Schwab K O
Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Mathildenstr. 1, 79106, Freiburg im Breisgau, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Apr;56(4):551-4. doi: 10.1007/s00103-012-1635-8.
Childhood obesity is associated with cardiovascular events in adulthood. Multidisciplinary conventional obesity treatment programmes may reduce the body mass index standard deviation score at any age. However, over the years they lose their effectiveness especially during childhood. Only one study dealing with adult type 2 diabetic patients could show persistent weight reduction over the period of 4 years. Therefore, these conventional programmes may have short-term but no long-term influence on cardiovascular events. Bariatric surgery in childhood is exclusively performed in cases of morbid obesity. In adults, experience with regard to persistent weight loss has existed for over 20 years now and has reached good therapeutic results in type 2 diabetes. However, randomized and controlled long-term studies as to cardiovascular events and death do not exist. The Swedish Obese Subjects (SOS) study showed a significant decrease of cardiovascular events and death in the bariatric surgery study group compared to the conventional therapy group, but the groups were not randomized. The surgery group was younger and healthier compared to the conservatively treated group. The late start of therapy probably also had an unfavourable influence on cardiovascular events.
儿童肥胖与成年期心血管事件相关。多学科传统肥胖治疗方案可能会降低任何年龄段的体重指数标准差评分。然而，多年来这些方案会失去其有效性，尤其是在儿童期。仅有一项针对成年2型糖尿病患者的研究显示，在4年期间体重持续减轻。因此，这些传统方案可能对心血管事件有短期而非长期影响。儿童肥胖症手术仅在病态肥胖的情况下进行。在成人中，关于持续减重的经验已有20多年，并且在2型糖尿病方面已取得良好的治疗效果。然而，尚无关于心血管事件和死亡的随机对照长期研究。瑞典肥胖受试者（SOS）研究表明，与传统治疗组相比，肥胖症手术研究组的心血管事件和死亡显著减少，但两组并非随机分组。与保守治疗组相比，手术组更年轻且更健康。治疗开始较晚可能也对心血管事件产生了不利影响。
