Marketou Maria E, Buechler Natalia Simantiraki, Fragkiadakis Kostantinos, Plevritaki Anthoula, Zervakis Stelios, Maragkoudakis Spyros, Tsiavos Alexandros, Simantirakis Emmanouel, Kochiadakis George
Cardiology Department, Heraklion University General Hospital, Crete, Greece.
Department of Pediatrics, St. Elisabethen Hospital, Loerrach, Germany.
Pediatr Res. 2023 Nov;94(5):1639-1647. doi: 10.1038/s41390-023-02709-9. Epub 2023 Jul 4.
Cardiovascular disease (CVD) is a process whose pathogenetic mechanisms start very early in life. Recently, the importance of visceral adipose tissue (VAT) has been highlighted in the development of CVD. VAT does not always depend on body mass index (BMI) and has been implicated in unfavorable metabolic activity and cardiovascular adverse events. Abnormally high deposition of VAT is associated with metabolic syndrome, obesity-associated phenotype, and cardiometabolic risk factors. Although the importance of visceral fat has not been studied broadly or extensively in long-term studies in children and adolescents, it appears that it does not have the same behavior as in adults, it is related to the appearance of cardiac risk factors. In adolescents, it plays a role in the pathogenesis of CVD that occur later in adulthood. Excess body weight and adiposity may lead to the development of early myocardial and pathological coronary changes in childhood. The purpose of this review is to summarize the risk factors, the clinical significance, and the prognostic role of visceral obesity in children and adolescents. In addition, extensive reference is made to the most commonly used techniques for the evaluation of VAT in clinical settings. IMPACT: Visceral obesity, plays an important role in cardiovascular health from very early in an individual's life. Visceral adipose tissue (VAT) distribution is not entirely related to body mass index (BMI) and provides additional prognostic information. There is a need to pay more attention to the assessment of VAT in young people, to develop methods that would go beyond the measurement of only BMI in clinical practice and to identify individuals with excess visceral adiposity and perhaps to monitor its changes.
心血管疾病（CVD）是一个发病机制在生命早期就开始的过程。最近，内脏脂肪组织（VAT）在心血管疾病发展中的重要性已得到强调。内脏脂肪组织并不总是取决于体重指数（BMI），并且与不良代谢活动和心血管不良事件有关。内脏脂肪组织异常高沉积与代谢综合征、肥胖相关表型和心脏代谢危险因素相关。尽管在儿童和青少年的长期研究中尚未广泛或深入地研究内脏脂肪的重要性，但它似乎与成年人的行为不同，它与心脏危险因素的出现有关。在青少年中，它在成年后期发生的心血管疾病发病机制中起作用。超重和肥胖可能导致儿童期早期心肌和病理性冠状动脉改变的发展。本综述的目的是总结儿童和青少年内脏肥胖的危险因素、临床意义和预后作用。此外，还广泛参考了临床环境中评估内脏脂肪组织最常用的技术。影响：内脏肥胖在个体生命的很早阶段就对心血管健康起着重要作用。内脏脂肪组织（VAT）分布并不完全与体重指数（BMI）相关，并提供额外的预后信息。有必要更加关注年轻人内脏脂肪组织的评估，开发超越临床实践中仅测量BMI的方法，识别内脏脂肪过多的个体，并可能监测其变化。
