Boddu Sirisha Kusuma, Giannini Cosimo, Marcovecchio M Loredana
Department of Pediatric Endocrinology and Diabetes, Rainbow Children's Hospital, Hyderabad, Telangana, India.
Department of Paediatrics, University of Chieti, Chieti, Italy.
Diabetologia. 2025 Jun 17. doi: 10.1007/s00125-025-06450-2.
Youth-onset metabolic diseases, including obesity and type 1 and type 2 diabetes, and their associated cardiometabolic complications represent a major global health challenge. The incidence and prevalence of these conditions vary across regions, with rising trends and a heavier burden observed in middle- and low-income countries. Diet, physical activity and lifestyle choices are key factors in the development and progression of metabolic diseases during childhood and adolescence, along with additional risk factors such as genetic predisposition, ancestry, ethnicity, lifetime events (i.e. puberty) and other environmental factors. Disparities in access to healthcare, diagnostic and management capabilities and treatment options across the world affect outcomes, contributing to high morbidity and mortality rates, particularly in low-resource settings. Compared with onset during adulthood, an early diagnosis of metabolic diseases is associated with a higher risk and severity of complications, including adverse vascular outcomes and premature mortality. Although clinical signs of cardiovascular complications typically appear in adulthood, they are the result of a long, subclinical disease process that can begin in childhood and adolescence. This underscores the need for early prevention strategies and effective treatments to reduce the short- and long-term health impacts of these conditions. Addressing the rising prevalence of metabolic diseases, especially among vulnerable populations, requires comprehensive, culturally tailored actions that consider the available resources in diverse settings.
青少年期发病的代谢性疾病，包括肥胖症、1型和2型糖尿病及其相关的心脏代谢并发症，是全球主要的健康挑战。这些疾病的发病率和患病率因地区而异，在中低收入国家呈上升趋势且负担更重。饮食、身体活动和生活方式选择是儿童和青少年时期代谢性疾病发生和发展的关键因素，此外还有其他风险因素，如遗传易感性、祖籍、种族、生命周期事件（如青春期）和其他环境因素。全球范围内，在获得医疗保健、诊断和管理能力以及治疗选择方面的差异影响治疗结果，导致高发病率和死亡率，特别是在资源匮乏地区。与成年期发病相比，代谢性疾病的早期诊断与并发症的更高风险和严重程度相关，包括不良血管结局和过早死亡。虽然心血管并发症的临床症状通常在成年期出现，但它们是一个漫长的亚临床疾病过程的结果，这个过程可能始于儿童期和青少年期。这凸显了早期预防策略和有效治疗的必要性，以减少这些疾病对短期和长期健康的影响。应对代谢性疾病患病率的上升，尤其是在弱势群体中的上升，需要采取全面的、针对不同文化背景的行动，同时考虑不同环境下的可用资源。
