慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

Carotid artery wall hypertrophy in children with metabolic syndrome

Preclinical vascular changes (increased stiffness and/or wall thickness) have been observed in children with known metabolic risk factors. Aim of the present study was to evaluate different carotid parameters, representative of vascular health, in children with and without metabolic syndrome (MS). We studied 38 children with MS (mean age 9.6+/-2.6 years; range 6-14 years) and 45 healthy age-matched subjects. Children who met three or more of the following criteria qualified as having the MS: fasting glucose >110 mg dl(-1), fasting triglyceride concentration >100 mg dl(-1), fasting high-density lipoprotein cholesterol concentration <50 mg dl(-1) for females or <45 mg dl(-1) for the males, waist circumference >75th percentile for age and gender and systolic or diastolic blood pressure >90th percentile for age, gender and height. Carotid B-mode ultrasound examinations were performed and intima-media thickness and diameters were measured in all subjects. Arterial geometry was further characterized by calculation of carotid cross-sectional area. Carotid intima-media thickness and lumen diameters were increased in children with MS as compared to children without MS. Moreover, carotid cross-sectional area was significantly higher in the group of children with MS 9.83+/-1.86 mm(2) [mean+/-s.d.] compared with the control group: 7.77+/-1.72 mm(2), P<0.001, even after adjustment for age, gender and height. Carotid hypertrophy is already detectable in children with MS. High-resolution B-mode ultrasound could provide a valuable tool for the cardiovascular risk stratification of children.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

雌激素膜受体与内皮型一氧化氮合酶

目前对雌激素膜受体的研究主要集中在其对内皮型一氧化氮合酶(eNOS)的快速调节方面,虽然对膜受体的结构还不完全清楚,但是对膜受体激活eNOS效应涉及的信号通路以及G蛋白偶联受体在信号转导通路中所起的作用已经有了较深的认识,本文就近年关于雌激素膜受体调节eNOS的研究进展作一综述。     

慢性炎性反应与儿童肥胖及代谢综合征

62届美国糖尿病协会 (ＡＤＡ)年会于 2 0 0 2年 6月 14～ 18日在美国旧金山举行 ,脂代谢紊乱 (脂毒性 )与 2型糖尿病 (Ｔ2ＤＭ)发病机制间的相关研究仍是本届大会关注的焦点之一 ,现就有关内容简述如下。1　脂毒性与胰岛素抵抗 (ＩＲ)ＩＲ是Ｔ2ＤＭ的发病环节之一。血循环中游离脂肪酸 (ＦＦＡｓ)升高 ,可在多个层面影响葡萄糖代谢 ,使胰岛素 (ＩＮＳ)作用的靶组织如肝脏、肌肉表现为ＩＲ。1.1　脂毒性与肝脏ＩＲ　内脏脂肪增加可导致肝脏ＩＲ ,其主要机制可能是内脏脂肪细胞释放的ＦＦＡｓ、肿瘤坏死因子 (ＴＮＦ) α、白介素 (ＩＬ) 6及…     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

慢性炎性反应与儿童肥胖及代谢综合征

The prevalence of overweight and metabolic syndrome is increasing in young people. Body fat produces a number of inflammatory cytokines, such as C-reactive protein, TNF-α, IL-6, etc, which lead to chronic subclinical inflammation. Chronic subclinical inflammation in childhood and adolescents is as-sociated with obesity,which closely related with metabolic syndrome and insulin resistance at all ages. This feature of the diseases provides an opportunity for the early identification of target groups and the use of ap-propriate lifestyle intervention can effectively interrupt the pathological processes at early stages.     

Carotid artery stiffness in obese children with the metabolic syndrome

Obesity and overweight have been associated with increased carotid intima-media thickness and stiffness in adults and children. Overweight and obesity have also been associated with an increased prevalence of the metabolic syndrome (MS). The aim of the study was to test the hypothesis that obese children with the MS have increased rigidity of their arteries compared with obese children without the MS. We studied 100 obese children (age range 6 to 14 years; 61 males, 39 females) consecutively seen in the outpatient clinic of a hospital department of pediatrics. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness and diameters of the common carotid artery. Common carotid arterial stiffness was significantly higher in the group of obese children with the MS (n = 38) at 1.29 +/- 0.06 mm (values log transformed) versus 1.12 +/- 0.04 mm (p <0.03) compared with those without the MS (n = 62). These differences persisted even after adjustment for age, gender, and C-reactive protein. Obese children with the MS had significantly higher plasma concentrations of C-reactive protein (1.57 +/- 0.06 microg/L, values log transformed) compared with obese children without the MS (1.38 +/- 0.05 microg/L, p <0.03). In conclusion, obese children who met the diagnostic criteria for the MS had higher common carotid artery stiffness and higher C-reactive protein plasma concentrations than obese children without the MS.     

Management of hypertension in children and adolescents with the metabolic syndrome

Because elevated blood pressure is one of the defining criteria of the metabolic syndrome, treatment of hypertension will be required in many, if not most, children and adolescents diagnosed with the metabolic syndrome. This review highlights several aspects of the approach to treatment of hypertension in young patients with the metabolic syndrome, including the definition of hypertension, use of nonpharmacologic measures, indications for instituting antihypertensive medications, and the potential adjunctive role that insulin-sensitizing agents may play in blood pressure reduction. The choice of antihypertensive agent is also discussed, along with consideration of the diabetogenic effects of various classes of antihypertensive agents. Consideration of all of these issues is important in achieving blood pressure control in children and adolescents with the metabolic syndrome, as appropriate treatment may help to forestall the development not only of type 2 diabetes but also of the cardiovascular disease that is frequently already present at the time of diagnosis of type 2 diabetes in adults.     

Dyslipidemia in the metabolic syndrome in children

The high triglyceride/low high-density lipoprotein cholesterol phenotype is a component of the metabolic syndrome. The obesity epidemic has increased the prevalence of this abnormality. Recognition of this dyslipidemia is increasingly common in pediatric practice. Treatment includes weight management, including the prevention of future excess weight gain, and exercise. Pharmacologic management is rarely required.     

The metabolic syndrome in children and adolescents

The metabolic syndrome was recently defined by the Adult Treatment Panel III. Despite a lack of uniform definition of the syndrome in pediatrics, recent studies have shown that the syndrome develops during childhood and is highly prevalent among overweight children and adolescents. The hypothesized central role of insulin resistance and obesity as a common underlying feature of the metabolic syndrome also appears to be already manifested in childhood. In view of the current obesity epidemic in children and adolescents, there is a vital need to provide adequate guidelines for the definition of the metabolic syndrome in pediatrics and for the development of screening and treatment strategies. This article focuses on the above issues, as well as on the impact of the syndrome on two major disease outcomes, type 2 diabetes and cardiovascular disease.