Endocrinology Department of Children's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310003, China,
Curr Diab Rep. 2014 Jan;14(1):447. doi: 10.1007/s11892-013-0447-z.
China is gradually taking its place as one of the world's economic giants and concurrently learning to understand how to bear the burdens of diseases that are more common in the fully developed world, such as pediatric obesity, metabolic syndrome, and type 2 diabetes mellitus. The purpose of this review is to consolidate the available information regarding these and draw the focus toward their sequential progression and increasing prevalence in Chinese children. Studies were collected in both English and Chinese, and the data were reviewed on the basis of disease prevalence and risk factors that are known from scientific literature that has been published to date. The majority of studies with appropriate content for inclusion here have been conducted within the last 15 years and up to date information from recent local and international research has also been included. Several factors have been implicated for the rise in obesity, most notably, the progressing economic expansion and exposure of local Chinese populations to Western influences. With this, metabolic syndrome has become a growing concern, as it is a precursor to cardiovascular disease and type 2 diabetes, leading to the alarmingly rapid development of deleterious consequences in children. The International Diabetes Federation proposed a definition for metabolic syndrome in 2007 (MS-IDF2007) worldwide, but whether it is also suitable for the Chinese population remains uncertain, so we have created the Chinese definition of metabolic syndrome upon the IDF framework. This MS-CHN2012 definition is based on multicenter studies to simplify and standardize primary care screening methods and is the first of its kind in China. Juvenile type 2 diabetes is the most worrisome result of obesity and metabolic syndrome, and studies have shown that the prevalence has doubled within 5 years-surpassing the prevalence of juvenile type 1 diabetes. Because of the extremely low number of studies currently published on these topics in China, emphasis needs to be placed on the assessment of the health status of the population. Screening methods are imperative because lifestyle interventions can reduce and even reverse the pathologic consequences of this disease, if detected early.
中国正逐渐成为世界经济大国之一,同时也在学习如何承担发达国家更为常见的疾病负担,如儿童肥胖症、代谢综合征和 2 型糖尿病。本综述的目的是整合有关这些疾病的现有信息,并将重点放在它们在中国儿童中的逐步发展和日益流行上。研究结果以英文和中文收集,根据从已发表的科学文献中了解到的疾病流行率和危险因素进行了综述。这里纳入的大多数内容适当的研究都是在过去 15 年内进行的,同时还纳入了最近来自当地和国际研究的最新信息。有几个因素被认为是肥胖率上升的原因,最显著的是,经济的不断扩张以及当地中国人接触西方的影响。随着肥胖症的增加,代谢综合征已成为一个日益严重的问题,因为它是心血管疾病和 2 型糖尿病的前兆,导致儿童中有害后果的迅速发展。国际糖尿病联合会(International Diabetes Federation)于 2007 年(MS-IDF2007)在全球范围内提出了代谢综合征的定义,但它是否也适用于中国人群尚不确定,因此我们在 IDF 框架的基础上提出了代谢综合征的中国定义。这个 MS-CHN2012 定义是基于多中心研究的,目的是简化和标准化基层医疗的筛查方法,这在中国是首例。青少年 2 型糖尿病是肥胖症和代谢综合征最令人担忧的结果,研究表明,5 年内其患病率翻了一番——超过了青少年 1 型糖尿病的患病率。由于目前在中国发表的关于这些主题的研究数量极少,因此需要重点评估人群的健康状况。筛查方法是必不可少的,因为如果早期发现,生活方式干预可以减轻甚至逆转这种疾病的病理后果。