Children with a classic form of congenital adrenal hyperplasia (CCAH) have a potentially increased risk of unfavorable cardiometabolic events due to the interplay of corticosteroid treatment, hyperandrogenism, and other factors. Although readily recognized in adults, these aspects are frequently overlooked in children and youth with CCAH; Aim: To review the evidence available from studies regarding cardiometabolic health outcomes in CCAH patients; Methods: A review of the literature was performed following PRISMA guidelines, including studies published between 2000 and 2024. We included studies reporting cardiometabolic outcomes in children and adolescents (<18 years) with CCAH. Where pediatric data were sparse, additional data were obtained from studies with older adolescents and young adults (15–25 years). Cardiometabolic outcomes included risk factors, such as obesity, insulin resistance, lipids, blood pressure, and vascular markers; Results: Twenty-five studies were analyzed. The prevalence of obesity was found to be higher in children with CCAH, as well as of increased visceral adiposity. Higher indices of insulin resistance were also a frequent finding in children with CCAH. CCAH patients had higher systolic blood pressure and more frequently loss of nocturnal blood pressure dipping, particularly among salt-wasting subtypes and in younger children. Subclinical atherosclerosis was indicated by increased carotid intima–media thickness, elevated hs-CRP, and impaired endothelial function. Other findings suggested changes in lipid profiles, particularly decreased HDL-c and increased triglycerides, although the findings were less consistent; Conclusions: Compared with the general pediatric population, children with CCAH were found to have an increase in multiple cardiometabolic risk factors. It is therefore vital to monitor these risk factors in pediatric CCAH, as well as tailoring treatment with cardiometabolic health in mind, to achieve better long-term cardiovascular and metabolic outcomes. Future research should focus on longitudinal studies of cardiometabolic outcomes and innovative therapeutic approaches to reduce these risks in patients with CCAH.

Childhood obesity is an important global health issue closely related to metabolic syndrome and metabolic dysfunction-associated fatty liver disease (MASLD), currently the most common chronic liver disease in children. Oxidative stress and insulin resistance are the driving forces in hepatocyte injury and disease progression. There is growing interest in new biomarkers for detecting and monitoring metabolic and hepatic changes. We aimed to synthesize current evidence regarding biomarkers of oxidative stress and MASLD, and the potential modulatory role of selenium in pediatric populations. A literature search of PubMed, Scopus, Web of Science, and the Cochrane Library identified studies in children and adolescents (0–18 years) published between January 2000 and December 2025. Associative diagnostic biomarkers included indicators of oxidative damage, antioxidant-defense markers, and integrated oxidative stress indices, which appear promising but lack pediatric reference ranges, while prognostic biomarkers capture the inflammatory consequences of redox imbalance but with limited liver specificity. Metabolomics profiling and multiomics approaches remain experimental. Selenium, an essential trace element with antioxidant properties, plays a role in maintaining redox balance through selenoproteins, but pediatric evidence is limited and at times contradictory. Few biomarkers are clinically ready. Further longitudinal studies in pediatric populations are needed to better clarify the role of selenium, as well as to support the development of age-appropriate diagnostic strategies utilizing multiomics for MASLD, empowering clinicians to implement timely interventions in childhood obesity.