Shashaj Blegina, Graziani Maria Pia, Tozzi Alberto Eugenio, Manco Melania
Recenti Prog Med. 2014 Dec;105(12):454-6. doi: 10.1701/1706.18614.
Prevalence of overweight and obesity in childhood has substantially increased worldwide in recent decades with children becoming obese at progressively younger ages. Obesity in children carries a wide range of serious complications, and contributes to an increased prevalence of cardiovascular risk factors such as hypertension, hypertrygliceridema, low high-density lipoprotein cholesterol (HDL), impaired glucose metabolism and early atherosclerotic changes not only in adulthood but since in very early pediatric age. In the ORIGIN study (Outcome Reduction with an Initial Glargine Intervention), cardiometabolic risk factors including fatty liver were already detectable in preschoolers at the onset of overweight/obesity despite short-term exposure to excess weight and fairly reduced insulin sensitivity. These facts together with the evidence that early cardiometabolic impairment reverts with lifestyle intervention in pediatric age, emphasize the need to start prevention of childhood obesity and screening of cardiometabolic co-morbities at the earliest stage with multidisciplinary strategies.
近几十年来，全球儿童超重和肥胖的患病率大幅上升，儿童肥胖的年龄越来越小。儿童肥胖会引发一系列严重并发症，不仅在成年期，而且在儿童早期就会导致心血管危险因素的患病率增加，如高血压、高甘油三酯血症、低高密度脂蛋白胆固醇（HDL）、糖代谢受损和早期动脉粥样硬化改变。在ORIGIN研究（甘精胰岛素初始干预降低结局研究）中，尽管超重/肥胖的时间较短且胰岛素敏感性相当低，但在学龄前儿童超重/肥胖开始时就已经可以检测到包括脂肪肝在内的心脏代谢危险因素。这些事实，再加上早期心脏代谢损害可通过儿童期生活方式干预得到逆转的证据，强调了需要尽早通过多学科策略开展儿童肥胖预防和心脏代谢合并症筛查。
