Department of Pediatrics, Hadassah Hebrew University School of Medicine, Jerusalem, Israel.
Ann N Y Acad Sci. 2013 Apr;1281(1):123-40. doi: 10.1111/nyas.12030. Epub 2013 Jan 28.
Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity) that occur in obese children. However, metabolic syndrome can also occur in lean individuals, suggesting that obesity is a marker for the syndrome, not a cause. Metabolic syndrome is difficult to define, due to its nonuniform classification and reliance on hard cutoffs in the evaluation of disorders with non-Gaussian distributions. Defining the syndrome is even more difficult in children, owing to racial and pubertal differences and lack of cardiovascular events. Lipid partitioning among specific fat depots is associated with insulin resistance, which can lead to mitochondrial overload and dysfunctional subcellular energy use and drive the various elements of metabolic syndrome. Multiple environmental factors, in particular a typical Western diet, drive mitochondrial overload, while other changes in Western society, such as stress and sleep deprivation, increase insulin resistance and the propensity for food intake. These culminate in an adverse biochemical phenotype, including development of altered glucose metabolism and early atherogenesis during childhood and early adulthood.
代谢综合征包括一组心血管危险因素（高血压、葡萄糖代谢异常、血脂异常和腹部肥胖），这些在肥胖儿童中出现。然而，代谢综合征也可能发生在瘦人身上，这表明肥胖是该综合征的一个标志物，而不是原因。由于非正态分布疾病的评估依赖于硬性截断值，因此代谢综合征的定义比较困难，而且分类也不统一。由于种族和青春期差异以及缺乏心血管事件，儿童代谢综合征的定义更加困难。特定脂肪储存部位的脂质分配与胰岛素抵抗有关，胰岛素抵抗可导致线粒体过载和功能障碍的细胞内能量利用，并推动代谢综合征的各个要素。多种环境因素，特别是典型的西方饮食，导致线粒体过载，而西方社会的其他变化，如压力和睡眠剥夺，会增加胰岛素抵抗和食物摄入的倾向。这些因素最终导致不良的生化表型，包括儿童和成年早期葡萄糖代谢异常和早期动脉粥样硬化的发展。
