Metabolic syndrome (MetS) was first described in the mid-1990s as syndrome X and recently also has been referred to as the insulin-resistant syndrome. It consists of dyslipidemia, hypertension, glucose intolerance, and obesity, which, when all factors are present, lead to the greatest risk of developing cardiovascular or coronary disease. Since this initial description, the definition has been refined to include low high-density lipoprotein (HDL) cholesterol, high circulating triglycerides, hypertension, glucose intolerance, and central obesity or increased waist circumference. Although MetS was first described in adults, a retrospective evaluation of pediatric data as far back as the National Health and Nutrition Examination Survey I (NHANES I) study (1988–1994) conducted in the United States suggests that MetS characteristics exist in 3% to 14% of all youth ...

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