Metabolic complications of obesity in childhood and adolescence: More than just diabetes

PURPOSE OF REVIEW: The alarming increase in the prevalence of pediatric obesity has led to a rise in associated metabolic complications in worldwide pediatric populations. This review summarizes recent literature on detection, pathophysiology, and potential intervention strategies for the metabolic derangements encountered in the overweight pediatric population. RECENT FINDINGS: Development of metabolic complications associated with obesity during childhood track into adulthood and increase the risk for type 2 diabetes and early cardiovascular disease. Clustering of these metabolic abnormalities, which include insulin resistance, hypertension and dyslipidemia, constitutes the metabolic syndrome, which may affect up to 50% of overweight adolescents. Other serious disorders associated with obesity and insulin resistance include polycystic ovary disease and fatty liver. Family and school-based programs focusing on lifestyle modifications, as well as pharmacotherapy, have shown preliminary promise in reversing some of these derangements. SUMMARY: As the trend in pediatric obesity continues to rise, providers must effectively identify children at risk for metabolic disturbances and implement long-lasting, successful treatment regimens. Continued research into the predecessors of cardiovascular disease that begin during childhood and how they can be altered is crucial to the future health of our pediatric population.