This review examines whether the relations and metabolic parameters necessa
ry for the development of syndrome X are present in children and whether th
e metabolic complications of obesity in children are explained by excess in
traabdominal adipose tissue (IAAT), or visceral fat. Despite the Limited us
e of imaging techniques in research studies, an increasing number of studie
s reported on IAAT and its relation to disease risk in children and adolesc
ents. For this article we reviewed studies that documented the early accumu
lation of IAAT in children and adolescents and the factors that contribute
to variation in the degree of IAAT accumulation. We also reviewed studies t
hat showed the clinical relevance of IAAT in children and adolescents throu
gh significant relations with adverse health effects including dyslipidemia
and glucose intolerance in obese and nonobese children and adolescents of
different ethnic groups.