Battista Michelle, Murray Robert D, Daniels Stephen R
Interdisciplinary PhD Program in Nutrition, The Ohio State University, Nationwide Children's Hospital for Healthy Weight and Nutrition, Columbus, Ohio, USA.
Semin Pediatr Surg. 2009 Aug;18(3):136-43. doi: 10.1053/j.sempedsurg.2009.04.003.
The clustering of traditional cardiovascular disease risk factors is known as the metabolic syndrome. The metabolic syndrome was first characterized as a distinct entity by Dr. Gerald Reaven in 1988. The intent was to identify individuals at greatest risk for cardiovascular disease mortality and those in urgent need of lifestyle intervention. Since then the metabolic syndrome has evolved into a diagnosable entity recognized by the National Cholesterol Education Program, Adult Treatment Panel III, World Health Organization, and the International Diabetes Foundation. However, the metabolic syndrome as a diagnosis faces considerable controversy, particularly when applied to the pediatric population. Due to the changes in growth and development, the adult criteria for the metabolic syndrome cannot be applied to children and adolescents. In fact, currently no all-inclusive definition for the metabolic syndrome exists for pediatrics. Despite its controversies, the identification of the metabolic syndrome and its component disorders in childhood and adolescence offers important information about risk for cardiovascular disease. Emerging evidence points to the presence of early functional and morphologic changes to the heart and blood vessels among obese children with the metabolic syndrome phenotype. Yet, the plasticity of the cardiovascular system during childhood and adolescence allows for the reversal of cardiovascular damage, but only if risks are identified early and treated aggressively. Recent national recommendations and screening directives offer pediatricians a comprehensive guide to risk prevention, assessment, and treatment.
传统心血管疾病风险因素的聚集被称为代谢综合征。1988年，杰拉尔德·雷文博士首次将代谢综合征描述为一种独特的病症。目的是识别心血管疾病死亡风险最高的个体以及那些急需进行生活方式干预的人。从那时起，代谢综合征已演变成一个可诊断的实体，得到了美国国家胆固醇教育计划成人治疗小组第三次报告、世界卫生组织和国际糖尿病联盟的认可。然而，将代谢综合征作为一种诊断面临着相当大的争议，尤其是应用于儿科人群时。由于生长发育的变化，成人代谢综合征的标准不能应用于儿童和青少年。事实上，目前儿科领域尚无关于代谢综合征的全面定义。尽管存在争议，但在儿童和青少年时期识别代谢综合征及其组成疾病，能提供有关心血管疾病风险的重要信息。新出现的证据表明，具有代谢综合征表型的肥胖儿童心脏和血管存在早期功能和形态学变化。然而，儿童和青少年时期心血管系统的可塑性使得心血管损伤有可能逆转，但前提是要尽早识别风险并积极治疗。最近的国家建议和筛查指南为儿科医生提供了风险预防、评估和治疗的全面指导。
