Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, Ontario, Canada.
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, Ontario, Canada.
Can J Cardiol. 2020 Sep;36(9):1352-1361. doi: 10.1016/j.cjca.2020.06.020. Epub 2020 Jul 3.
The prevalence of obesity in childhood is high and continues to increase globally. It is currently estimated that 381 million children worldwide have overweight or obesity. This disease stems from multiple complex pathways that can present early in life. This is particularly concerning because childhood obesity is associated with cardiovascular risk factors that can lead to early atherosclerosis and premature cardiovascular disease (CVD). Hypertension, dysglycemia, dyslipidemia, and systemic inflammation are associated with vascular changes in childhood, and these contribute to increased risk of cardiovascular events in adulthood if not adequately treated. Interventions to treat childhood obesity include multicomponent family-based behaviour modification programs, which have been demonstrated to have moderate short-term effects on weight-related outcomes; their effects on cardiovascular risk factors, however, are less well understood. Although supervised, structured exercise interventions result in improvements in blood pressure, inflammation, carotid artery intima media thickness, dysglycemia, dyslipidemia, and endothelial dysfunction in children with obesity in the short term, our understanding of how to translate these interventions into long-term sustainable exercise or physical activity recommendations remains uncertain. Research focus in these areas will help in treating childhood obesity and associated CVD risk factors to prevent CVD development in adulthood.
儿童肥胖症的患病率很高，且在全球范围内持续上升。目前估计，全球有 3.81 亿儿童超重或肥胖。这种疾病源于多种复杂的途径，这些途径可能在生命早期就出现。这尤其令人担忧，因为儿童肥胖与心血管危险因素有关，这些危险因素可导致早期动脉粥样硬化和过早的心血管疾病 (CVD)。高血压、血糖异常、血脂异常和全身炎症与儿童时期的血管变化有关，如果得不到适当治疗，这些变化会增加成年后患心血管事件的风险。治疗儿童肥胖症的干预措施包括多成分的以家庭为基础的行为改变方案，这些方案已被证明对体重相关结果有中度的短期效果；然而，它们对心血管危险因素的影响却知之甚少。虽然监督下的结构化运动干预措施可在短期内改善肥胖儿童的血压、炎症、颈动脉内膜中层厚度、血糖异常、血脂异常和内皮功能障碍，但我们如何将这些干预措施转化为长期可持续的运动或体力活动建议仍不确定。在这些领域的研究重点将有助于治疗儿童肥胖症和相关的 CVD 危险因素，以预防成年期 CVD 的发展。
