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The 10th EFLM Symposium for Balkan Region under the title »Pediatric Laboratory Medicine: Some Aspects of Obesity, Metabolic Syndrome, Neonatal Screening, Reference and Critical Values« has featured 15 lectures on these topics delivered by lecturers from Europe, Canada, Serbia, Slovenia and Macedonia. The intention was to use this condensed time frame to discuss five very important issues in pediatric laboratory medicine. Namely, the sudden increase in the prevalence of childhood obesity, with its related co-morbidities such as hypertriglyceridemia, hyperinsulinemia, hypertension, early atherosclerosis, metabolic syndrome and non-alcoholic fatty liver disease (NAFLD), has brought about major health care problems in many countries. This highlights the importance of timely monitoring the obesity trends in children and adolescents, especially with the increased frequency of the metabolic syndrome expected in this population in the near future (1). In parallel with the increase in the prevalence of obesity and metabolic syndrome, non-alcoholic fatty liver disease has become recognized as the most frequently occurring hepatopathy in adults and children. Due to the heterogeneity of diagnostic methods used to establish a diagnosis in the available studies and the different characteristics of the populations examined, the exact prevalence of pediatric NAFLD is still unknown. Age, sex and race/ethnicity are recognized as significant risk determinants, and pathogenetic roles have been established for the sex hormones, insulin sensitivity and adipocytokines (2). Metabolic workup is recommended even for the youngest age group of 2–6 years. There is data pointing to birth weight as a factor in the occurrence of obesity and its complications in later life (3). Conditions such as isolated impaired fasting glucose or impaired glucose tolerance or a combination of these two glucose disturbances may be defined as prediabetes (4).