儿童、青少年肥胖的研究进展
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摘要
肥胖是一个世界性的健康问题。据流行病学资料统计,发达国家及发展中国家的肥胖人数均有增长,特别是近10年,全球肥胖及超重患病率显著增加。儿童青少年肥胖受遗传及环境的共同影响,随着疾病的发展,儿童青少年的生理及心理受到了不同程度的损害。本文主要阐述了儿童青少年肥胖的病因、诊断,并针对性的总结预防、干预及治疗措施,为儿童青少年肥胖的深入研究提供线索。
Obesity is a global public health problem. According to epidemiological statistics, obesity has increased in both developed and developing countries. The worldwide prevalence of childhood obesity has increased remarkably over the past decades~([1]). Children and adolescents obesity is the result of genetic and environmental factors. With the development of obesity, children and adolescents' physiology and psychology are harmed to varying degrees. This article mainly elaborates the causes and diagnosis of obesity in children and adolescents, and summarizes the preventive,intervention and treatment measures in order to provide clues for further research on obesity in children and adolescents.
Obesity is a global public health problem. According to epidemiological statistics, obesity has increased in both developed and developing countries. The worldwide prevalence of childhood obesity has increased remarkably over the past decades~([1]). Children and adolescents obesity is the result of genetic and environmental factors. With the development of obesity, children and adolescents' physiology and psychology are harmed to varying degrees. This article mainly elaborates the causes and diagnosis of obesity in children and adolescents, and summarizes the preventive,intervention and treatment measures in order to provide clues for further research on obesity in children and adolescents.
引文
[1]Grandone A,Di Sessa A,Umano GR,Toraldo R,Miraglia Del Giudice E.New treatment modalities for obesity[J].Best Pract Res Clin Endocrinol Metab,2018,32(4):535-549.
[2]Wang YC,Mcpherson K,Marsh T,Gortmaker SL,Brown M.Health and economic burden of the projected obesity trends in the USA and the UK[J].Lancet,2011,378(9793):815.
[3]陈贻珊,张一民,孔振兴,等.我国儿童青少年超重、肥胖流行现状调查[J].中华疾病控制杂志,2017,21(9):866-869.
[4]郭文海,丁丹阳,王艳.儿童肥胖相关危险因素的研究进展[J].中国中西医结合儿科学,2016,8(4):399-402.
[5]李晓卉,郭红侠,黄艳丽,等.父母超重肥胖对儿童青少年超重肥胖的影响[J].中国学校卫生,2016,37(2):239-242.
[6]Ong KK,Northstone K,Wells JC.Earliermother'sage at menarche predicts rapid infancy growth and childhood obesity[J].PLoSMed.2007,4(4):5.
[7]薛红妹,刘言,段若男,等.中国儿童青少年超重肥胖流行趋势及相关影响因素[J].中国学校卫生.2014,35(8):1258-1262.
[8]林少倩,何丕,等.山东省3县农村地区儿童超重肥胖的影响因素分析[J].山东大学学报(医学版),2012,50(6):125.
[9]刘青青,余灿清,高文静,等.中国18岁以下双生子出生体重与超重/肥胖的关联分析[J].中华流行病学杂志.2016,37(4):464-468.
[10]Ren J,Wu J,Ji M,et al.The effect of high birth weight on overweight and obesity in childhood and adolescence.A cohort study in China[J].Saudi Medical Journal,2013,34(6):623-631.
[11]张宁.低出生体重儿的赶上生长与儿童肥胖关系的研究[J].现代妇女:医学前沿,2015(2):353.
[12]胡立群,龚群.儿童肥胖病因学研究进展[J].中国妇幼健康研究,2008,19(6):589-591.
[13]袁登越,刘炬,邓文清,等.脂肪和肥胖相关基因与肥胖关系的研究进展[J].动物营养学报,2017,29(3):755-761.
[14]阳赣萍,彭司华,左双燕,等.中国人群瘦素受体Gln223Arg、Pro1019Pro基因多态性与肥胖关联性的Meta分析[J].中华流行病学杂志,2011,32(10):1037-1042.
[15]孟祥睿,宋洁云,马军,等.FTO基因多态性与儿童青少年肥胖指标的相关性[J].中国学校卫生,2014,35(10):1525-1528.
[16]Gungor NK.Overweight and obesity in children and adolescents[J].Journal of Clinical Research in Pediatric Endocrinology,2014,6(3):129-143.
[17]付利万,张美仙,高利旺,等.SEC16B基因多态性与体质指数和肥胖关联的Meta分析[J].中华流行病学杂志,2016,37(9):1288-1295.
[18]宋洁云,王都,马军,等.肥胖儿童黑皮素4受体基因筛查和突变功能预测研究[J].中国当代儿科杂志,2015,17(4):356-361.
[19]Ma L,Tataranni PA,Hanson RL,et al.Variations in peptide YY and Y2receptor genes are associated with sevga'e obesity in Pima Indianmen[J].Diabetes,2005,54(5):1598-1602.
[20]Ka K,Ka H,M L,et al.Endotoxemia,nutrition,and cardiometabolic disorders[J].Acta diabetologica,2015,52(2):395-404.
[21]张旭光,才绍江,王岚,等.不同膳食模式对个体代谢和肠道菌群影响的研究进展[J].中华内分泌代谢杂志.2016(2):165-170.
[22]Jingxiong J,Rosenqvist U,Huishan W,et al.Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing,China[J].Public Health Nutrition,2009,12(7):973-978.
[23]张桂玲,胡金萍,卢青军,等.喂养行为与生活方式对儿童期单纯性肥胖影响的分析[J].中国妇幼保健,2010,25(35):5207-5209.
[24]游诚,赵莎,丁大为,等.孕期增重和婴儿喂养方式与儿童肥胖的相关性研究[J].中国中西医结合儿科学,2015,7(5):488-490.
[25]IG K,HJ L,SY K,et al.Physical Activity,Study Sitting Time,Leisure Sitting Time,and Sleep Time Are Differently Associated With Obesity in Korean Adolescents:A Population-Based Study[J].Medicine.2015,94(44):e1965.
[26]Arora T,Taheri S.Is sleep education an effective tool for sleep improvement and minimizing metabolic disturbance and obesity in adolescents?[J].Sleep Medicine Reviews,2016.
[27]曹敏.儿童肥胖影响因素分析[J].中外医疗,2008,27(29):89-89.
[28]曹岩,李振江,程柄香.儿童单纯性肥胖的心理特点及肥胖因素的矫治[J].白求恩医科大学学报,1997,23(5):554-555.
[29]中华人民共和国卫生部.中小学生一日学习时间卫生要求[J].G B/T17223-2012.2012.
[30]Ginneken VV,Sitnyakowsky L,Jeffery JE.Infectobesity:viral infections(especially with human adenovirus-36:Ad-36)may be a cause of obesity[J].Medical Hypotheses,2009,72(4):383-388.
[31]Cole TJ,Bellizzi MC,Flegal KM,et al.Establishing a standard definition for child overweight and obesity worldwide:international survey[J].Bmj,2000,320(7244):1240-1243.
[32]中国肥胖问题工作组,季成叶.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[33]张迎修,周景洋,赵金山,等.山东省7-17岁正常体重中小学生腹型肥胖流行现状及血压特征分析[J].中华流行病学杂志,2013,34(11):1068-1070.
[34]侯冬青,赵小元,刘军廷,等.儿童青少年肥胖与成年后糖尿病的关联分析[J].中华预防医学杂志,2016(1):23-27.
[35]戎芬,武俊青,李玉艳,等.出生体重与儿童期超重肥胖的关系[J].中国儿童保健杂志,2011,19(11):989-991.
[36]何字纳.中国居民膳食纤维摄人状况及其与慢性病关系的研究[J].达能营养中心学术年会会议,2014.
[37]Ogden CL,Carroll MD,Kit BK,et al.Prevalence of Childhood and Adult Obesity in the United States,2011-2012[J].Jama,2014,311(8):806.
[38]Association AD.Nutrition Recommendations and Interventions for Diabetes[J].Diabetes Care.2007,30 Suppl 1(4):S48.
[39]刘军廷,赵小元,程红,等.北京市学龄儿童肥胖类型与心血管危险因素的关联性研究[J].中华高血压杂志,2014,35(6):3-8.
[40]Pedroni-Pereira A,Araujo DS,Scudine KGDO,et al.Chewing in adolescents with overweight and obesity:An exploratory study with behavioral approach[J].Appetite,2016,107:527-533.
[41]关炳生,王存川.减肥手术在儿童及青少年中的应用进展[J].中华肥胖与代谢病电子杂志,2015,1(2):89-91.
[42]Bariatric surgery for obese children and adolescents:a review of the moral challenges[J].Bmc Medical Ethics,2013,14(1):1-13.
[43]Alqahtani AR,Elahmedi MO,Al QA.Co-morbidity resolution in morbidly obese children and adolescents undergoing sleeve gastrectomy[J].Surgery for Obesity&Related Diseases,2014,10(5):842-850.
[44]Wickham CA,Carbone ET.Who's calling for weight loss?A systematic review of mobile phone weight loss programs for adolescents[J].Nutrition Reviews,2015,73(6):386-398.
[2]Wang YC,Mcpherson K,Marsh T,Gortmaker SL,Brown M.Health and economic burden of the projected obesity trends in the USA and the UK[J].Lancet,2011,378(9793):815.
[3]陈贻珊,张一民,孔振兴,等.我国儿童青少年超重、肥胖流行现状调查[J].中华疾病控制杂志,2017,21(9):866-869.
[4]郭文海,丁丹阳,王艳.儿童肥胖相关危险因素的研究进展[J].中国中西医结合儿科学,2016,8(4):399-402.
[5]李晓卉,郭红侠,黄艳丽,等.父母超重肥胖对儿童青少年超重肥胖的影响[J].中国学校卫生,2016,37(2):239-242.
[6]Ong KK,Northstone K,Wells JC.Earliermother'sage at menarche predicts rapid infancy growth and childhood obesity[J].PLoSMed.2007,4(4):5.
[7]薛红妹,刘言,段若男,等.中国儿童青少年超重肥胖流行趋势及相关影响因素[J].中国学校卫生.2014,35(8):1258-1262.
[8]林少倩,何丕,等.山东省3县农村地区儿童超重肥胖的影响因素分析[J].山东大学学报(医学版),2012,50(6):125.
[9]刘青青,余灿清,高文静,等.中国18岁以下双生子出生体重与超重/肥胖的关联分析[J].中华流行病学杂志.2016,37(4):464-468.
[10]Ren J,Wu J,Ji M,et al.The effect of high birth weight on overweight and obesity in childhood and adolescence.A cohort study in China[J].Saudi Medical Journal,2013,34(6):623-631.
[11]张宁.低出生体重儿的赶上生长与儿童肥胖关系的研究[J].现代妇女:医学前沿,2015(2):353.
[12]胡立群,龚群.儿童肥胖病因学研究进展[J].中国妇幼健康研究,2008,19(6):589-591.
[13]袁登越,刘炬,邓文清,等.脂肪和肥胖相关基因与肥胖关系的研究进展[J].动物营养学报,2017,29(3):755-761.
[14]阳赣萍,彭司华,左双燕,等.中国人群瘦素受体Gln223Arg、Pro1019Pro基因多态性与肥胖关联性的Meta分析[J].中华流行病学杂志,2011,32(10):1037-1042.
[15]孟祥睿,宋洁云,马军,等.FTO基因多态性与儿童青少年肥胖指标的相关性[J].中国学校卫生,2014,35(10):1525-1528.
[16]Gungor NK.Overweight and obesity in children and adolescents[J].Journal of Clinical Research in Pediatric Endocrinology,2014,6(3):129-143.
[17]付利万,张美仙,高利旺,等.SEC16B基因多态性与体质指数和肥胖关联的Meta分析[J].中华流行病学杂志,2016,37(9):1288-1295.
[18]宋洁云,王都,马军,等.肥胖儿童黑皮素4受体基因筛查和突变功能预测研究[J].中国当代儿科杂志,2015,17(4):356-361.
[19]Ma L,Tataranni PA,Hanson RL,et al.Variations in peptide YY and Y2receptor genes are associated with sevga'e obesity in Pima Indianmen[J].Diabetes,2005,54(5):1598-1602.
[20]Ka K,Ka H,M L,et al.Endotoxemia,nutrition,and cardiometabolic disorders[J].Acta diabetologica,2015,52(2):395-404.
[21]张旭光,才绍江,王岚,等.不同膳食模式对个体代谢和肠道菌群影响的研究进展[J].中华内分泌代谢杂志.2016(2):165-170.
[22]Jingxiong J,Rosenqvist U,Huishan W,et al.Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing,China[J].Public Health Nutrition,2009,12(7):973-978.
[23]张桂玲,胡金萍,卢青军,等.喂养行为与生活方式对儿童期单纯性肥胖影响的分析[J].中国妇幼保健,2010,25(35):5207-5209.
[24]游诚,赵莎,丁大为,等.孕期增重和婴儿喂养方式与儿童肥胖的相关性研究[J].中国中西医结合儿科学,2015,7(5):488-490.
[25]IG K,HJ L,SY K,et al.Physical Activity,Study Sitting Time,Leisure Sitting Time,and Sleep Time Are Differently Associated With Obesity in Korean Adolescents:A Population-Based Study[J].Medicine.2015,94(44):e1965.
[26]Arora T,Taheri S.Is sleep education an effective tool for sleep improvement and minimizing metabolic disturbance and obesity in adolescents?[J].Sleep Medicine Reviews,2016.
[27]曹敏.儿童肥胖影响因素分析[J].中外医疗,2008,27(29):89-89.
[28]曹岩,李振江,程柄香.儿童单纯性肥胖的心理特点及肥胖因素的矫治[J].白求恩医科大学学报,1997,23(5):554-555.
[29]中华人民共和国卫生部.中小学生一日学习时间卫生要求[J].G B/T17223-2012.2012.
[30]Ginneken VV,Sitnyakowsky L,Jeffery JE.Infectobesity:viral infections(especially with human adenovirus-36:Ad-36)may be a cause of obesity[J].Medical Hypotheses,2009,72(4):383-388.
[31]Cole TJ,Bellizzi MC,Flegal KM,et al.Establishing a standard definition for child overweight and obesity worldwide:international survey[J].Bmj,2000,320(7244):1240-1243.
[32]中国肥胖问题工作组,季成叶.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[33]张迎修,周景洋,赵金山,等.山东省7-17岁正常体重中小学生腹型肥胖流行现状及血压特征分析[J].中华流行病学杂志,2013,34(11):1068-1070.
[34]侯冬青,赵小元,刘军廷,等.儿童青少年肥胖与成年后糖尿病的关联分析[J].中华预防医学杂志,2016(1):23-27.
[35]戎芬,武俊青,李玉艳,等.出生体重与儿童期超重肥胖的关系[J].中国儿童保健杂志,2011,19(11):989-991.
[36]何字纳.中国居民膳食纤维摄人状况及其与慢性病关系的研究[J].达能营养中心学术年会会议,2014.
[37]Ogden CL,Carroll MD,Kit BK,et al.Prevalence of Childhood and Adult Obesity in the United States,2011-2012[J].Jama,2014,311(8):806.
[38]Association AD.Nutrition Recommendations and Interventions for Diabetes[J].Diabetes Care.2007,30 Suppl 1(4):S48.
[39]刘军廷,赵小元,程红,等.北京市学龄儿童肥胖类型与心血管危险因素的关联性研究[J].中华高血压杂志,2014,35(6):3-8.
[40]Pedroni-Pereira A,Araujo DS,Scudine KGDO,et al.Chewing in adolescents with overweight and obesity:An exploratory study with behavioral approach[J].Appetite,2016,107:527-533.
[41]关炳生,王存川.减肥手术在儿童及青少年中的应用进展[J].中华肥胖与代谢病电子杂志,2015,1(2):89-91.
[42]Bariatric surgery for obese children and adolescents:a review of the moral challenges[J].Bmc Medical Ethics,2013,14(1):1-13.
[43]Alqahtani AR,Elahmedi MO,Al QA.Co-morbidity resolution in morbidly obese children and adolescents undergoing sleeve gastrectomy[J].Surgery for Obesity&Related Diseases,2014,10(5):842-850.
[44]Wickham CA,Carbone ET.Who's calling for weight loss?A systematic review of mobile phone weight loss programs for adolescents[J].Nutrition Reviews,2015,73(6):386-398.