Pietrobelli Angelo, Malavolti Marcella, Battistini Nino C, Fuiano Nicola
Pediatric Unit, Verona University Medical School, Verona, Italy.
Int J Pediatr Obes. 2008;3 Suppl 1:67-71. doi: 10.1080/17477160801897133.
Obesity is associated with an increased all-cause mortality rate and even small weight losses can be associated with short-term reduction in risk factors for disease. There is strong evidence that weight loss in obese subjects improves risk factors for diabetes and cardiaovascular diseases. Metabolic syndrome (MS) in adults is defined as a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which includes abdominal obesity, dyslipidemia, glucose intolerance and hypertension. Application of the MS concept in children and adolescents is controversial; in fact no consensus exists on a specific definition for pediatric MS. Lack of consensus is in part due to body evolution associated with childhood and puberty that is related to changes in metabolic and clinical characteristics. The aim of this article is to try to clarify the differences between the MS as a concept and the MS as a diagnostic category, as well as to develop a theory related to its pathophysiology. We comment on the relationship between obesity, regional fat distribution and the MS, and finally we offer some insights into MS methodological approaches for estimating metabolic risk-factor clustering in children and adolescents.
肥胖与全因死亡率增加相关，即使是少量体重减轻也可能与疾病风险因素的短期降低有关。有强有力的证据表明，肥胖受试者体重减轻可改善糖尿病和心血管疾病的风险因素。成人代谢综合征（MS）被定义为心血管疾病和2型糖尿病的一组风险因素，包括腹型肥胖、血脂异常、糖耐量异常和高血压。MS概念在儿童和青少年中的应用存在争议；事实上，对于儿童MS的具体定义尚无共识。缺乏共识部分是由于与儿童期和青春期相关的身体发育，这与代谢和临床特征的变化有关。本文的目的是试图阐明作为一个概念的MS和作为一种诊断类别的MS之间的差异，并建立一种与其病理生理学相关的理论。我们评论了肥胖、局部脂肪分布与MS之间的关系，最后我们对评估儿童和青少年代谢风险因素聚集的MS方法学途径提供了一些见解。
