Behind and beyond the pediatric metabolic syndrome.
Behind and beyond the pediatric metabolic syndrome.
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DOI：
10.1186/1824-7288-35-41
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发表时间：
2009-12-22
影响因子：
3.6
通讯作者：
Pietrobelli A
中科院分区：
文献类型：
--
作者：
Brambilla P;Pietrobelli A
基于最近对临床实践中个体管理的定义和有用性的关注，代谢综合征在儿科中的使用日益增多，需要一种关键的方法。我们从儿科的角度回顾了这些方面，并提出了一系列有关代谢综合征在临床环境中意味着什么的问题。讨论了 IDF 新提出的儿科定义，指出它没有充分考虑儿童和青少年的特殊性。对两个肥胖儿童病例进行比较是为了表明这种诊断如何可能对正确的治疗造成混淆。我们强调需要对代谢综合征的每个组成部分制定与健康相关的限制，而不是百分位派生的切点，以及通过多项目筛查表将估计扩展到其他家庭或个人风险因素的机会。总之，代谢综合征在儿科年龄的使用目前受到重要的限制（即成人衍生的定义、排除但不排除个体代谢风险的可能性、青春期代谢综合征的不稳定性、诊断对具体治疗的实用性差）。因此，对儿童和青少年谨慎使用代谢综合症似乎是儿科医生最好和诚实的立场，等待长期、纵向的后续研究来澄清整个问题。
The growing use of the Metabolic Syndrome in pediatric age need a critical approach, on the basis of recent concerns on definition and usefulness for individual management in clinical practice. We reviewed these aspects from a pediatric point of view, providing a set of questions about what the Metabolic Syndrome means in a clinical setting. The new proposed pediatric definition by IDF was discussed, by outlying how it does not fully consider the peculiarities of children and adolescents. The comparison between two cases of obese children was used in order to show how this diagnosis could be confusing for a correct management. We stressed the need for health-related limits for each component of the Metabolic Syndrome instead of percentile-derived cut-points, as well as the opportunity to extend the estimation to other family or individual risk factors by means of a multiple-items screening form. In conclusion, Metabolic Syndrome use in pediatric age suffers at present from important limitations (i.e., adult derived definition, possibility to rule-in but not to rule-out the individual metabolic risk, instability of MetS during adolescence, poor usefulness of the diagnosis for specific treatment). Consequently, a prudent use of Metabolic Syndrome for children and adolescents seems to be the best and honest position for paediatricians, waiting for long term, longitudinal follow-up studies that could clarify the entire question.
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影响因子：
37.8
作者：
Jolliffe, Courtney J.;Janssen, Ian
通讯作者：
Janssen, Ian
影响因子：
5.2
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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