Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA.
Division of Pediatric Endocrinology and Diabetes, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Rubenstein Bldg, Rm 3114, Baltimore, MD, 21287, USA.
Curr Atheroscler Rep. 2023 Jul;25(7):405-415. doi: 10.1007/s11883-023-01111-4. Epub 2023 May 31.
The global epidemic of youth-onset obesity is tightly linked to the rising burden of cardiometabolic disease across the lifespan. While the link between childhood obesity and cardiovascular disease is established, this contemporary review summarizes recent and novel advances in this field that elucidate the mechanisms and impact of this public health issue.
The review highlights the emerging data supporting the relationship between childhood adverse events, social determinants of health, and systemic and institutional systems as etiological factors. We also provide updates on new screening and treatment approaches including updated nutrition and dietary guidelines and benchmarks for pediatric obesity screening, novel pharmacological agents for pediatric obesity and type 2 diabetes such as glucagon-like 1 peptide receptor agonists, and we discuss the long-term safety and efficacy data on surgical management of pediatric obesity. The global burden of pediatric obesity continues to rise and is associated with accelerated and early vascular aging especially in youth with obesity and type 2 diabetes. Socio-ecological determinants of risk mediate and moderate the relationship of childhood obesity with cardiometabolic disease. Recognizing the importance of neighborhood level influences as etiological factors in the development of cardiovascular disease is critical for designing effective policies and interventions. Novel surgical and pharmacological interventions are effective pediatric weight-loss interventions, but future research is needed to assess whether these agents, within a socio-ecological framework, will be associated with abatement of the pediatric obesity epidemic and related increased cardiovascular disease risk.
全球青少年肥胖症的流行与整个生命周期中心血管代谢疾病负担的增加密切相关。虽然儿童肥胖与心血管疾病之间的联系已得到证实，但本综述总结了该领域的最新进展，阐明了这一公共卫生问题的机制和影响。
本综述强调了支持儿童时期不良事件、健康的社会决定因素以及系统性和制度性系统作为病因因素之间关系的新兴数据。我们还提供了新的筛查和治疗方法的最新信息，包括更新的营养和饮食指南以及儿科肥胖筛查的基准、用于儿科肥胖和 2 型糖尿病的新型药理学药物，如胰高血糖素样肽 1 受体激动剂，并讨论了儿童肥胖症手术管理的长期安全性和疗效数据。全球儿童肥胖症的负担继续增加，与血管老化加速和早期有关，特别是在肥胖和 2 型糖尿病的青少年中。风险的社会生态决定因素调节和缓和了儿童肥胖与心血管代谢疾病之间的关系。认识到邻里水平影响作为心血管疾病发展的病因因素的重要性，对于制定有效的政策和干预措施至关重要。新型手术和药理学干预措施是有效的儿科减重干预措施，但需要进一步研究这些药物是否会在社会生态框架内与减轻儿科肥胖症流行及其相关的心血管疾病风险有关。
