1.12 CME

Sindrom Metabolik pada Anak

Pembicara: Dr. Dhanya Soodhana

Senior Specialist, Pediatric and Adolescent Endocrinology, Aster MIMS, Calicut

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Keterangan

Metabolic syndrome in children is a growing health concern characterized by a cluster of conditions that increase the risk of developing cardiovascular disease and type 2 diabetes. These conditions include abdominal obesity, insulin resistance, high blood pressure, elevated blood sugar levels, and abnormal lipid profiles such as high triglycerides and low HDL cholesterol. The rise in childhood obesity is a significant contributing factor to the prevalence of metabolic syndrome among young populations. Early detection and intervention are crucial, as lifestyle modifications involving diet, physical activity, and behavioral changes can effectively manage and even reverse the components of metabolic syndrome. Addressing these risk factors early helps prevent long-term health complications and promotes healthier futures for affected children.

Ringkasan

  • Metabolic syndrome in children and adolescents is an escalating, underdiagnosed problem with increased risk factors for cardiovascular issues. It involves a clustering of cardiovascular risk factors like hypertension, high triglyceride levels, impaired fasting blood glucose, increased abdominal obesity, and low HDL. Though definitions vary, early identification and intervention are crucial for optimal outcomes.
  • The pathogenesis of obesity, type 2 diabetes, and dyslipidemia involves interconnected mechanisms such as excess adipose tissue, insulin resistance, and bioactive molecules. It's regulated by a defended fat mass set point model, making weight loss more complex than just "calories in vs. calories out." South Asians are at increased risk due to abdominal obesity and increased visceral obesity.
  • Management focuses on lifestyle modifications, including diet and exercise. It includes pharmacological interventions when needed. Medications are often off-label and should be used as adjuncts to lifestyle changes. Specific choices depend on individual factors, such as insulin resistance or history of emotional eating.
  • Early recognition of overweight children is crucial for lifestyle modifications and weight loss, preventing progression to obesity. Goals should be specific and individualized, aiming for 5-10% weight loss gradually to reduce complications. Intense behavioral lifestyle treatment and motivational interviewing are also very important to treat obese children.
  • Pharmacotherapy options include Metformin, Orlistat, and GLP-1 analogs, each targeting different aspects of metabolic syndrome. Specific medications can be chosen based on emotional eating, cravings, or other factors. Regular monitoring of lipid profiles, liver enzymes, glycated hemoglobin, and blood pressure is essential.

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