Pomahacova Renata, Paterova Petra, Nykodymova Eva, Polak Petr, Sladkova Eva, Skalicka Eva, Sykora Josef
Department of Paediatrics, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023 Dec;167(4):328-334. doi: 10.5507/bp.2023.036. Epub 2023 Sep 4.
Obesity has become a serious medical condition where many factors can contribute to excess weight gain. The most common type of childhood obesity is simple obesity, which is due to gene-obesogenic environment interaction. Only a minority are due to pathological causes. Secondary causes of obesity, while less common, include these: genetic syndromes, drug-related obesity, as well as endocrine disorders (hypothyroidism, Cushing's syndrome, growth hormone deficiency, hypogonadism, pseudohypoparathyroidism type Ia, insulinoma, hypothalamic obesity and polycystic ovary syndrome). Given that some conditions may be treatable, physicians must be aware of obesity due to endocrinopathies and distinguish them from simple obesity, and treat them properly. Although rare among children, early detection of the endocrine cause of obesity leads to reduced morbidity and, in some cases, reduced mortality in these individuals. The aim of this review is to summarize the current findings on obesity-related endocrinopathies in children (illustrated by clinical examples), highlighting aspects of pathogenetic mechanisms, genetics, the clinical diagnosis, growth, body mass index and possible therapeutic approaches. Early detection and correction of endocrine obesity is of paramount importance for obese children who could benefit from timely diagnosis and an improved management of obesity as many disturbances related to obesity can be reversed at the early stage, if weight loss is achieved.
肥胖已成为一种严重的医学状况,许多因素都可能导致体重过度增加。儿童肥胖最常见的类型是单纯性肥胖,这是基因与致肥胖环境相互作用的结果。只有少数是由病理原因引起的。肥胖的继发性原因虽然不太常见,但包括以下这些:遗传综合征、药物相关性肥胖以及内分泌紊乱(甲状腺功能减退、库欣综合征、生长激素缺乏、性腺功能减退、Ia型假性甲状旁腺功能减退、胰岛素瘤、下丘脑性肥胖和多囊卵巢综合征)。鉴于某些情况可能是可治疗的,医生必须了解内分泌疾病导致的肥胖,并将其与单纯性肥胖区分开来,并进行适当治疗。虽然在儿童中很少见,但早期发现肥胖的内分泌原因可降低这些个体的发病率,在某些情况下还可降低死亡率。本综述的目的是总结目前关于儿童肥胖相关内分泌疾病的研究结果(通过临床实例说明),重点介绍发病机制、遗传学、临床诊断、生长、体重指数以及可能的治疗方法等方面。对于肥胖儿童来说,早期发现并纠正内分泌性肥胖至关重要,因为如果实现体重减轻,许多与肥胖相关的紊乱在早期阶段是可以逆转的,这些儿童可以从及时诊断和改善肥胖管理中受益。