Valdez Rodolfo, Greenlund Kurt J, Khoury Muin J, Yoon Paula W
National Office of Public Health Genomics, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mail Stop K-89, Atlanta, GA 30341, USA.
Pediatrics. 2007 Sep;120 Suppl 2:S78-86. doi: 10.1542/peds.2007-1010G.
Several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. In addition, type 2 diabetes and cardiovascular disease seem to share risk factors, including obesity and dyslipidemia, and might even share etiology, which has important implications for screening and prevention strategies for both diseases. Primary prevention, in particular, has gained importance because the results of major randomized, controlled trials strongly suggest that, at least in high-risk adult groups, type 2 diabetes can be prevented or delayed. Furthermore, some intervention studies indicate that the risk factors for diabetes and cardiovascular disease can be reduced in children. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have 1 or more first- or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Currently, there are no overall screening strategies recommended for either diabetes or cardiovascular disease among children and adolescents. The evidence is strong, however, that youth with a positive family history already show signs of increased risk for these conditions. Family history can be part of the approach to screening for children at risk of diabetes and cardiovascular disease and should be part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.
多项研究表明，2型糖尿病或心血管疾病的风险在儿童期即可检测到，尽管这些疾病可能直到成年期才会出现。此外，2型糖尿病和心血管疾病似乎有共同的风险因素，包括肥胖和血脂异常，甚至可能有共同的病因，这对这两种疾病的筛查和预防策略具有重要意义。特别是一级预防变得越发重要，因为大型随机对照试验的结果强烈表明，至少在高危成年人群中，2型糖尿病是可以预防或延缓的。此外，一些干预研究表明，儿童期糖尿病和心血管疾病的风险因素是可以降低的。检测糖尿病或心血管疾病风险的一个简单方法是查看家族病史。大量研究表明，有1名或多名患糖尿病或心血管疾病的一级或二级亲属的成年人患这些疾病或发病的风险很高。目前，对于儿童和青少年，尚无针对糖尿病或心血管疾病的全面筛查策略推荐。然而，有充分证据表明，家族病史呈阳性的青少年已经显示出这些疾病风险增加的迹象。家族病史可以作为筛查有糖尿病和心血管疾病风险儿童的方法之一，也应该成为旨在减轻儿童期这些疾病及其风险因素负担的预防运动的一部分。
