Department of Pediatrics, University of Chieti, Chieti, Italy.
Paediatric Outpatient Department, Moscow, Russia.
Front Endocrinol (Lausanne). 2022 Nov 16;13:1061524. doi: 10.3389/fendo.2022.1061524. eCollection 2022.
In our modern society, where highly palatable and calorie-rich foods are readily available, and sedentary lifestyle is common among children and adolescents, we face the pandemic of obesity, nonalcoholic fatty liver disease, hypertension, atherosclerosis, and T2D. Insulin resistance (IR) is known to be the main underlying mechanism of all these associated health consequences; therefore, the early detection of IR is fundamental for preventing them.A Consensus Statement, internationally supported by all the major scientific societies in pediatric endocrinology, was published in 2010, providing all the most recent reliable evidence to identify the definition of IR in children, its measurement, its risk factors, and the effective strategies to prevent and treat it. However, the 2010 Consensus concluded that further research was necessary to assess some of the discussed points, in particular the best way to measure insulin sensitivity, standardization of insulin measurements, identification of strong surrogate biomarkers of IR, and the effective role of lifestyle intervention and medications in the prevention and treatment of IR.The aim of this review is to update each point of the consensus with the most recent available studies, with the goal of giving a picture of the current state of the scientific literature regarding IR in children, with a particular regard for issues that are not yet fully clarified.
在我们的现代社会,高可口和高热量的食物随处可得,儿童和青少年普遍久坐不动,因此我们面临肥胖症、非酒精性脂肪肝疾病、高血压、动脉粥样硬化和 T2D 的流行。胰岛素抵抗(IR)是所有这些相关健康后果的主要潜在机制;因此,早期发现 IR 对于预防这些疾病至关重要。2010 年发表了一项国际上得到所有儿科内分泌主要科学协会支持的共识声明,提供了所有最新的可靠证据来确定儿童 IR 的定义、测量方法、危险因素以及预防和治疗的有效策略。然而,2010 年的共识认为,有必要进一步研究一些讨论的要点,特别是衡量胰岛素敏感性的最佳方法、胰岛素测量的标准化、IR 的强替代生物标志物的鉴定,以及生活方式干预和药物在预防和治疗 IR 中的有效作用。
本综述的目的是用最新的可用研究更新共识中的每一个要点,以了解儿童 IR 领域的当前科学文献状况,特别关注尚未完全阐明的问题。