Park Hyunjin, Choi Jung Eun, Jun Seunghee, Lee Hyelim, Kim Hae Soon, Lee Hye Ah, Park Hyesook
Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.
Clin Exp Pediatr. 2024 Jul;67(7):347-355. doi: 10.3345/cep.2023.00892. Epub 2023 Nov 16.
The global prevalence of childhood and adolescent obesity, exacerbated by the coronavirus disease 2019 pandemic, affects school-aged children and preschoolers. Early-onset obesity, which carries a high risk of metabolic complications, may contribute to a lower age at the onset of cardiovascular disease. As metabolic diseases such as diabetes, dyslipidemia, and nonalcoholic fatty liver disease observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessments from adulthood to childhood to enable early detection. However, consensus is lacking regarding the definition of metabolic diseases in children. In response, various indicators such as the pediatric simple metabolic syndrome score, continuous metabolic syndrome score, single-point insulin sensitivity estimator, and fatty liver index have been proposed in several studies. These indicators may aid the early detection of metabolic complications associated with pediatric obesity, although further validation studies are needed. Obesity assessments are shifting in perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessments. Sarcopenic obesity, defined as the muscle- to-fat ratio, has been proposed in pediatric populations and is associated with metabolic health in children and adolescents. The National Health Screening Program for Children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying groups at a high risk of metabolic complications. Early detection and intervention through comprehensive health screening are critical for mitigating long-term complications of childhood obesity.
2019年冠状病毒病大流行加剧了全球儿童和青少年肥胖的流行，影响着学龄儿童和学龄前儿童。早发性肥胖具有很高的代谢并发症风险，可能导致心血管疾病发病年龄降低。随着在成年期观察到的糖尿病、血脂异常和非酒精性脂肪性肝病等代谢性疾病在儿科人群中越来越受到认可，人们强调将疾病易感性评估从成年期转移到儿童期，以便能够早期发现。然而，关于儿童代谢性疾病的定义缺乏共识。对此，多项研究提出了各种指标，如儿科简单代谢综合征评分、连续代谢综合征评分、单点胰岛素敏感性估计值和脂肪肝指数。这些指标可能有助于早期发现与儿科肥胖相关的代谢并发症，不过还需要进一步的验证研究。肥胖评估的视角正在从视觉上的肥胖转向对代谢健康和身体成分的考量，以填补健康影响评估方面的空白。肌肉与脂肪比率定义的肌少症性肥胖已在儿科人群中被提出，并且与儿童和青少年的代谢健康相关。韩国的全国儿童健康筛查计划已经扩大，但在实验室检测方面仍面临限制。这些检测通过识别代谢并发症高风险群体来促进及时干预。通过全面健康筛查进行早期发现和干预对于减轻儿童肥胖的长期并发症至关重要。
