Obesity and Growth during Childhood and Puberty
Obesity and Growth during Childhood and Puberty
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DOI：
10.1159/000342545
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发表时间：
2013-01-01
期刊：
影响因子：
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通讯作者：
Chiarelli, Francesco
中科院分区：
文献类型：
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作者：
Marcovecchio, M. Loredana;Chiarelli, Francesco
儿童期和青春期的生长速度不同，并受到遗传和环境因素相互作用的影响。营养状况在调节生长方面起着重要作用，生命早期体重过重会影响生长模式。儿童肥胖是一个日益严重且令人担忧的问题，与多种短期和长期代谢和心血管并发症有关。此外，有证据表明儿童时期过度肥胖会影响生长模式和青春期发育。多项研究表明，在青春期前，与瘦儿童相比，肥胖儿童的身高增长速度更高，骨龄也更快。然而，这种青春期前的生长优势往往会在青春期逐渐减弱，此时肥胖儿童与瘦儿童相比，生长突增速度会降低。肥胖儿童的生长激素 (GH) 分泌减少，因此表明生长速度的加快与 GH 无关。与肥胖儿童加速生长有关的因素包括瘦素和胰岛素水平升高、肾上腺雄激素、胰岛素样生长因子 (IGF)-1、IGF 结合蛋白 1 和 GH 结合蛋白。儿童期体重过重也会影响青春期发育，通过影响青春期开始的时间和青春期激素水平。有明确的证据表明，肥胖会导致女孩青春期迹象提前出现。此外，肥胖女孩患雄激素过多症的风险也增加。在一些研究中，男孩的过度肥胖与青春期提前有关，而其他研究则报告了青春期开始的延迟。关于儿童期和青春期肥胖症之间关联的现有证据强调了抗击儿童期肥胖症流行的另一个原因；这可以防止异常生长和青春期模式。版权所有 (C) 2013 S. Karger AG，巴塞尔
Growth during childhood and adolescence occurs at different rates and is influenced by the interaction between genetic and environmental factors. Nutritional status plays an important role in regulating growth, and excess body weight early in life can influence growth patterns. Childhood obesity is a growing and alarming problem, associated with several short-term and long-term metabolic and cardiovascular complications. In addition, there is evidence suggesting that excess adiposity during childhood influences growth patterns and pubertal development. Several studies have shown that during prepubertal years obese children have higher height velocity and accelerated bone age compared to lean subjects. However, this prepubertal advantage in growth tends to gradually decrease during puberty, when obese children show a reduced growth spurt compared with lean subjects. Growth hormone (GH) secretion in obese children is reduced, therefore suggesting that increased growth is GH independent. Factors which have been implicated in the accelerated growth in obese children include increased leptin and insulin levels, adrenal androgens, insulin-like growth factor (IGF)-1, IGF-binding protein-1 and GH-binding proteins. Excess body weight during childhood can also influence pubertal development, through an effect on timing of pubertal onset and levels of pubertal hormonal levels. There is clear evidence indicating that obesity leads to early appearance of pubertal signs in girls. In addition, obese girls are also at increased risk of hyperandrogenism. In boys, excess adiposity has been associated with advanced puberty in some studies, whereas others have reported a delay in pubertal onset. The existing evidence on the association between childhood and adolescence obesity underlines a further reason for fighting the epidemics of childhood obesity; that is preventing abnormal growth and pubertal patterns. Copyright (C) 2013 S. Karger AG, Basel