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儿童肥胖症:当前及未来管理方案综述

Childhood obesity: A review of current and future management options.

作者信息

Apperley Louise J, Blackburn James, Erlandson-Parry Karen, Gait Lucy, Laing Peter, Senniappan Senthil

机构信息

Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK.

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK.

出版信息

Clin Endocrinol (Oxf). 2022 Mar;96(3):288-301. doi: 10.1111/cen.14625. Epub 2021 Nov 8.

Abstract

Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.

摘要

肥胖在全球儿童群体中越来越普遍。除了患病率不断上升外,肥胖的严重程度也在持续增加。综合来看,这些发现显示出一个令人担忧的趋势,并凸显了公共卫生面临的最重大挑战之一。儿童肥胖会影响身体的多个器官,并与高发病率以及最终的过早死亡相关。与肥胖相关的并发症,包括血脂异常、高血压、脂肪肝疾病和心理社会并发症,在儿童群体中越来越普遍。目前的治疗指南侧重于通过生活方式和行为改变进行干预,药物治疗和手术则适用于对这种治疗无效的患者。对成人肥胖的研究已经确立了一些新型药物疗法,这些疗法已在临床实践中得到批准和应用;然而,此类疗法在儿童群体中的研究和应用一直滞后。尽管与成人相比,相关研究相对较少,但新的疗法正在进行试验,这将使未来儿童肥胖的治疗选择更加丰富。本综述总结了目前在医学和手术治疗肥胖方面的证据。未来的治疗药物以及那些具有减肥作用但有其他适应证的药物也作为综述的一部分被纳入并进行讨论。该综述总结了每种干预措施的最新研究,并展示了每种治疗选择的潜在疗效和局限性。

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