Obesity, insulin resistance, diabetes, and cardiovascular risk in children - An American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism)
Obesity, insulin resistance, diabetes, and cardiovascular risk in children - An American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism)
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DOI：
10.1161/01.cir.0000060923.07573.f2
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发表时间：
2003-03-18
期刊：
影响因子：
37.8
通讯作者：
Daniels, SR
中科院分区：
文献类型：
--
作者：
Steinberger, J;Daniels, SR
动脉粥样硬化性心血管疾病是西方成年人的头号杀手，但与之相关的病理过程和危险因素已被证明始于儿童时期。肥胖在胰岛素抵抗综合征中起着核心作用，胰岛素抵抗综合征包括高胰岛素血症、高血压、高脂血症、2型糖尿病和动脉粥样硬化性心血管疾病的风险增加。据报道，儿童中2型糖尿病的发病率惊人地增加。3,4机体对胰岛素作用的抵抗导致胰腺分泌这种激素增加，从而导致高胰岛素血症。儿童期开始的肥胖往往先于高胰岛素状态。胰岛素抵抗综合征的其他组成部分也存在于儿童和青少年中。在年轻人中，肥胖和胰岛素抵抗之间存在关联，胰岛素抵抗、高血压和血脂异常之间也存在关联。越来越多的数据表明，儿童和青少年时期的超重与成年后的胰岛素抵抗、血脂异常和血压升高有显著关系。肥胖青少年的体重减轻导致胰岛素浓度下降和胰岛素敏感性改善。此外，已确定左心室质量增加是成人心血管疾病的独立危险因素，在儿童期也存在。最近的研究发现，左心室肥厚与其他危险因素有关，包括儿童和青少年的肥胖和胰岛素抵抗。7 .从风险过渡的细节
Atherosclerotic cardiovascular disease is the No. 1 killer in the adult population of Western societies, 1 but the pathological processes and risk factors associated with its development have been shown to begin during childhood. 2 Obesity plays a central role in the insulin resistance syndrome, which includes hyperinsulinemia, hypertension, hyperlipidemia, type 2 diabetes mellitus, and an increased risk of atherosclerotic cardiovascular disease. The incidence of type 2 diabetes reported in children has increased alarmingly. 3, 4Resistance of the body to the actions of insulin results in increased production of this hormone by the pancreas and ensuing hyperinsulinemia. Obesity beginning in childhood often precedes the hyperinsulinemic state. Other components of the insulin resistance syndrome are also present in children and adolescents. 5, 6 An association between obesity and insulin resistance has been reported in the young, as has the link between insulin resistance, hypertension, and abnormal lipid profile. There is an increasing amount of data showing that being overweight during childhood and adolescence is significantly associated with insulin resistance, dyslipidemia, and elevated blood pressure in young adulthood. Weight loss by obese youngsters results in a decrease in insulin concentration and improvement in insulin sensitivity. Moreover, it has been determined that increased left ventricular mass, which is an independent risk factor for cardiovascular disease in adults, is present in childhood. Recent research has found that left ventricular hypertrophy is related to other risk factors, including obesity and insulin resistance in children and adolescents. 7 The specifics of the transition from risk