Nazim Joanna, Starzyk Jerzy
Klinika Endokrynologii Dzieci i Młodziezy Katedry Pediatrii, Polsko-Amerykański Instytut Pediatrii, Uniwersytet Jagielloński Collegium Medium w Krakowie.
Przegl Lek. 2009;66(1-2):96-9.
The significant increase in the prevalence of obesity in children and adolescents over past decades caused the concomitant rise in the incidence of glucose intolerance and diabetes. Impaired glucose tolerance is present in 10-27% of obese children, while type 2 diabetes accounts for more than 10% of all cases of diabetes in Caucasian adolescents. Obesity may also accelerate the onset of type 1 diabetes. Insulin resistance with visceral and intramyocellular lipid accumulation, reduced adiponectin level and elevation of inflammatory cytokines play an important role in the pathogenesis of glucose metabolism disturbances. This article presented the influence of obesity on the development and clinical presentation of different types of diabetes and addresses the problems of differential diagnosis of diabetes type in obese children and adolescents. The recommendations for case finding and the treatment options taking into account the pathophysiology underlying hyperglycemia were discussed.
在过去几十年中，儿童和青少年肥胖患病率的显著增加导致了葡萄糖耐量异常和糖尿病发病率的随之上升。10%-27%的肥胖儿童存在糖耐量受损，而在白种人青少年中，2型糖尿病占所有糖尿病病例的10%以上。肥胖还可能加速1型糖尿病的发病。内脏和肌细胞内脂质堆积导致的胰岛素抵抗、脂联素水平降低以及炎症细胞因子升高在糖代谢紊乱的发病机制中起重要作用。本文介绍了肥胖对不同类型糖尿病发生发展及临床表现的影响，并探讨了肥胖儿童和青少年糖尿病类型的鉴别诊断问题。还讨论了基于高血糖潜在病理生理学的病例发现建议和治疗选择。
