Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Endocrinol Diabetes Obes. 2011 Feb;18(1):23-7. doi: 10.1097/MED.0b013e3283424b37.
Childhood obesity is rising to epidemic proportions throughout the world, and much emphasis has been placed on the long-term consequences that can result later, in adulthood. This article reviews the metabolic consequences of obesity that can manifest as disease during the childhood years.
Obese children suffer from many disease processes once thought to affect only adults. They can have type 2 diabetes mellitus, and potentially early β cell failure with rapid progression to an insulin requirement. There is a high prevalence of fatty liver disease in obese children, and complications such as steatohepatitis and even cirrhosis can develop during childhood. Visceral fat has been shown to have many different properties than subcutaneous fat, and children with central adiposity can develop the metabolic syndrome with insulin resistance, hypertension, and dyslipidemia. Hyperandrogenism, sleep disturbances, and many types of orthopedic complications can also develop in young children.
Physicians should not only warn obese children and their families about the long-term consequences of obesity for which they are at risk in adulthood, they should also screen for the many diseases that may already be present.
在全球范围内，儿童肥胖症的发病率呈上升趋势，人们高度重视肥胖可能给成年后带来的长期后果。本文综述了肥胖在儿童时期可能表现为疾病的代谢后果。
肥胖儿童会患许多以前认为仅影响成年人的疾病。他们可能患有 2 型糖尿病，并且β细胞功能衰竭的风险较高，可能迅速进展为胰岛素依赖。肥胖儿童中脂肪肝的发病率很高，在儿童时期可能会出现脂肪性肝炎和甚至肝硬化等并发症。内脏脂肪具有与皮下脂肪不同的许多特性，具有中心性肥胖的儿童可出现胰岛素抵抗、高血压和血脂异常的代谢综合征。高雄激素血症、睡眠障碍和许多类型的骨科并发症也可能在幼儿中出现。
医生不仅应警告肥胖儿童及其家属肥胖对其成年后患长期疾病的风险，还应筛查可能已经存在的多种疾病。
