ABSTRACT
Insulin resistance syndrome (IRS), (metabolic syndrome, syndrome X) was first described by Reaven (1) in 1988, as a result of tissue resistance to insulin and the link between insulin resistance (IR) and obesity, Type 2 diabetes (T2DM), coronary artery disease, hypertension, dyslipidemia, and hyperuricemia. IRS has since been expanded from this core phenotype and become known by a variety of names, including metabolic syndrome, dysmetabolic syndrome, and syndrome X. Today, IRS has become increasingly recognized by physicians as a matter of immense public concern because of its frequency and impact upon the health of those affected by it. IRS may affect more than 50% of adults in the United States with even higher prevalences in the highly prone racial groups such as African-Americans, Mexican-Americans, and Native Americans (2). Studies suggest that IRS may originate in utero (3-5). The association of low birth weight and development of IR and, consequently, T2DM has been confirmed in different populations (6,7). Longitudinal studies have shown that children with components of metabolic syndrome in childhood continue with them into adulthood where they acquire more of them (8). Thus, they increase the medical and economic burdens on society with their increased early morbidity and mortality rates (9). Obesity plays a central role in the development of IRS, which increases the risk for development of T2DM and cardiovascular disease (CVD) including hypertension, hypercoagulation, and atherosclerosis (10,11). Diabetes mellitus is rapidly evolving as an epidemic of the 21st century closely following the dramatic rise in obesity rates. The presently estimated worldwide number of 190 million persons afflicted by T2DM is predicted to grow to over 300 million by the year 2025 (12). In the United States, the estimated lifetime risk of diabetes for children born in the year 2000 is more than one in three (13). The increased incidence of T2DM in children parallels the increase in the prevalence and severity of obesity in
children (14). According to the third National Health and Nutrition Examination Survey (NHANES), 4% of all adolescents and nearly 30% of overweight adolescents in the United States have IRS (15). IR was found to predict cardiovascular risk factors in young, healthy adolescents, while body weight during childhood was also observed to play an important role in being predictive of risk factors for CVD (16). Thus, current indications suggest that children born today will live less healthy lives and will die earlier than their parents.
