Yeste D, Carrascosa A
Servicio de Pediatría, Unidades de Endocrinología y Obesidad Pediátrica, Hospital Universitario Vall d' Hebron, Barcelona, Universidad Autónoma de Barcelona, España.
An Pediatr (Barc). 2011 Aug;75(2):135.e1-9. doi: 10.1016/j.anpedi.2011.03.025. Epub 2011 May 14.
Obesity is the most frequent nutritional disorder in childhood and adolescence. The rise in its prevalence and severity has underlined the numerous and significant obesity-related metabolic disorders. Altered glucose metabolism, manifested as impaired glucose tolerance, appears early in severely obese children and adolescents. Obese young people with glucose intolerance are characterized by marked peripheral insulin resistance and relative beta-cell failure. Lipid deposition in muscle and the visceral compartment, and not only obesity per se, is related to increased peripheral insulin resistance, the triggering factor of the metabolic syndrome. Other elements of the metabolic syndrome, such as dyslipidaemia, and hypertension, are already present in obese youngsters and worsen with the degree of obesity. The long-term impact of obesity-related insulin resistance on cardiovascular morbidity in these patients is expected to emerge as these youngsters become young adults.
肥胖是儿童和青少年时期最常见的营养失调症。其患病率和严重程度的上升凸显了众多与肥胖相关的重大代谢紊乱。葡萄糖代谢改变，表现为糖耐量受损，在重度肥胖的儿童和青少年中出现较早。糖耐量不耐受的肥胖青少年的特征是明显的外周胰岛素抵抗和相对的β细胞功能衰竭。肌肉和内脏脂肪沉积，而不仅仅是肥胖本身，与外周胰岛素抵抗增加有关，而外周胰岛素抵抗是代谢综合征的触发因素。代谢综合征的其他因素，如血脂异常和高血压，在肥胖青少年中已经存在，并随着肥胖程度的加重而恶化。随着这些青少年成长为年轻人，预计肥胖相关的胰岛素抵抗对这些患者心血管发病率的长期影响将会显现。
