Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions.
Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions.
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DOI：
10.1016/j.nut.2012.07.003
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
DeBoer MD
中科院分区：
文献类型：
--
作者：
DeBoer MD
心血管疾病（CVD）和2型糖尿病起源于儿童时期，特别是肥胖儿童和青少年，这为高危人群提供了早期生活方式干预的重要机会。然而，并不是所有的肥胖者都有同样的疾病发展风险。对肥胖青少年进行准确的筛查可以识别出那些最需要加强干预以预防或延缓未来疾病的人。一个潜在的筛选目标是肥胖相关的炎症，它会导致胰岛素抵抗、代谢综合征和心血管疾病。在成人中，炎症标志物高敏c反应蛋白（hsCRP）对中度心血管疾病风险个体的风险分层和治疗起始具有实用价值。在青少年中，hsCRP与成人的胰岛素抵抗程度、代谢综合征和颈动脉中膜厚度有许多相同的关联。然而，目前缺乏将儿童时期hsCRP水平升高（胰岛素升高或脂联素降低）与成人疾病结局联系起来的长期数据。未来仍需努力确定儿童临床和实验室特征，这些特征可作为预测成人疾病进展的筛选试验。这类测试可能有助于促使医生和患者家属改变生活方式，最终改善预防工作。
Cardiovascular disease (CVD) and type 2 diabetes mellitus have their roots in childhood, particularly in obese children and adolescents, raising important opportunities for early lifestyle intervention in at-risk individuals. However, not all obese individuals are at the same risk for disease progression. Accurate screening of obese adolescents may identify those in greatest need for intensive intervention to prevent or delay future disease. One potential screening target is obesity-related inflammation, which contributes to insulin resistance, metabolic syndrome, and CVD. In adults, the inflammatory marker high-sensitivity C-reactive protein (hsCRP) has utility for risk stratification and treatment initiation in individuals of intermediate CVD risk. In adolescents, hsCRP shares many of the associations of hsCRP in adults regarding the degree of insulin resistance, metabolic syndrome, and carotid artery media thickness. However, long-term data linking increased hsCRP levels—and increased insulin or decreased adiponectin—in childhood to adult disease outcomes are lacking at this time. Future efforts continue to be needed to identify childhood clinical and laboratory characteristics that could be used as screening tests to predict adult disease progression. Such tests may have utility in motivating physicians and patients' families toward lifestyle changes, ultimately improving prevention efforts.
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影响因子：
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