Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity.

cardiovascular risk childhood obesity childhood overweight dyslipidemia hyperinsulinemia hypertension metabolic syndrome

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
17 Apr 2023
Historique:
received: 13 02 2023
revised: 25 03 2023
accepted: 12 04 2023
medline: 16 5 2023
pubmed: 16 5 2023
entrez: 16 5 2023
Statut: epublish

Résumé

Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity.

Identifiants

pubmed: 37189984
pii: children10040735
doi: 10.3390/children10040735
pmc: PMC10136891
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Références

Pediatrics. 2007 Aug;120(2):340-5
pubmed: 17671060
Curr Diab Rep. 2008 Aug;8(4):279-86
pubmed: 18631440
Front Endocrinol (Lausanne). 2022 Jun 29;13:925976
pubmed: 35846321
Front Endocrinol (Lausanne). 2021 Nov 25;12:780888
pubmed: 34899613
BMC Public Health. 2014 Jan 08;14:14
pubmed: 24400816
Breastfeed Med. 2011 Dec;6(6):367-8
pubmed: 22133032
J Clin Endocrinol Metab. 2007 Jan;92(1):98-103
pubmed: 17032722
Diabetes. 2000 Jun;49(6):1042-8
pubmed: 10866058
Circulation. 2005 Nov 15;112(20):3066-72
pubmed: 16275870
JAMA. 2017 Jun 20;317(23):2427-2444
pubmed: 28632873
World J Hepatol. 2020 Dec 27;12(12):1168-1181
pubmed: 33442446
Circulation. 2020 Aug 18;142(7):621-642
pubmed: 32546049
Front Genet. 2020 Jan 29;10:1270
pubmed: 32082357
Am J Epidemiol. 2000 Nov 15;152(10):908-11; discussion 912
pubmed: 11092432
Diabetes Care. 2020 Jan;43(Suppl 1):S14-S31
pubmed: 31862745
J Pediatr Endocrinol Metab. 2016 May 1;29(5):553-60
pubmed: 26910741
Ann Pediatr Endocrinol Metab. 2020 Jun;25(2):104-111
pubmed: 32615690
J Clin Endocrinol Metab. 2014 Mar;99(3):1044-52
pubmed: 24423351
Obesity (Silver Spring). 2014 Feb;22(2):488-96
pubmed: 23963708
Atherosclerosis. 2008 Jul;199(1):193-200
pubmed: 18031749
Metabolism. 2016 Aug;65(8):1136-50
pubmed: 26477269
Hum Biol. 1986 Oct;58(5):719-35
pubmed: 3804294
Nephrol Dial Transplant. 2017 Sep 01;32(9):1517-1524
pubmed: 27312148
Obes Res. 2005 Dec;13(12):2195-201
pubmed: 16421355
Circulation. 2002 Jun 11;105(23):2712-8
pubmed: 12057983
Eur J Pediatr. 2015 Dec;174(12):1649-55
pubmed: 26141171
Curr Diab Rep. 2016 Jan;16(1):8
pubmed: 26747052
Nutr Rev. 2015 Jun;73(6):376-85
pubmed: 26011912
Environ Pollut. 2020 Oct;265(Pt A):115008
pubmed: 32574892
J Natl Med Assoc. 2017 Autumn;109(3):203-210
pubmed: 28987250
Int J Obes (Lond). 2012 Oct;36(10):1261-9
pubmed: 22710928
Pediatr Rev. 2016 May;37(5):193-202
pubmed: 27139327
Nutrients. 2022 Feb 10;14(4):
pubmed: 35215393
J Biol Chem. 2010 Jun 4;285(23):17271-6
pubmed: 20348094
Nat Rev Endocrinol. 2011 Jun;7(6):346-53
pubmed: 21467970
Int J Obes (Lond). 2007 Apr;31(4):591-600
pubmed: 17384660
Curr Diab Rep. 2007 Feb;7(1):34-42
pubmed: 17254516
Physiol Rep. 2022 Oct;10(19):e15469
pubmed: 36200185
Atherosclerosis. 2010 Dec;213(2):611-5
pubmed: 20971467
J Clin Endocrinol Metab. 2004 Jan;89(1):108-13
pubmed: 14715836
Diabetes Res Clin Pract. 2006 Jun;72(3):315-21
pubmed: 16325296
J Pediatr Endocrinol Metab. 2021 Feb 24;34(4):495-502
pubmed: 33639044
Diabetes. 2001 Nov;50(11):2444-50
pubmed: 11679420
Eur J Endocrinol. 2021 Jul 01;185(2):265-278
pubmed: 34061767
Am J Clin Nutr. 2005 Nov;82(5):1046-51
pubmed: 16280437
J Lipid Res. 2009 Apr;50 Suppl:S335-9
pubmed: 19029122
Environ Health Perspect. 2015 Oct;123(10):1015-21
pubmed: 25910281
Ann Intern Med. 2016 Mar 1;164(5):305-12
pubmed: 26857595
Int J Environ Res Public Health. 2016 Aug 23;13(9):
pubmed: 27563917
Int J Mol Sci. 2018 Jun 02;19(6):
pubmed: 29865233
J Clin Endocrinol Metab. 2010 Dec;95(12):5189-98
pubmed: 20829185
Circulation. 2016 Nov 1;134(18):e367-e386
pubmed: 27647451
Environ Health. 2015 Jun 20;14:54
pubmed: 26092037
Int J Obes Relat Metab Disord. 2003 Nov;27(11):1398-404
pubmed: 14574352
J Clin Endocrinol Metab. 2009 Dec;94(12):4828-34
pubmed: 19837941
Clin Endocrinol (Oxf). 2010 Jun;72(6):770-4
pubmed: 19769620
Diabetes Care. 2005 Apr;28(4):878-81
pubmed: 15793189
Environ Res. 2019 Jun;173:443-451
pubmed: 30974370
Hypertension. 2003 Sep;42(3):247-52
pubmed: 12900431
J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):319-334
pubmed: 28107283
Int J Environ Res Public Health. 2021 Aug 06;18(16):
pubmed: 34444092
Environ Pollut. 2022 Feb 15;295:118632
pubmed: 34906593
Diabetes Metab. 2003 Nov;29(5):526-32
pubmed: 14631330
Obes Res. 2005 Jul;13(7):1135-40
pubmed: 16076981
Reprod Toxicol. 2017 Mar;68:3-33
pubmed: 27760374
Eur J Pediatr. 2023 Feb;182(2):803-812
pubmed: 36482090
Acta Biomed. 2015 Apr 27;86(1):5-16
pubmed: 25948022
Pediatrics. 2011 Dec;128 Suppl 5:S213-56
pubmed: 22084329
J Endocrinol Invest. 2009 May;32(5):401-5
pubmed: 19794287
J Lipid Res. 1999 Mar;40(3):432-8
pubmed: 10064731
Diabetes Care. 2005 Sep;28(9):2289-304
pubmed: 16123508
Environ Sci Pollut Res Int. 2019 Dec;26(35):35670-35686
pubmed: 31728953
J Pediatr Endocrinol Metab. 2017 Jan 1;30(1):49-55
pubmed: 27992361
N Engl J Med. 2014 Sep 18;371(12):1131-41
pubmed: 25229917
Pediatrics. 2017 Sep;140(3):
pubmed: 28827377
Diabetologia. 2020 Jul;63(7):1312-1323
pubmed: 32130460
Nutr Metab Cardiovasc Dis. 2014 Jul;24(7):737-43
pubmed: 24656140
JAMA Pediatr. 2022 Oct 1;176(10):1043-1045
pubmed: 35816325
Mol Med. 2008 Mar-Apr;14(3-4):222-31
pubmed: 18235842
Front Endocrinol (Lausanne). 2022 Nov 14;13:1006008
pubmed: 36452324
Sci Total Environ. 2021 Jul 10;777:146146
pubmed: 33684750
Metabolism. 2006 Aug;55(8):1002-6
pubmed: 16839833
J Cell Physiol. 2019 Jun;234(6):7847-7855
pubmed: 30536398
Trends Biochem Sci. 2009 Oct;34(10):500-10
pubmed: 19729309
J Am Coll Cardiol. 2011 Jun 21;57(25):2461-73
pubmed: 21679848
Pediatr Nephrol. 2015 Dec;30(12):2169-76
pubmed: 26135139
Future Sci OA. 2018 May 23;4(6):FSO310
pubmed: 30057787
Biochem Pharmacol. 2022 May;199:115015
pubmed: 35395240
Int J Obes (Lond). 2015 Jul;39(7):1070-8
pubmed: 25869598
Am J Physiol Endocrinol Metab. 2003 Jun;284(6):E1112-8
pubmed: 12736156
Obes Rev. 2018 Nov;19(11):1476-1491
pubmed: 30156016
Int J Mol Sci. 2022 Jan 25;23(3):
pubmed: 35163268
Int J Epidemiol. 2015 Aug;44(4):1288-304
pubmed: 25855720
Environ Health Prev Med. 2009 Mar;14(2):142-9
pubmed: 19568858
J Clin Invest. 2006 Jul;116(7):1784-92
pubmed: 16823476
Glob Pediatr Health. 2021 Jan 11;8:2333794X20987453
pubmed: 33490309
N Engl J Med. 1986 Jan 16;314(3):138-44
pubmed: 3455748
Hypertension. 2012 Apr;59(4):811-7
pubmed: 22353609
Int J Mol Sci. 2022 Apr 18;23(8):
pubmed: 35457285
Best Pract Res Clin Endocrinol Metab. 2012 Oct;26(5):641-53
pubmed: 22980046
PLoS One. 2022 Jun 16;17(6):e0268503
pubmed: 35709251
Metab Syndr Relat Disord. 2020 Dec;18(10):462-470
pubmed: 32795106
Endocr Metab Immune Disord Drug Targets. 2009 Sep;9(3):269-76
pubmed: 19594415
World J Gastroenterol. 2016 Sep 28;22(36):8078-93
pubmed: 27688650
Circulation. 2010 Oct 19;122(16):1604-11
pubmed: 20921439
Endocr Rev. 2015 Dec;36(6):E1-E150
pubmed: 26544531
Nutrients. 2021 May 28;13(6):
pubmed: 34071499
Arch Dis Child. 2007 Dec;92(12):1067-72
pubmed: 17301109
N Engl J Med. 2022 May 19;386(20):1877-1888
pubmed: 35373933
Environ Pollut. 2022 Dec 15;315:120399
pubmed: 36228844
Medicine (Baltimore). 2020 Jul 24;99(30):e20923
pubmed: 32791673
Int J Environ Res Public Health. 2022 Jul 07;19(14):
pubmed: 35886134
Diabetes Care. 1991 Mar;14(3):173-94
pubmed: 2044434
Diabetologia. 1996 Mar;39(3):298-305
pubmed: 8721775
Diabetes Care. 1999 Feb;22(2):345-54
pubmed: 10333956
J Adolesc Health. 2017 Jul;61(1):107-114
pubmed: 28363717
N Engl J Med. 2004 Jun 3;350(23):2362-74
pubmed: 15175438
Neth Heart J. 2017 Apr;25(4):231-242
pubmed: 28194698
Circulation. 2005 Aug 2;112(5):666-73
pubmed: 16061755
Environ Health Perspect. 2015 Jul;123(7):679-88
pubmed: 25768209
Clin Lab. 2005;51(11-12):625-32
pubmed: 16329620
Nat Rev Microbiol. 2018 Mar;16(3):171-181
pubmed: 29307889
Circulation. 2004 Oct 19;110(16):2494-7
pubmed: 15477412
N Engl J Med. 1998 Jun 4;338(23):1650-6
pubmed: 9614255
Environ Health. 2018 Jan 18;17(1):9
pubmed: 29347948
Clin Obes. 2020 Feb;10(1):e12345
pubmed: 31692279
J Hepatol. 2020 Jul;73(1):202-209
pubmed: 32278004
Nutrients. 2021 May 05;13(5):
pubmed: 34062990
Pediatrics. 2019 May;143(5):
pubmed: 30967484
Front Endocrinol (Lausanne). 2022 Aug 22;13:971202
pubmed: 36072927
Sleep Med Disord. 2017;1(4):
pubmed: 29517065
Am J Epidemiol. 2005 Sep 1;162(5):397-403
pubmed: 16076830
N Engl J Med. 1991 Aug 8;325(6):373-81
pubmed: 2062328
Eur J Clin Nutr. 2018 Sep;72(9):1239-1245
pubmed: 30185840
Diabetol Metab Syndr. 2020 Oct 27;12:93
pubmed: 33117455
Diabetes Metab Res Rev. 2022 Oct;38(7):e3559
pubmed: 35728124
Circ Res. 2003 Dec 12;93(12):1159-69
pubmed: 14670831
Pediatrics. 2017 Aug;140(2):
pubmed: 28739653
Clin Nutr. 2013 Feb;32(1):93-7
pubmed: 22841400
J Am Coll Cardiol. 2014 Sep 9;64(10):997-1002
pubmed: 25190234
Int J Mol Sci. 2022 Sep 05;23(17):
pubmed: 36077575
Acta Paediatr. 2023 Jan;112(1):34-41
pubmed: 35727183
Am J Epidemiol. 1995 Mar 1;141(5):428-39
pubmed: 7879787
Hypertension. 2013 May;61(5):948-51
pubmed: 23460277
Environ Int. 2021 Jun;151:106469
pubmed: 33711537
Int J Pediatr Obes. 2011 Jun;6(2-2):e283-9
pubmed: 21070100
Diabetes Care. 2014 Jul;37(7):1870-7
pubmed: 24742659
Circulation. 2004 Jan 27;109(3):433-8
pubmed: 14744958
Environ Res. 2021 Apr;195:110740
pubmed: 33460636
Int J Pediatr Obes. 2009;4(4):196-204
pubmed: 19922033
Front Public Health. 2022 Jul 06;10:923744
pubmed: 35874993
J Pediatr. 2009 Oct;155(4):535-41
pubmed: 19555970
Am J Epidemiol. 1999 Oct 1;150(7):667-74
pubmed: 10512420
Environ Res. 2019 May;172:454-461
pubmed: 30831435
Horm Res Paediatr. 2010;73(3):166-74
pubmed: 20197668
Child Obes. 2018 Jan;14(1):18-25
pubmed: 29019419
Diabetes. 2009 Apr;58(4):773-95
pubmed: 19336687
Sci Total Environ. 2022 Jul 15;830:154737
pubmed: 35337871
N Engl J Med. 2011 Nov 17;365(20):1876-85
pubmed: 22087679
BMC Med. 2022 Oct 20;20(1):397
pubmed: 36266660
Am J Hum Biol. 2012 May-Jun;24(3):350-60
pubmed: 22378322
Adv Med Sci. 2009;54(2):150-7
pubmed: 19875356
Diabetes Care. 2004 Mar;27(3):775-80
pubmed: 14988301
Diabetes Care. 2010 Nov;33(11):2468-70
pubmed: 20724652
Chemosphere. 2020 Jan;238:124677
pubmed: 31524616
Front Endocrinol (Lausanne). 2020 Mar 03;11:56
pubmed: 32194501
Front Pediatr. 2021 Oct 22;9:745805
pubmed: 34746061
Int J Environ Res Public Health. 2021 Feb 12;18(4):
pubmed: 33673219
Eur J Clin Nutr. 2021 Jul;75(7):1109-1117
pubmed: 33279947
Nutrients. 2020 Apr 14;12(4):
pubmed: 32295104
Front Endocrinol (Lausanne). 2019 Aug 16;10:568
pubmed: 31474943
Front Endocrinol (Lausanne). 2019 Jun 28;10:426
pubmed: 31316471
Am J Gastroenterol. 2010 Sep;105(9):2093-102
pubmed: 20372110
Clin Chem. 2008 Jun;54(6):945-55
pubmed: 18436717
Gastroenterology. 2010 Apr;138(4):1357-64, 1364.e1-2
pubmed: 20064512
N Engl J Med. 2017 Nov 23;377(21):2063-2072
pubmed: 29166236
Front Endocrinol (Lausanne). 2019 Jun 04;10:342
pubmed: 31214120
Nutrients. 2022 Feb 08;14(3):
pubmed: 35277061
Nutrients. 2018 Mar 17;10(3):
pubmed: 29562591
JAMA. 2001 May 16;285(19):2486-97
pubmed: 11368702
Circulation. 2009 Feb 3;119(4):628-47
pubmed: 19139390
Nutr Metab Cardiovasc Dis. 2018 Dec;28(12):1230-1236
pubmed: 30355472
Pediatr Diabetes. 2017 Feb;18(1):59-66
pubmed: 26825860
Clin Epigenetics. 2021 Dec 22;13(1):231
pubmed: 34937578
Ann Glob Health. 2018 Jul 27;84(2):239-249
pubmed: 30873814
Hypertension. 1999 Jul;34(1):144-50
pubmed: 10406838
PLoS One. 2015 Nov 30;10(11):e0143786
pubmed: 26618358
Diabetes Care. 2007 Jul;30(7):1851-6
pubmed: 17440172
Circulation. 2001 Mar 20;103(11):1546-50
pubmed: 11257083
J Am Coll Cardiol. 2013 Oct 8;62(15):1309-19
pubmed: 23954339
Matern Child Nutr. 2018 Jan;14(1):
pubmed: 28597536
Pediatrics. 2016 Mar;137(3):e20153177
pubmed: 26908664
Front Pediatr. 2019 Nov 26;7:491
pubmed: 31850288
Hypertens Res. 2019 Mar;42(3):400-410
pubmed: 30622318
Can J Cardiol. 2020 May;36(5):671-682
pubmed: 32389340
Cardiovasc Diabetol. 2012 Oct 13;11:128
pubmed: 23062212
Int J Obes (Lond). 2022 May;46(5):1018-1026
pubmed: 35091671
J Diabetes Res. 2018 Nov 4;2018:3407306
pubmed: 30525052
Circulation. 2007 May 1;115(17):2316-22
pubmed: 17420347
Front Endocrinol (Lausanne). 2022 Sep 29;13:1006588
pubmed: 36246913
Int J Cardiol. 2022 Feb 1;348:128-133
pubmed: 34902503
Environ Health. 2016 Apr 12;15:50
pubmed: 27071747
Circulation. 2003 Nov 18;108(20):2460-6
pubmed: 14581396
J Clin Endocrinol Metab. 2004 Jan;89(1):207-12
pubmed: 14715851
Environ Int. 2022 Jun 25;166:107375
pubmed: 35777115
Pediatrics. 2013 Sep;132(3):e718-26
pubmed: 23940240
Arch Pediatr Adolesc Med. 2003 Aug;157(8):821-7
pubmed: 12912790
Diabetes. 1988 Dec;37(12):1595-607
pubmed: 3056758
Pediatr Res. 2022 Nov;92(5):1374-1380
pubmed: 35132129
Curr Diab Rep. 2004 Feb;4(1):53-62
pubmed: 14764281
Chemosphere. 2001 Apr;43(2):243-56
pubmed: 11297404
Mater Sociomed. 2020 Jun;32(2):117-122
pubmed: 32843859
Horm Res Paediatr. 2017;88(3-4):181-193
pubmed: 28848168
Front Endocrinol (Lausanne). 2019 Oct 01;10:669
pubmed: 31632348
Endocr Disruptors (Austin). 2015;3(1):
pubmed: 27231701
Nutrients. 2019 Aug 02;11(8):
pubmed: 31382417
FEBS Lett. 2022 Dec;596(24):3107-3123
pubmed: 35957500
Diabetes Care. 2018 Nov;41(11):2421-2430
pubmed: 30275282
Pediatr Diabetes. 2007 Oct;8(5):299-306
pubmed: 17850473
Kidney Int. 2015 Oct;88(4):843-50
pubmed: 26108064
Obes Rev. 2016 Dec;17(12):1258-1275
pubmed: 27452904
Eur J Endocrinol. 2022 May 16;187(1):15-26
pubmed: 35521698
Int J Obes (Lond). 2014 Sep;38 Suppl 2:S4-14
pubmed: 25376220
Placenta. 2014 Feb;35 Suppl:S39-45
pubmed: 24378039
Ital J Pediatr. 2018 Jul 31;44(1):88
pubmed: 30064525
Arterioscler Thromb Vasc Biol. 2008 Jun;28(6):1039-49
pubmed: 18356555
J Pediatr (Rio J). 2022 Mar-Apr;98 Suppl 1:S73-S85
pubmed: 34921754
J Clin Endocrinol Metab. 2015 Jan;100(1):301-8
pubmed: 25243573
J Pediatr. 2008 Feb;152(2):201-6
pubmed: 18206689
Environ Res. 2017 Nov;159:606-612
pubmed: 28917205
Lancet. 2001 Oct 27;358(9291):1400-4
pubmed: 11705484
Pediatr Res. 2017 Sep;82(3):405-415
pubmed: 28426647
Int J Pediatr Obes. 2008 Oct 1;3 Suppl 2:3-8
pubmed: 18850405
Pediatrics. 2011 Mar;127(3):e544-51
pubmed: 21300681
Am J Epidemiol. 2012 Oct 1;176 Suppl 7:S142-9
pubmed: 23035138
Curr Obes Rep. 2017 Mar;6(1):18-27
pubmed: 28205155
Atherosclerosis. 2006 Jun;186(2):345-53
pubmed: 16129441
Int J Obes (Lond). 2015 Apr;39(4):650-7
pubmed: 24158121
PLoS One. 2016 Feb 22;11(2):e0149351
pubmed: 26901828

Auteurs

Malgorzata Wasniewska (M)

Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy.

Giorgia Pepe (G)

Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy.

Tommaso Aversa (T)

Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy.

Simonetta Bellone (S)

Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.

Luisa de Sanctis (L)

Department of Public Health and Pediatric Sciences, University of Torino, 10126 Turin, Italy.

Procolo Di Bonito (P)

Department of Internal Medicine, "Santa Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy.

Maria Felicia Faienza (MF)

Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy.

Nicola Improda (N)

Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy.

Maria Rosaria Licenziati (MR)

Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy.

Claudio Maffeis (C)

Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy.

Alice Maguolo (A)

Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy.

Giuseppina Patti (G)

Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, 16128 Genova, Italy.

Barbara Predieri (B)

Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41124 Modena, Italy.

Mariacarolina Salerno (M)

Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy.

Stefano Stagi (S)

Health Sciences Department, University of Florence and Meyer Children's Hospital IRCCS, 50139 Florence, Italy.

Maria Elisabeth Street (ME)

Unit of Paediatrics, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126 Parma, Italy.

Giuliana Valerio (G)

Department of Movement Sciences and Wellbeing, University of Napoli "Parthenope", 80133 Napoli, Italy.

Domenico Corica (D)

Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy.

Valeria Calcaterra (V)

Department of Pediatrics, "Vittore Buzzi" Children's Hospital, 20157 Milano, Italy.

Classifications MeSH