Raj Manu
Population Health Research Institute (PHRI) and David Braley Cardiac, Vascular, and Stroke Research Institute (DBCVSRI), Hamilton, Ontario, Canada.
Indian J Endocrinol Metab. 2012 Jan;16(1):13-9. doi: 10.4103/2230-8210.91176.
The global prevalence of overweight and obesity in children and adolescents has increased substantially over the past several decades. These trends are also visible in developing economies like India. Childhood obesity impacts all the major organ systems of the body and is well known to result in significant morbidity and mortality. Obesity in childhood and adolescence is associated with established risk factors for cardiovascular diseases and accelerated atherosclerotic processes, including elevated blood pressure (BP), atherogenic dyslipidemia, atherosclerosis, metabolic syndrome, type II diabetes mellitus, cardiac structural and functional changes and obstructive sleep apnea. Probable mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system and altered vascular function. Adiposity promotes cardiovascular risk clustering during childhood and adolescence. Insulin resistance has a strong association with childhood obesity. A variety of proinflammatory mediators that are associated with cardiometabolic dysfunction are also known to be influenced by obesity levels. Obesity in early life promotes atherosclerotic disease in vascular structures such as the aorta and the coronary arteries. Childhood and adolescent adiposity has strong influences on the structure and function of the heart, predominantly of the left ventricle. Obesity compromises pulmonary function and increases the risk of sleep-disordered breathing and obstructive sleep apnea. Neglecting childhood and adolescent obesity will compromise the cardiovascular health of the pediatric population and is likely to result in a serious public health crisis in future.
在过去几十年中，全球儿童和青少年超重及肥胖的患病率大幅上升。这些趋势在印度等发展中经济体也很明显。儿童肥胖会影响身体所有主要器官系统，众所周知会导致显著的发病率和死亡率。儿童期和青少年期肥胖与心血管疾病的既定风险因素以及加速的动脉粥样硬化进程相关，包括血压升高、致动脉粥样硬化血脂异常、动脉粥样硬化、代谢综合征、2型糖尿病、心脏结构和功能改变以及阻塞性睡眠呼吸暂停。肥胖相关高血压的可能机制包括胰岛素抵抗、钠潴留、交感神经系统活动增加、肾素 - 血管紧张素 - 醛固酮系统激活以及血管功能改变。肥胖会促使儿童期和青少年期心血管风险聚集。胰岛素抵抗与儿童肥胖密切相关。已知多种与心脏代谢功能障碍相关的促炎介质也受肥胖程度影响。早年肥胖会促进主动脉和冠状动脉等血管结构中的动脉粥样硬化疾病。儿童期和青少年期肥胖对心脏结构和功能有很大影响，主要是对左心室。肥胖会损害肺功能，增加睡眠呼吸紊乱和阻塞性睡眠呼吸暂停的风险。忽视儿童期和青少年期肥胖将损害儿童群体的心血管健康，并可能在未来导致严重的公共卫生危机。
