The border between obesity and metabolic disease in children and adolescents. Why and how to investigate? A review of the literature

The prevalence of childhood overweight and obesity is increasing around the world, which is generating a search for new diagnostic alternatives. Differentiating between metabolically healthy and metabolically unhealthy individuals can help both in the therapeutic plan and in the prognostic view. In this review, we will address the role of the following markers: total cholesterol, high-density cholesterol; low density lipoprotein; triglycerides; uric acid; fasting blood glucose; glycated haemoglobin; insulin; C-peptide; interleukin-6; tumour necrosis factor-α; C-reactive protein; adipokines (leptin and adiponectin); micro ribonucleic acids, plasminogen activator inhibitor type 1, alanine aminotransferase, aspartate aminotransferase, vitamin D and thyroid-stimulating hormone. The presentation of specific reference values for children and adolescents in an objective and practical way will allow the identification the best moment for intervention in this population group.