Choukem Simeon-Pierre, Tochie Joel Noutakdie, Sibetcheu Aurelie T, Nansseu Jobert Richie, Hamilton-Shield Julian P
1Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
Health and Human Development (2HD) Research Network, Douala, Cameroon.
Int J Pediatr Endocrinol. 2020;2020:6. doi: 10.1186/s13633-020-0076-7. Epub 2020 Mar 24.
Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA).
This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population.
We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed.
We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents.
The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.
最近，发展中国家儿童和青少年超重/肥胖现象的增长比例失调，据估计，未来可在儿童期和青少年期确认的心血管疾病（CVD）负担也将随之增加。识别与儿童和青少年超重/肥胖相关的心血管危险因素（CVRF）对于定制CVD预防干预措施至关重要。虽然这在高收入国家已得到广泛研究，但撒哈拉以南非洲（SSA）地区缺乏一致或具有代表性的数据。
本范围综述综合了关于SSA地区儿童和青少年超重及肥胖相关CVRF的当代研究，以提供该人群当前超重/肥胖和CVD负担的证据。
我们检索了截至2019年7月31日的MEDLINE和谷歌学术，查找关于SSA地区儿童和青少年超重/肥胖及CVRF的观察性和实验性研究以及系统综述，无语言限制。四名研究人员两两一组，独立选择并提取相关数据。对所有纳入研究的方法学质量进行评估。
我们纳入了88项研究，共涉及来自20个SSA国家的86,637名儿童和青少年。62项（70.5%）研究的偏倚风险较低，18项（20.5%）为中度，8项（9%）为高度。SSA地区儿童和青少年超重/肥胖现象正以惊人的速度上升。其主要关联因素包括身体活动不足、不健康饮食、高社会经济地位、性别以及高母体体重指数。在超重/肥胖的SSA地区儿童和青少年中确定的CVRF主要是代谢综合征、高血压、血脂异常、糖尿病和葡萄糖耐量异常。对于SSA地区儿童和青少年超重/肥胖或超重/肥胖儿童和青少年中的CVRF管理，缺乏指南或共识。
当前研究结果表明，迫切需要审查SSA地区国家的现行卫生政策。需要开展健康教育，并将SSA地区儿童和青少年当前的致胖环境转变为促进身体活动和健康饮食习惯的环境。
