Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity?
Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity?
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DOI：
10.3389/fendo.2018.00187
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发表时间：
2018
影响因子：
5.2
通讯作者：
Wasniewska M
中科院分区：
文献类型：
--
作者：
Corica D;Aversa T;Valenzise M;Messina MF;Alibrandi A;De Luca F;Wasniewska M
目的是评估(1)首次评估时超重/肥胖儿童的代谢特征和心脏代谢风险，根据超重严重程度和年龄对患者进行分层；(2)探讨肥胖和心脏代谢疾病家族史与儿童肥胖严重程度的关系。在这项横断面、回顾性、观察性研究中，招募了260名超重和肥胖儿童（139名女性），年龄在2.4至17.2岁之间。收集了关于肥胖和心脏代谢疾病的FH数据。每位患者都接受了临床和生理检查，并进行了空腹血代谢检查。计算胰岛素抵抗稳态模型评估（HOMA-IR）、甘油三酯与高密度脂蛋白胆固醇比值、血浆动脉粥样硬化指数。为了评估肥胖的严重程度，将儿童BMI标准差(SD)≤2.5和BMI SD >2.5分为两组。此外，对研究人群进行分析，根据患者实足年龄（<8岁、8 - 11岁、10 - 11岁）将其分为三组。BMI SD与实足年龄呈负相关（p < 0.005），且在<8岁组显著升高。BMI SD与肥胖患者的FH呈正相关。重度肥胖患者（BMI SD >2.5）年龄更轻（p < 0.005），以青春期前患者居多，HOMA-IR显著高于对照组（p = 0.04），动脉高血压、2型糖尿病、冠心病FH患病率显著高于对照组。(1)肥胖家族史和心脏代谢疾病是儿童期早发性肥胖的重要危险因素，与肥胖的严重程度有关。(2)即使在最年幼的肥胖儿童中，代谢谱，尤其是HOMA-IR，在第一次评估时也会发生改变。(3)采用BMI SD对肥胖严重程度进行分层，可有效估计患者的心脏代谢风险。
The objectives were to evaluate (1) the metabolic profile and cardiometabolic risk in overweight/obese children at first assessment, stratifying patients according to severity of overweight and age; and (2) to investigate the relationship between family history (FH) for obesity and cardiometabolic diseases and severity of childhood obesity. In this cross-sectional, retrospective, observational study, 260 children (139 female), aged between 2.4 and 17.2 years, with overweight and obesity were recruited. Data regarding FH for obesity and cardiometabolic diseases were collected. Each patient underwent clinical and auxological examination and fasting blood sampling for metabolic profile. Homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-to-high-density lipoprotein cholesterol ratio, and atherogenic index of plasma were calculated. To evaluate the severity of obesity, children were divided into two groups for BMI standard deviation (SD) ≤2.5 and BMI SD >2.5. Moreover, study population was analyzed, dividing it into three groups based on the chronological age of patient (<8, 8–11, >11 years). BMI SD was negatively correlated with chronological age (p < 0.005) and significantly higher in the group of children <8 years. BMI SD was positively associated with FH for obesity. Patients with more severe obesity (BMI SD >2.5) were younger (p < 0.005), mostly prepubertal, presented a significantly higher HOMA-IR (p = 0.04), and had a significantly higher prevalence of FH for arterial hypertension, type 2 diabetes mellitus, and coronary heart disease than the other group. (1) Family history of obesity and cardiometabolic diseases are important risk factors for precocious obesity onset in childhood and are related to the severity of obesity. (2) Metabolic profile, especially HOMA-IR, is altered even among the youngest obese children at first evaluation. (3) Stratification of obesity severity, using BMI SD, is effective to estimate the cardiometabolic risk of patients.
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