| Abstract | | At the same time as the epidemic of obesity in children and adolescents, we are also witnessing an epidemic rise in its complications, including the metabolic syndrome. Concomitantly present, commonly rooted and interconnected risk factors (hypertension, insulin resistance, diabetes mellitus) are probably directly involved in the development, progression and complications of atherosclerosis. The increased atherosclerotic cardiovascular risk is usually related to a complex disorder of lipid metabolism, called atherogenic dyslipidaemia, which is mainly due to the increased presence of apoB lipoproteins, in particular small, dense low-density lipoprotein cholesterol (LDL) particles and reduced levels of highdensity lipoprotein cholesterol (HDL) particles. Thus the priority goal of treatment of atherogenic dyslipidaemia is to normalise the levels of LDL- and non-HDL cholesterol, followed by measures to increase HDL-cholesterol. The cornerstone of dyslipidaemia treatment in the metabolic syndrome is always appropriate lifestyle change, a more healthy diet (antiatherogenic and antidiabetogenic) and an increase in the level of regular physical activity. Lipid-lowering pharmacological treatment is rarely indicated in children, and only if intensive and consistent measures to change the lifestyle prove completely unsuccessful, as the currently available drugs do not address the underlying mechanisms of the lipid abnormalities.
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