJ, Ayers CR, Khera A, McGuire DK, et al. Application of the screening for Heart Attack Prevention and Education Task Force recommendations to an urban population: observations from the Dallas Heart Study. Arch Intern Med 2008;168:1055-62. https://doi.org/10.1001/archinte.168.10.1055
  286. Grundy SM. United States Cholesterol Guidelines 2001: expanded scope of intensive low-density lipoprotein-lowering therapy. Am J Cardiol 2001;88(7B):23J-7J.
  287. Mozaffarian D, Appel LJ, Van Horn L. Components of a cardioprotective diet: new insights. Circulation 2011;123:2870-91. https://doi.org/10.1161/CIRCULATIONAHA.110.968735
  288. Astrup A, Hjorth MF. Classification of obesity targeted personalized dietary weight loss management based on carbohydrate tolerance. Eur J Clin Nutr 2018;72:1300-4. https://doi.org/10.1038/s41430-018-0227-6
  289. Chu L, Morrison KM, Riddell MC, Raha S, Timmons BW. Effect of 7 days of exercise on exogenous carbohydrate oxidation and insulin resistance in children with obesity. Appl Physiol Nutr Metab 2018;43:677-83. https://doi.org/10.1139/apnm-2017-0358
  290. Churuangsuk C, Kherouf M, Combet E, Lean M. Low-carbohydrate diets for overweight and obesity: a systematic review of the systematic reviews. Obes Rev 2018;19:1700-18. https://doi.org/10.1111/obr.12744
  291. Bailes JR, Strow MT, Werthammer J, McGinnis RA, Elitsur Y. Effect of low-carbohydrate, unlimited calorie diet on the treatment of childhood obesity: a prospective controlled study. Metab Syndr Relat Disord 2003;1:221-5. https://doi.org/10.1089/154041903322716697
  292. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003;348:2082-90. https://doi.org/10.1056/NEJMoa022207
  293. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003;348:2074-81. https://doi.org/10.1056/NEJMoa022637
  294. Guthrie JF, Morton JF. Food sources of added sweeteners in the diets of Americans. J Am Diet Assoc 2000;100:43-51, quiz 49-50. https://doi.org/10.1016/S0002-8223(00)00018-3
  295. Dietz WH. Sugar-sweetened beverages, milk intake, and obesity in children and adolescents. J Pediatr 2006;148:152-4. https://doi.org/10.1016/j.jpeds.2005.12.045
  296. Dietz WH. Television, obesity, and eating disorders. Adolesc Med 1993;4:543-50.
  297. Dowla S, Pendergrass M, Bolding M, Gower B, Fontaine K, Ashraf A, et al. Effectiveness of a carbohydrate restricted diet to treat non-alcoholic fatty liver disease in adolescents with obesity: trial design and methodology. Contemp Clin Trials 2018;68:95-101. https://doi.org/10.1016/j.cct.2018.03.014
  298. Hall KD, Chung ST. Low-carbohydrate diets for the treatment of obesity and type 2 diabetes. Curr Opin Clin Nutr Metab Care 2018;21:308-12. https://doi.org/10.1097/MCO.0000000000000470
  299. Sartorius K, Sartorius B, Madiba TE, Stefan C. Does high-carbohydrate intake lead to increased risk of obesity? A systematic review and meta-analysis. BMJ Open 2018;8:e018449. https://doi.org/10.1136/bmjopen-2017-018449
  300. Kaartinen NE, Knekt P, Kanerva N, Valsta LM, Eriksson JG, Rissanen H, et al. Dietary carbohydrate quantity and quality in relation to obesity: a pooled analysis of three Finnish population-based studies. Scand J Public Health 2016;44:385-93. https://doi.org/10.1177/1403494815622860
  301. Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa SY, et al. Dietary carbohydrate intake, presence of obesity and the incident risk of type 2 diabetes in Japanese men. J Diabetes Investig 2016;7:343-51. https://doi.org/10.1111/jdi.12433
  302. Sartorius B, Sartorius K, Aldous C, Madiba TE, Stefan C, Noakes T. Carbohydrate intake, obesity, metabolic syndrome and cancer risk? A two-part systematic review and meta-analysis protocol to estimate attributability. BMJ Open 2016;6:e009301. https://doi.org/10.1136/bmjopen-2015-009301
  303. Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, et al. Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 2006;355:1991-2002. https://doi.org/10.1056/NEJMoa055317
  304. Fruge AD, Byrd SH, Fountain BJ, Cossman JS, Schilling MW, Gerard P. Increased physical activity may be more protective for metabolic syndrome than reduced caloric intake. An analysis of estimated energy balance in U.S. adults: 2007-2010 NHANES. Nutr Metab Cardiovasc Dis 2015;25:535-40. https://doi.org/10.1016/j.numecd.2015.03.006
  305. Cano-Ibanez N, Bueno-Cavanillas A, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Zomeno MD, et al. Dietary intake in population with metabolic syndrome: is the prevalence of inadequate intake influenced by geographical area? Cross-sectional analysis from PREDIMED-Plus study. Nutrients 2018;10:E1661. https://doi.org/10.3390/nu10111661
  306. Navarro JCA, Antoniazzi L, Oki AM, Bonfim MC, Hong V, Bortolotto LA, et al. Prevalence of metabolic syndrome and framingham risk score in apparently healthy vegetarian and omnivorous men. Arq Bras Cardiol 2018;110:430-7.
  307. de Mello Fontanelli M, Sales CH, Carioca AAF, Marchioni DM, Fisberg RM. The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load. Eur J Nutr 2018;57:1197-205. https://doi.org/10.1007/s00394-017-1402-6
  308. Ma Y, Li Y, Chiriboga DE, Olendzki BC, Hebert JR, Li W, et al. Association between carbohydrate intake and serum lipids. J Am Coll Nutr 2006;25:155-63. https://doi.org/10.1080/07315724.2006.10719527
  309. Liese AD, Gilliard T, Schulz M, D'Agostino RB Jr, Wolever TM. Carbohydrate nutrition, glycaemic load, and plasma lipids: the Insulin Resistance Atherosclerosis Study. Eur Heart J 2007;28:80-7. https://doi.org/10.1093/eurheartj/ehl389
  310. Lewis CJ, Park YK, Dexter PB, Yetley EA. Nutrient intakes and body weights of persons consuming high and moderate levels of added sugars. J Am Diet Assoc 1992;92:708-13.
  311. Slyper AH. The influence of carbohydrate quality on cardiovascular disease, the metabolic syndrome, type 2 diabetes, and obesity - an overview. J Pediatr Endocrinol Metab 2013;26:617-29. https://doi.org/10.1515/jpem-2012-0419
  312. Tran BT, Jeong BY, Oh JK. The prevalence trend of metabolic syndrome and its components and risk factors in Korean adults: results from the Korean National Health and Nutrition Examination Survey 2008-2013. BMC Public Health 2017;17:71. https://doi.org/10.1186/s12889-016-3936-6
  313. Kastorini CM, Panagiotakos DB, Chrysohoou C, Georgousopoulou E, Pitaraki E, Puddu PE, et al. Metabolic syndrome, adherence to the Mediterranean diet and 10-year cardiovascular disease incidence: The ATTICA study. Atherosclerosis 2016;246:87-93. https://doi.org/10.1016/j.atherosclerosis.2015.12.025
  314. He DH, Yang M, Zhang RH, Ma XG, Huang LC, Huang ES, et al. Dietary patterns associated metabolic syndrome in Chinese adults. Biomed Environ Sci 2015;28:370-3. https://doi.org/10.3967/bes2015.051
  315. Lockard B, Earnest CP, Oliver J, Goodenough C, Rasmussen C, Greenwood M, et al. Retrospective analysis of protein- and carbohydrate-focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women. Metab Syndr Relat Disord 2016;14:228-37. https://doi.org/10.1089/met.2015.0096
  316. Um YJ, Oh SW, Lee CM, Kwon HT, Joh HK, Kim YJ, et al. Dietary fat intake and the risk of metabolic syndrome in Korean adults. Korean J Fam Med 2015;36:245-52. https://doi.org/10.4082/kjfm.2015.36.5.245
  317. Yubero-Serrano EM, Delgado-Lista J, Tierney AC, Perez-Martinez P, Garcia-Rios A, Alcala-Diaz JF, et al. Insulin resistance determines a differential response to changes in dietary fat modification on metabolic syndrome risk factors: the LIPGENE study. Am J Clin Nutr 2015;102:1509-17. https://doi.org/10.3945/ajcn.115.111286
  318. Melanson EL, Astrup A, Donahoo WT. The relationship between dietary fat and fatty acid intake and body weight, diabetes, and the metabolic syndrome. Ann Nutr Metab 2009;55:229-43. https://doi.org/10.1159/000229004
  319. Vessby B. Dietary fat, fatty acid composition in plasma and the metabolic syndrome. Curr Opin Lipidol 2003;14:15-9. https://doi.org/10.1097/00041433-200302000-00004
  320. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549-55. https://doi.org/10.1001/jama.295.13.1549
  321. Uusitupa M, Schwab U, Makimattila S, Karhapaa P, Sarkkinen E, Maliranta H, et al. Effects of two high-fat diets with different fatty acid compositions on glucose and lipid metabolism in healthy young women. Am J Clin Nutr 1994;59:1310-6. https://doi.org/10.1093/ajcn/59.6.1310
  322. Julibert A, Bibiloni MDM, Bouzas C, Martinez-Gonzalez MA, Salas-Salvado J, Corella D, et al. Total and subtypes of dietary fat intake and its association with components of the metabolic syndrome in a mediterranean population at high cardiovascular risk. Nutrients 2019;11:E1493. https://doi.org/10.3390/nu11071493
  323. Vollmer WM, Sacks FM, Svetkey LP. New insights into the effects on blood pressure of diets low in salt and high in fruits and vegetables and low-fat dairy products. Curr Control Trials Cardiovasc Med 2001;2:71-4. https://doi.org/10.1186/cvm-2-2-071
  324. Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA 2007;298:309-16. https://doi.org/10.1001/jama.298.3.309
  325. Kris-Etherton P, Daniels SR, Eckel RH, Engler M, Howard BV, Krauss RM, et al. Summary of the scientific conference on dietary fatty acids and cardiovascular health: conference summary from the nutrition committee of the American Heart Association. Circulation 2001;103:1034-9. https://doi.org/10.1161/01.CIR.103.7.1034
  326. Riccardi G, Giacco R, Rivellese AA. Dietary fat, insulin sensitivity and the metabolic syndrome. Clin Nutr 2004;23:447-56. https://doi.org/10.1016/j.clnu.2004.02.006
  327. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-9. https://doi.org/10.1056/NEJM199711203372102
  328. Tierney AC, McMonagle J, Shaw DI, Gulseth HL, Helal O, Saris WH, et al. Effects of dietary fat modification on insulin sensitivity and on other risk factors of the metabolic syndrome--LIPGENE: a European randomized dietary intervention study. Int J Obes (Lond) 2011;35:800-9. https://doi.org/10.1038/ijo.2010.209
  329. Zoccali C, Mallamaci F. Background dietary patterns and the time course of the blood pressure response to low sodium intake. Hypertension 2017;70:890-2. https://doi.org/10.1161/HYPERTENSIONAHA.117.10129
  330. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001;344:3-10. https://doi.org/10.1056/NEJM200101043440101
  331. Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller ER 3rd, Lin PH, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr 2001;74:80-9. https://doi.org/10.1093/ajcn/74.1.80
  332. Vollmer WM, Sacks FM, Ard J, Appel LJ, Bray GA, Simons-Morton DG, et al. Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial. Ann Intern Med 2001;135:1019-28. https://doi.org/10.7326/0003-4819-135-12-200112180-00005
  333. Campanozzi A, Avallone S, Barbato A, Iacone R, Russo O, De Filippo G, et al. High sodium and low potassium intake among Italian children: relationship with age, body mass and blood pressure. PLoS One 2015;10:e0121183. https://doi.org/10.1371/journal.pone.0121183
  334. Campbell WW, Kim JE, Amankwaah AF, Gordon SL, Weinheimer-Haus EM. Higher total protein intake and change in total protein intake affect body composition but not metabolic syndrome indexes in middle-aged overweight and obese adults who perform resistance and aerobic exercise for 36 weeks. J Nutr 2015;145:2076-83. https://doi.org/10.3945/jn.115.213595
  335. Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation 2008;117:754-61. https://doi.org/10.1161/CIRCULATIONAHA.107.716159
  336. Van Elswyk ME, Weatherford CA, McNeill SH. A systematic review of renal health in healthy individuals associated with protein intake above the US recommended daily allowance in randomized controlled trials and observational studies. Adv Nutr 2018;9:404-18. https://doi.org/10.1093/advances/nmy026
  337. Goran MI. Metabolic precursors and effects of obesity in children: a decade of progress, 1990-1999. Am J Clin Nutr 2001;73:158-71. https://doi.org/10.1093/ajcn/73.2.158
  338. Bakker EA, Lee DC, Sui X, Artero EG, Ruiz JR, Eijsvogels TMH, et al. Association of resistance exercise, independent of and combined with aerobic exercise, with the incidence of metabolic syndrome. Mayo Clin Proc 2017;92:1214-22. https://doi.org/10.1016/j.mayocp.2017.02.018
  339. Bateman LA, Slentz CA, Willis LH, Shields AT, Piner LW, Bales CW, et al. Comparison of aerobic versus resistance exercise training effects on metabolic syndrome (from the Studies of a Targeted Risk Reduction Intervention Through Defined Exercise - STRRIDE-AT/RT). Am J Cardiol 2011;108:838-44. https://doi.org/10.1016/j.amjcard.2011.04.037
  340. Christ M, Iannello C, Iannello PG, Grimm W. Effects of a weight reduction program with and without aerobic exercise in the metabolic syndrome. Int J Cardiol 2004;97:115-22. https://doi.org/10.1016/j.ijcard.2004.01.034
  341. Fatone C, Guescini M, Balducci S, Battistoni S, Settequattrini A, Pippi R, et al. Two weekly sessions of combined aerobic and resistance exercise are sufficient to provide beneficial effects in subjects with Type 2 diabetes mellitus and metabolic syndrome. J Endocrinol Invest 2010;33:489-95. https://doi.org/10.1007/BF03346630
  342. Kim JW, Kim DY. Effects of aerobic exercise training on serum sex hormone binding globulin, body fat index, and metabolic syndrome factors in obese postmenopausal women. Metab Syndr Relat Disord 2012;10:452-7. https://doi.org/10.1089/met.2012.0036
  343. Yassine HN, Marchetti CM, Krishnan RK, Vrobel TR, Gonzalez F, Kirwan JP. Effects of exercise and caloric restriction on insulin resistance and cardiometabolic risk factors in older obese adults--a randomized clinical trial. J Gerontol A Biol Sci Med Sci 2009;64:90-5.
  344. Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 2008;118:346-54. https://doi.org/10.1161/CIRCULATIONAHA.108.772822
  345. Wewege MA, Thom JM, Rye KA, Parmenter BJ. Aerobic, resistance or combined training: a systematic review and meta-analysis of exercise to reduce cardiovascular risk in adults with metabolic syndrome. Atherosclerosis 2018;274:162-71. https://doi.org/10.1016/j.atherosclerosis.2018.05.002
  346. Johnson NA, Sachinwalla T, Walton DW, Smith K, Armstrong A, Thompson MW, et al. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 2009;50:1105-12. https://doi.org/10.1002/hep.23129
  347. Keating SE, Hackett DA, Parker HM, O'Connor HT, Gerofi JA, Sainsbury A, et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol 2015;63:174-82. https://doi.org/10.1016/j.jhep.2015.02.022
  348. Christiansen T, Paulsen SK, Bruun JM, Overgaard K, Ringgaard S, Pedersen SB, et al. Comparable reduction of the visceral adipose tissue depot after a diet-induced weight loss with or without aerobic exercise in obese subjects: a 12-week randomized intervention study. Eur J Endocrinol 2009;160:759-67. https://doi.org/10.1530/EJE-08-1009
  349. Xiao T, Fu YF. Resistance training vs. aerobic training and role of other factors on the exercise effects on visceral fat. Eur Rev Med Pharmacol Sci 2015;19:1779-84.
  350. Oh S, So R, Shida T, Matsuo T, Kim B, Akiyama K, et al. High-intensity aerobic exercise improves both hepatic fat content and stiffness in sedentary obese men with nonalcoholic fatty liver disease. Sci Rep 2017;7:43029. https://doi.org/10.1038/srep43029
  351. Yoshimura E, Kumahara H, Tobina T, Matsuda T, Ayabe M, Kiyonaga A, et al. Lifestyle intervention involving calorie restriction with or without aerobic exercise training improves liver fat in adults with visceral adiposity. J Obes 2014;2014:197216.
  352. Lee S, Deldin AR, White D, Kim Y, Libman I, Rivera-Vega M, et al. Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial. Am J Physiol Endocrinol Metab 2013;305:E1222-9. https://doi.org/10.1152/ajpendo.00285.2013
  353. Thomas EL, Brynes AE, McCarthy J, Goldstone AP, Hajnal JV, Saeed N, et al. Preferential loss of visceral fat following aerobic exercise, measured by magnetic resonance imaging. Lipids 2000;35:769-76. https://doi.org/10.1007/s11745-000-0584-0
  354. van der Heijden GJ, Wang ZJ, Chu ZD, Sauer PJ, Haymond MW, Rodriguez LM, et al. A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity (Silver Spring) 2010;18:384-90. https://doi.org/10.1038/oby.2009.274
  355. Ohkawara K, Tanaka S, Miyachi M, Ishikawa-Takata K, Tabata I. A dose-response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials. Int J Obes (Lond) 2007;31:1786-97. https://doi.org/10.1038/sj.ijo.0803683
  356. Okura T, Nakata Y, Ohkawara K, Numao S, Katayama Y, Matsuo T, et al. Effects of aerobic exercise on metabolic syndrome improvement in response to weight reduction. Obesity (Silver Spring) 2007;15:2478-84. https://doi.org/10.1038/oby.2007.294
  357. Ismail I, Keating SE, Baker MK, Johnson NA. A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Obes Rev 2012;13:68-91. https://doi.org/10.1111/j.1467-789X.2011.00931.x
  358. Davis JN, Ventura EE, Shaibi GQ, Byrd-Williams CE, Alexander KE, Vanni AK, et al. Interventions for improving metabolic risk in overweight Latino youth. Int J Pediatr Obes 2010;5:451-5. https://doi.org/10.3109/17477161003770123
  359. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007;116:1081-93. https://doi.org/10.1161/CIRCULATIONAHA.107.185649
  360. Molina-Molina E, Lunardi Baccetto R, Wang DQ, de Bari O, Krawczyk M, Portincasa P. Exercising the hepatobiliary-gut axis. The impact of physical activity performance. Eur J Clin Invest 2018;48:e12958. https://doi.org/10.1111/eci.12958
  361. Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, Mora-Rodriguez R. Effectiveness of aerobic exercise programs for health promotion in metabolic syndrome. Med Sci Sports Exerc 2019;51:1876-83. https://doi.org/10.1249/MSS.0000000000001983
  362. Crist LA, Champagne CM, Corsino L, Lien LF, Zhang G, Young DR. Influence of change in aerobic fitness and weight on prevalence of metabolic syndrome. Prev Chronic Dis 2012;9:E68.
  363. Wang X, Hsu FC, Isom S, Walkup MP, Kritchevsky SB, Goodpaster BH, et al. Effects of a 12-month physical activity intervention on prevalence of metabolic syndrome in elderly men and women. J Gerontol A Biol Sci Med Sci 2012;67:417-24.
  364. Hashida R, Kawaguchi T, Bekki M, Omoto M, Matsuse H, Nago T, et al. Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: a systematic review. J Hepatol 2017;66:142-52. https://doi.org/10.1016/j.jhep.2016.08.023
  365. Robins SJ. Cardiovascular disease with diabetes or the metabolic syndrome: should statins or fibrates be first line lipid therapy? Curr Opin Lipidol 2003;14:575-83. https://doi.org/10.1097/00041433-200312000-00005
  366. Scott R, Donoghoe M, Watts GF, O'Brien R, Pardy C, Taskinen MR, et al. Impact of metabolic syndrome and its components on cardiovascular disease event rates in 4900 patients with type 2 diabetes assigned to placebo in the FIELD randomised trial. Cardiovasc Diabetol 2011;10:102. https://doi.org/10.1186/1475-2840-10-102
  367. Scott R, O'Brien R, Fulcher G, Pardy C, D'Emden M, Tse D, et al. Effects of fenofibrate treatment on cardiovascular disease risk in 9,795 individuals with type 2 diabetes and various components of the metabolic syndrome: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Diabetes Care 2009;32:493-8. https://doi.org/10.2337/dc08-1543
  368. Burguera B, Schauer P, Kahan S. What to offer the 99% of patients with severe obesity who do not undergo bariatric surgery? Mayo Clin Proc 2019;94:957-60. https://doi.org/10.1016/j.mayocp.2018.11.020
  369. Younis A, Younis A, Tzur B, Peled Y, Shlomo N, Goldenberg I, et al. Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease. Cardiovasc Diabetol 2016;15:149. https://doi.org/10.1186/s12933-016-0466-6
  370. Tenenbaum A, Fisman EZ. Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? Cardiovasc Diabetol 2004;3:10. https://doi.org/10.1186/1475-2840-3-10
  371. Tenenbaum A, Fisman EZ, Motro M, Adler Y. Atherogenic dyslipidemia in metabolic syndrome and type 2 diabetes: therapeutic options beyond statins. Cardiovasc Diabetol 2006;5:20. https://doi.org/10.1186/1475-2840-5-20
  372. Kastelein JJ, van der Steeg WA, Holme I, Gaffney M, Cater NB, Barter P, et al. Lipids, apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment. Circulation 2008;117:3002-9. https://doi.org/10.1161/CIRCULATIONAHA.107.713438
  373. Keaney JF Jr, Curfman GD, Jarcho JA. A pragmatic view of the new cholesterol treatment guidelines. N Engl J Med 2014;370:275-8. https://doi.org/10.1056/NEJMms1314569
  374. Bays HE, Jones PH, Brown WV, Jacobson TA; National Lipid Association. National Lipid Association Annual Summary of Clinical Lipidology 2015. J Clin Lipidol 2014;8(6 Suppl):S1-36. https://doi.org/10.1016/S1933-2874(14)00007-5
  375. Jacobson TA. Combination lipid-altering therapy: an emerging treatment paradigm for the 21st century. Curr Atheroscler Rep 2001;3:373-82. https://doi.org/10.1007/s11883-001-0075-y
  376. Robins SJ, Rubins HB, Faas FH, Schaefer EJ, Elam MB, Anderson JW, et al. Insulin resistance and cardiovascular events with low HDL cholesterol: the Veterans Affairs HDL Intervention Trial (VA-HIT). Diabetes Care 2003;26:1513-7. https://doi.org/10.2337/diacare.26.5.1513
  377. Dujovne CA, Williams CD, Ito MK. What combination therapy with a statin, if any, would you recommend? Curr Atheroscler Rep 2011;13:12-22. https://doi.org/10.1007/s11883-010-0150-3
  378. Boden WE, Pearson TA. Raising low levels of high-density lipoprotein cholesterol is an important target of therapy. Am J Cardiol 2000;85:645-50, A10. https://doi.org/10.1016/S0002-9149(99)00826-7
  379. AIM-HIGH Investigators, Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011;365:2255-67. https://doi.org/10.1056/NEJMoa1107579
  380. Jacobson TA. Combination lipid-lowering therapy with statins: safety issues in the postcerivastatin era. Expert Opin Drug Saf 2003;2:269-86. https://doi.org/10.1517/14740338.2.3.269
  381. Blaha MJ, Blumenthal RS, Brinton EA, Jacobson TA; National Lipid Association Taskforce on Non-HDL Cholesterol. The importance of non-HDL cholesterol reporting in lipid management. J Clin Lipidol 2008;2:267-73. https://doi.org/10.1016/j.jacl.2008.06.013
  382. Jacobson TA, Ito MK, Maki KC, Orringer CE, Bays HE, Jones PH, et al. National lipid association recommendations for patient-centered management of dyslipidemia: part 1--full report. J Clin Lipidol 2015;9:129-69. https://doi.org/10.1016/j.jacl.2015.02.003
  383. Windler E, Zyriax BC, Bamberger C, Rinninger F, Beil FU. Current strategies and recent advances in the therapy of hypercholesterolemia. Atheroscler Suppl 2009;10:1-4.
  384. ACCORD Study Group, Ginsberg HN, Elam MB, Lovato LC, Crouse JR 3rd, Leiter LA, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med 2010;362:1563-74. https://doi.org/10.1056/NEJMoa1001282
  385. Robins SJ. Lipid therapy for cardiovascular disease with insulin resistance, diabetes, or the metabolic syndrome. Curr Cardiol Rep 2005;7:457-64. https://doi.org/10.1007/s11886-005-0064-9
  386. Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009;374:1677-86. https://doi.org/10.1016/S0140-6736(09)61457-4
  387. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care 2014;37 Suppl 1:S14-80. https://doi.org/10.2337/dc14-S014
  388. Alsumali A, Al-Hawag A, Samnaliev M, Eguale T. Systematic assessment of decision analytic models for the cost-effectiveness of bariatric surgery for morbid obesity. Surg Obes Relat Dis 2018;14:1041-59. https://doi.org/10.1016/j.soard.2018.03.005
  389. Busetto L. Timing of bariatric surgery in people with obesity and diabetes. Ann Transl Med 2015;3:94. https://doi.org/10.3978/j.issn.2305-5839.2015.03.62
  390. Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, et al. Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". Obes Surg 2018;28:2117-21. https://doi.org/10.1007/s11695-018-3283-z
  391. Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, et al. Practical recommendations of the obesity management task force of the European association for the study of obesity for the post-bariatric surgery medical management. Obes Facts 2017;10:597-632. https://doi.org/10.1159/000481825
  392. Busetto L, Dixon J, De Luca M, Shikora S, Pories W, Angrisani L. Bariatric surgery in class I obesity : a Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg 2014;24:487-519. https://doi.org/10.1007/s11695-014-1214-1
  393. Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis 2020;16:175-247. https://doi.org/10.1016/j.soard.2019.10.025
  394. Rega-Kaun G, Kaun C, Jaegersberger G, Prager M, Hackl M, Demyanets S, et al. Roux-en-Y-bariatric surgery reduces markers of metabolic syndrome in morbidly obese patients. Obes Surg 2020;30:391-400. https://doi.org/10.1007/s11695-019-04190-y
  395. Reiter-Purtill J, Ley S, Kidwell KM, Mikhail C, Austin H, Chaves E, et al. Change, predictors and correlates of weight- and health-related quality of life in adolescents 2-years following bariatric surgery. Int J Obes (Lond) 2019. doi: 10.1038/s41366-019-0394-0. [Epub ahead of print].
  396. Mital S, Nguyen HV. Incremental cost-effectiveness of aspiration therapy vs bariatric surgery and no treatment for morbid obesity. Am J Gastroenterol 2019;114:1470-7. https://doi.org/10.14309/ajg.0000000000000359
  397. Wee CC, Huskey KW, Bolcic-Jankovic D, Colten ME, Davis RB, Hamel M. Sex, race, and consideration of bariatric surgery among primary care patients with moderate to severe obesity. J Gen Intern Med 2014;29:68-75. https://doi.org/10.1007/s11606-013-2603-1
  398. Dixon JB, Zimmet P, Alberti KG, Rubino F; International Diabetes Federation Taskforce on Epidemiology and Prevention. Bariatric surgery: an IDF statement for obese Type 2 diabetes. Diabet Med 2011;28:628-42. https://doi.org/10.1111/j.1464-5491.2011.03306.x
  399. Allen SR, Lawson L, Garcia V, Inge TH. Attitudes of bariatric surgeons concerning adolescent bariatric surgery (ABS). Obes Surg 2005;15:1192-5. https://doi.org/10.1381/0960892055002176
  400. Desai NK, Wulkan ML, Inge TH. Update on adolescent bariatric surgery. Endocrinol Metab Clin North Am 2016;45:667-76. https://doi.org/10.1016/j.ecl.2016.04.015
  401. Al-Qahtani AR. Laparoscopic adjustable gastric banding in adolescent: safety and efficacy. J Pediatr Surg 2007;42:894-7. https://doi.org/10.1016/j.jpedsurg.2006.12.057
  402. O'Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol 2010;25:1358-65. https://doi.org/10.1111/j.1440-1746.2010.06391.x
  403. Horgan S, Holterman MJ, Jacobsen GR, Browne AF, Berger RA, Moser F, et al. Laparoscopic adjustable gastric banding for the treatment of adolescent morbid obesity in the United States: a safe alternative to gastric bypass. J Pediatr Surg 2005;40:86-90; discussion 90-1. https://doi.org/10.1016/j.jpedsurg.2004.09.034
  404. Inge TH, Garcia V, Daniels S, Langford L, Kirk S, Roehrig H, et al. A multidisciplinary approach to the adolescent bariatric surgical patient. J Pediatr Surg 2004;39:442-7; discussion 446-7. https://doi.org/10.1016/j.jpedsurg.2003.11.025
  405. Breaux CW. Obesity surgery in children. Obes Surg 1995;5:279-84. https://doi.org/10.1381/096089295765557647
  406. Strauss RS, Bradley LJ, Brolin RE. Gastric bypass surgery in adolescents with morbid obesity. J Pediatr 2001;138:499-504. https://doi.org/10.1067/mpd.2001.113043
  407. Stanford A, Glascock JM, Eid GM, Kane T, Ford HR, Ikramuddin S, et al. Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. J Pediatr Surg 2003;38:430-3. https://doi.org/10.1053/jpsu.2003.50074
  408. Sugerman HJ, Sugerman EL, DeMaria EJ, Kellum JM, Kennedy C, Mowery Y, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg 2003;7:102-8. https://doi.org/10.1016/S1091-255X(02)00125-7
  409. Fernandez AZ Jr, DeMaria EJ, Tichansky DS, Kellum JM, Wolfe LG, Meador J, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc 2004;18:193-7. https://doi.org/10.1007/s00464-003-8926-y
  410. Helmrath MA, Brandt ML, Inge TH. Adolescent obesity and bariatric surgery. Surg Clin North Am 2006;86:441-54, x. https://doi.org/10.1016/j.suc.2005.12.015
  411. Goldschmidt AB, Khoury J, Jenkins TM, Bond DS, Thomas JG, Utzinger LM, et al. Adolescent loss-of-control eating and weight loss maintenance after bariatric surgery. Pediatrics 2018;141:e20171659. https://doi.org/10.1542/peds.2017-1659
  412. Inge TH, Coley RY, Bazzano LA, Xanthakos SA, McTigue K, Arterburn D, et al. Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study. Surg Obes Relat Dis 2018;14:1374-86. https://doi.org/10.1016/j.soard.2018.04.002
  413. Bianciardi E, Di Lorenzo G, Niolu C, Betro S, Zerbin F, Gentileschi P, et al. Body image dissatisfaction in individuals with obesity seeking bariatric surgery: exploring the burden of new mediating factors. Riv Psichiatr 2019;54:8-17.
  414. Price PH, Kaizer AM, Daniels SR, Jenkins TM, Inge TH, Eckel RH. Physical activity improves lipid and weight-loss outcomes after metabolic bariatric surgery in adolescents with severe obesity. Obesity (Silver Spring) 2019;27:989-96. https://doi.org/10.1002/oby.22475
  415. Tsai WS, Inge TH, Burd RS. Bariatric surgery in adolescents: recent national trends in use and in-hospital outcome. Arch Pediatr Adolesc Med 2007;161:217-21. https://doi.org/10.1001/archpedi.161.3.217
  416. Inge TH, Donnelly LF, Vierra M, Cohen AP, Daniels SR, Garcia VF. Managing bariatric patients in a children's hospital: radiologic considerations and limitations. J Pediatr Surg 2005;40:609-17. https://doi.org/10.1016/j.jpedsurg.2005.01.005
  417. Stefater MA, Inge TH. Bariatric surgery for adolescents with Type 2 diabetes: an emerging therapeutic strategy. Curr Diab Rep 2017;17:62. https://doi.org/10.1007/s11892-017-0887-y
  418. Coutant R, Bouhours-Nouet N, Donzeau A, Fauchard M, Decrequy A, Malka J, et al. Bariatric surgery in adolescents with severe obesity: Review and state of the art in France. Ann Endocrinol (Paris) 2017;78:462-8. https://doi.org/10.1016/j.ando.2017.03.002
  419. Canoy D, Yang TO. Obesity in children: bariatric surgery. BMJ Clin Evid 2015;2015:0325.
  420. Borges Da Silva V, Borges Da Silva R, Prud'homme A, Campan P, Azorin JM, Belzeaux R. Association between binge eating disorder and psychiatric comorbidity profiles in patients with obesity seeking bariatric surgery. Compr Psychiatry 2018;87:79-83. https://doi.org/10.1016/j.comppsych.2018.09.004
  421. Field AE, Inge TH, Belle SH, Johnson GS, Wahed AS, Pories WJ, et al. Association of obesity subtypes in the longitudinal assessment of bariatric surgery study and 3-year postoperative weight change. Obesity (Silver Spring) 2018;26:1931-7. https://doi.org/10.1002/oby.22287
  422. Ryder JR, Gross AC, Fox CK, Kaizer AM, Rudser KD, Jenkins TM, et al. Factors associated with long-term weight-loss maintenance following bariatric surgery in adolescents with severe obesity. Int J Obes (Lond) 2018;42:102-7. https://doi.org/10.1038/ijo.2017.193
  423. Michalsky MP, Inge TH, Jenkins TM, Xie C, Courcoulas A, Helmrath M, et al. Cardiovascular risk factors after adolescent bariatric surgery. Pediatrics 2018;141:e20172485. https://doi.org/10.1542/peds.2017-2485
  424. Inge TH, Krebs NF, Garcia VF, Skelton JA, Guice KS, Strauss RS, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 2004;114:217-23. https://doi.org/10.1542/peds.114.1.217
  425. O'Brien PE. Controversies in bariatric surgery. Br J Surg 2015;102:611-8. https://doi.org/10.1002/bjs.9760
  426. O'Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg 2019;29:3-14. https://doi.org/10.1007/s11695-018-3525-0
  427. O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg 2013;257:87-94. https://doi.org/10.1097/SLA.0b013e31827b6c02
  428. O'Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obes Surg 2006;16:1032-40. https://doi.org/10.1381/096089206778026316
  429. van Geelen SM, Bolt IL, van der Baan-Slootweg OH, van Summeren MJ. The controversy over pediatric bariatric surgery: an explorative study on attitudes and normative beliefs of specialists, parents, and adolescents with obesity. J Bioeth Inq 2013;10:227-37. https://doi.org/10.1007/s11673-013-9440-0
  430. Epstein LH, McCurley J, Valoski A, Wing RR. Growth in obese children treated for obesity. Am J Dis Child 1990;144:1360-4.
  431. Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA 1990;264:2519-23. https://doi.org/10.1001/jama.1990.03450190051027
  432. Valoski A, Epstein LH. Nutrient intake of obese children in a family-based behavioral weight control program. Int J Obes 1990;14:667-77.
  433. Xanthakos SA, Khoury JC, Inge TH, Jenkins TM, Modi AC, Michalsky MP, et al. Nutritional risks in adolescents after bariatric surgery. Clin Gastroenterol Hepatol 2020;18:1070-81.e5. https://doi.org/10.1016/j.cgh.2019.10.048
  434. Anker SD, Anker MS, von Haehling S. Weight loss and health status after bariatric surgery in adolescents. N Engl J Med 2016;374:1988. https://doi.org/10.1056/NEJMc1602007
  435. Inge TH, Jenkins TM, Xanthakos SA, Dixon JB, Daniels SR, Zeller MH, et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol 2017;5:165-73. https://doi.org/10.1016/S2213-8587(16)30315-1
  436. Hofmann B. Bariatric surgery for obese children and adolescents: a review of the moral challenges. BMC Med Ethics 2013;14:18. https://doi.org/10.1186/1472-6939-14-18
  437. Black JA, White B, Viner RM, Simmons RK. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obes Rev 2013;14:634-44. https://doi.org/10.1111/obr.12037
  438. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 2004;89:108-13. https://doi.org/10.1210/jc.2003-031188
  439. Ford ES, Ajani UA, Mokdad AH; National Health and Nutrition Examination. The metabolic syndrome and concentrations of C-reactive protein among U.S. youth. Diabetes Care 2005;28:878-81. https://doi.org/10.2337/diacare.28.4.878
  440. Viner RM, Segal TY, Lichtarowicz-Krynska E, Hindmarsh P. Prevalence of the insulin resistance syndrome in obesity. Arch Dis Child 2005;90:10-4. https://doi.org/10.1136/adc.2003.036467
  441. Mellerio H, Alberti C, Druet C, Capelier F, Mercat I, Josserand E, et al. Novel modeling of reference values of cardiovascular risk factors in children aged 7 to 20 years. Pediatrics 2012;129:e1020-9. https://doi.org/10.1542/peds.2011-0449

피인용 문헌

  1. Ocular findings in metabolic syndrome: a review vol.5, pp.6, 2020, https://doi.org/10.1097/j.pbj.0000000000000104
  2. Lipid-Induced Mechanisms of Metabolic Syndrome vol.2020, 2020, https://doi.org/10.1155/2020/5762395
  3. Dietary Strategies for Metabolic Syndrome: A Comprehensive Review vol.12, pp.10, 2020, https://doi.org/10.3390/nu12102983
  4. Association between Demodex folliculorum and Metabolic Syndrome vol.19, pp.11, 2020, https://doi.org/10.1111/jocd.13721
  5. Association of Serum Amylase Activity and the Copy Number Variation of AMY1/2A/2B with Metabolic Syndrome in Chinese Adults vol.14, 2020, https://doi.org/10.2147/dmso.s339604
  6. The Accuracy of Visceral Adiposity Index for the Screening of Metabolic Syndrome: A Systematic Review and Meta-Analysis vol.2021, 2020, https://doi.org/10.1155/2021/6684627
  7. Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom vol.131, pp.1, 2021, https://doi.org/10.1172/jci142246
  8. Predictors of Metabolic Syndrome in Adults and Older Adults from Amazonas, Brazil vol.18, pp.3, 2020, https://doi.org/10.3390/ijerph18031303
  9. High serum miR-421 is associated with metabolic dysregulation and inflammation in patients with metabolic syndrome vol.13, pp.6, 2020, https://doi.org/10.2217/epi-2020-0247
  10. High Density Lipoprotein Cholesterol Efflux Capacity and Atherosclerosis in Cardiovascular Disease: Pathophysiological Aspects and Pharmacological Perspectives vol.10, pp.3, 2021, https://doi.org/10.3390/cells10030574
  11. Waist Circumference Is Not Associated with Impaired Fasting Blood Glucose in a Sample of Mexican Children and Teenagers: Results from a State Screening Program vol.8, pp.3, 2020, https://doi.org/10.3390/children8030172
  12. Carotid Atherosclerosis, Ultrasound and Lipoproteins vol.9, pp.5, 2020, https://doi.org/10.3390/biomedicines9050521
  13. HDL Dysfunctionality: Clinical Relevance of Quality Rather Than Quantity vol.9, pp.7, 2020, https://doi.org/10.3390/biomedicines9070729
  14. Effector Memory CD8+ and CD4+ T Cell Immunity Associated with Metabolic Syndrome in Obese Children vol.24, pp.4, 2020, https://doi.org/10.5223/pghn.2021.24.4.377
  15. Telmisartan prevents high-fat diet-induced neurovascular impairments and reduces anxiety-like behavior vol.41, pp.9, 2020, https://doi.org/10.1177/0271678x211003497
  16. Egg consumption and health effects: A narrative review vol.86, pp.10, 2020, https://doi.org/10.1111/1750-3841.15892
  17. Non-alcoholic fatty liver disease and type 2 diabetes mellitus: the problem of conjunction and phasing vol.18, pp.3, 2020, https://doi.org/10.14341/omet12758
  18. Non-Alcoholic Fatty Liver Disease (NAFLD) and Potential Links to Depression, Anxiety, and Chronic Stress vol.9, pp.11, 2020, https://doi.org/10.3390/biomedicines9111697
  19. Role of Sumac (Rhus coriaria L.) in the management of metabolic syndrome and related disorders: Focus on NAFLD-atherosclerosis interplay vol.87, 2020, https://doi.org/10.1016/j.jff.2021.104811
  20. Olive leaf extract supplementation improves the vascular and metabolic alterations associated with aging in Wistar rats vol.11, pp.1, 2020, https://doi.org/10.1038/s41598-021-87628-7
  21. Kernel machine SNP set analysis finds the association of BUD13, ZPR1, and APOA5 variants with metabolic syndrome in Tehran Cardio-metabolic Genetics Study vol.11, pp.1, 2020, https://doi.org/10.1038/s41598-021-89509-5
  22. Endocrine comorbidities of pediatric obesity vol.64, pp.12, 2020, https://doi.org/10.3345/cep.2021.00213
  23. “Obesity and Insulin Resistance” Is the Component of the Metabolic Syndrome Most Strongly Associated with Oxidative Stress vol.11, pp.1, 2022, https://doi.org/10.3390/antiox11010079