DOES BARIATRIC SURGERY HAVE A ROLE IN THE METABOLIC SYNDROME IN PEDIATRICS?

• Autor(a) principal: Urbano, Filipa
• Data de Publicação: 2023
• Outros Autores: Simão, Carla
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.58043/rphrc.102
• topic: hipertensão essencial; síndrome metabólica; obesidade pediátrica; doenças cardiovasculares; cirurgia bariátrica; comportamentos de redução do risco; essential hypertension; metabolic syndrome; pediatric obesity; cardiovascular diseases; bariatric surgery; risk reduction behavior

Introduction: Metabolic syndrome is the combination of arterial hypertension, obesity, visceral adiposity, insulin resistance and dyslipidemia. These cardiovascular risk factors influence each other and the treatment of this syndrome as a whole is essential for the control of each of these factors. Non-pharmacological measures are the mainstay of treatment, followed by pharmacological therapy. Nevertheless, bariatric surgery has become an increasingly used complementary therapeutic approach, with good results, particularly in cases not controlled with conservative therapeutic measures. Case description: 14-year-old adolescent with a family history of cardiovascular risk, sedentary, with visceral obesity, insulin resistance, hepatic steatosis and a recent diagnosis of high blood pressure. The lack of control of the clinical situation with non-pharmacological and pharmacological therapy determined the bariatric surgery at 15 years old. Subsequent follow-up revealed global clinical improvement associated with a marked reduction in body mass index, normalization of blood pressure and insulin values, and improvement in hepatic steatosis. Additionally, there was an overall feeling of well-being after the surgery, with greater acceptance and adherence to non- pharmacological measures to control different risk factors, not verified before the surgery. Discussion: Metabolic syndrome has a polygenic cause and is associated with different modifiable and non-modifiable cardiovascular risk factors, whose global control is essential. Nevertheless, this factors’ association limits the effectiveness of isolated medical intervention and, in some cases, surgical therapy is essential. Bariatric surgery has been shown to be a successful method and should be accessible and done early. Conclusions: Acting early in the prevention of cardiovascular diseases represents the possibility of changing the natural history of these important systemic diseases.