310
[85]. This remarkable increase in abdominal obesity rate has been analyzed in both
developing and developed countries [86, 87]. The rate of obesity both in children
and adolescents has increased equally [88]. The epidemic of obesity has also been
observed in infants age 6 months and younger; such an outcome cannot be explained
by no physical activity and food choices in this age group [89].
Type 2 Diabetes Mellitus
Diabetes mellitus (DM) has been defined by the American Diabetes Association
(ADA) as: “a group of metabolic diseases characterized by hyperglycemia resulting
from defects in insulin secretion, insulin action, or both [90].” DM may occur due
to the loss of function or pancreatic tissue mass deduction [91]. Type 2 diabetes
(TD2) which is also commonly known as non-insulin dependent diabetes or DM
constitutes 90–95% cases of diabetes and occurs due to dysfunction of pancreatic
beta cells and enhanced insulin resistance [84]. The World Health Organization
(WHO) has observed that worldwide 347 million people are suffering from diabetes
(90% of which is T2D) [92]. Children and young people have shown significant
increase in diabetes prevalence in a short duration [93].
The most important T2D driving factor is obesity; 70% of the T2D risk is associated with weight gain. Obesity is related to insulin resistance that induces the production of beta cells, causing hyperinsulinemia usually in initial stages of MetS and
T2D. Moreover, obesity is neither enough nor necessary for T2D occurrence; these
situations can take place independently. Certainly 57% of the individuals with obesity were not having T2D and 20% of adults having T2D were not overweight [94].
Nonalcoholic Fatty Liver Disease and Hyperlipidemia
The liver is the main organ for lipid metabolism. Nonalcoholic fatty liver disease
(NAFLD) is classified by additional glyceride storage in hepatocytes. Worldwide
25% population is suffering from NAFLD [95] and it accounts for 8% of children
[96]. NAFLD and its more dangerous form, nonalcoholic steatohepatitis (NASH),
are linked with the increasing rate of mortality related to the liver [95], and NAFLD
is one of the risk factors of cardiovascular disease [97]. Hyperlipidemia is the most
common condition which accounts for 69% of NAFLD cases, obesity accounts for
51% of NAFLD cases, T2D (23%) and MetS (43%) [95]. Initially, NAFLD thought
to take place mostly in females [98] but growing evidence reveals that men and possibly post-menopausal women are at greater risk of having NAFLD [99].
Hyperlipidemia is raised level of triglycerides (hypertriglyceridemia), phospholipids, cholesterol (hypercholesterolemia), or a mixture of blood. Moreover, there is a
connection between hyperlipidemia and NAFLD, not all patients suffering from one
disease are by the other [100]. Total cholesterol levels and LDL cholesterol also
S. G. Niazi et al.
[85]. This remarkable increase in abdominal obesity rate has been analyzed in both
developing and developed countries [86, 87]. The rate of obesity both in children
and adolescents has increased equally [88]. The epidemic of obesity has also been
observed in infants age 6 months and younger; such an outcome cannot be explained
by no physical activity and food choices in this age group [89].
Type 2 Diabetes Mellitus
Diabetes mellitus (DM) has been defined by the American Diabetes Association
(ADA) as: “a group of metabolic diseases characterized by hyperglycemia resulting
from defects in insulin secretion, insulin action, or both [90].” DM may occur due
to the loss of function or pancreatic tissue mass deduction [91]. Type 2 diabetes
(TD2) which is also commonly known as non-insulin dependent diabetes or DM
constitutes 90–95% cases of diabetes and occurs due to dysfunction of pancreatic
beta cells and enhanced insulin resistance [84]. The World Health Organization
(WHO) has observed that worldwide 347 million people are suffering from diabetes
(90% of which is T2D) [92]. Children and young people have shown significant
increase in diabetes prevalence in a short duration [93].
The most important T2D driving factor is obesity; 70% of the T2D risk is associated with weight gain. Obesity is related to insulin resistance that induces the production of beta cells, causing hyperinsulinemia usually in initial stages of MetS and
T2D. Moreover, obesity is neither enough nor necessary for T2D occurrence; these
situations can take place independently. Certainly 57% of the individuals with obesity were not having T2D and 20% of adults having T2D were not overweight [94].
Nonalcoholic Fatty Liver Disease and Hyperlipidemia
The liver is the main organ for lipid metabolism. Nonalcoholic fatty liver disease
(NAFLD) is classified by additional glyceride storage in hepatocytes. Worldwide
25% population is suffering from NAFLD [95] and it accounts for 8% of children
[96]. NAFLD and its more dangerous form, nonalcoholic steatohepatitis (NASH),
are linked with the increasing rate of mortality related to the liver [95], and NAFLD
is one of the risk factors of cardiovascular disease [97]. Hyperlipidemia is the most
common condition which accounts for 69% of NAFLD cases, obesity accounts for
51% of NAFLD cases, T2D (23%) and MetS (43%) [95]. Initially, NAFLD thought
to take place mostly in females [98] but growing evidence reveals that men and possibly post-menopausal women are at greater risk of having NAFLD [99].
Hyperlipidemia is raised level of triglycerides (hypertriglyceridemia), phospholipids, cholesterol (hypercholesterolemia), or a mixture of blood. Moreover, there is a
connection between hyperlipidemia and NAFLD, not all patients suffering from one
disease are by the other [100]. Total cholesterol levels and LDL cholesterol also
S. G. Niazi et al.