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国际儿科研究杂志

International Journal of Pediatrics Research

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International Journal of Pediatrics Research. 2024; 4: (2) ; 10.12208/j.ijped.20240013 .

Research progress on the relationship between childhood obesity and metabolic syndrome
儿童肥胖与代谢综合征关系的研究进展

作者： 田颖 *

河南中医药大学 河南郑州

*通讯作者： 田颖,单位：河南中医药大学 河南郑州；

引用本文: 田颖 儿童肥胖与代谢综合征关系的研究进展[J]. 国际儿科研究杂志, 2024; 4: (2) : 22-30.
Published: 2024/12/31 14:24:16

摘要

儿童肥胖已成为全球性公共卫生挑战，与代谢综合征（Metabolic Syndrome, MetS）的发病密切相关。近年来，随着肥胖儿童数量急剧增加，MetS在儿童及青少年中的患病率显著上升，表现为中心性肥胖、胰岛素抵抗、血脂异常及高血压等多种代谢紊乱。本文系统综述了儿童肥胖与MetS的流行病学特征、病理生理机制、诊断标准及干预策略的最新研究进展。流行病学研究表明，全球儿童肥胖率持续攀升，中国718岁儿童MetS患病率达4.5%-12.3%，肥胖儿童中甚至高达30.1%。性别差异显著，男孩腹型肥胖风险更高。在病理生理机制方面，内脏脂肪堆积导致的慢性低度炎症、脂肪因子（如内脂素）分泌异常、Ghrelin/LEAP2激素失衡及肠道菌群紊乱共同促进了胰岛素抵抗和代谢异常。目前，儿童MetS的诊断仍缺乏统一标准，国际糖尿病联盟（IDF）建议以腰围百分位数为核心指标。在干预方面，生活方式调整（如膳食多样化、增加运动）仍是首选策略，部分研究支持益生菌调节肠道菌群可能成为新靶点。药物治疗（如二甲双胍）在特定人群中有效，但长期安全性仍需更多证据支持。未来研究应关注多组学技术（如代谢组学、宏基因组学）在儿童MetS早期预测和个体化治疗中的应用，并推动基于家庭学校社区的综合干预模式。

关键词： 儿童肥胖；代谢综合征；胰岛素抵抗；内脏脂肪；肠道菌群；干预策略

Abstract

Childhood obesity has become a global public health challenge and is closely related to the onset of Metabolic Syndrome (MetS). In recent years, with the sharp increase in the number of obese children, the prevalence of MetS among children and adolescents has significantly risen, manifested as various metabolic disorders such as central obesity, insulin resistance, dyslipidemia and hypertension. This article systematically reviews the latest research progress on the epidemiological characteristics, pathophysiological mechanisms, diagnostic criteria and intervention strategies of childhood obesity and MetS. Epidemiological studies have shown that the global rate of childhood obesity continues to rise. In China, the prevalence of MetS among children aged 718 is 4.5% to 12.3%, and even as high as 30.1% among obese children. There is a significant gender difference, with boys having a higher risk of abdominal obesity. In terms of pathophysiological mechanisms, chronic low-grade inflammation caused by visceral fat accumulation, abnormal secretion of adipokines (such as fensin), hormonal imbalance of Ghrelin/LEAP2, and intestinal flora disorder jointly promote insulin resistance and metabolic abnormalities. At present, there is still a lack of unified standards for the diagnosis of MetS in children. The International Diabetes Federation (IDF) suggests taking the waist circumference percentile as the core indicator. In terms of intervention, lifestyle adjustments (such as dietary diversification and increased physical activity) remain the preferred strategy. Some studies support that probiotics regulating the intestinal flora may become a new target. Drug treatment (such as metformin) is effective in specific populations, but more evidence is still needed to support its long-term safety. Future research should focus on the application of multi-omics technologies (such as metabolomics and metagenomics) in the early prediction and individualized treatment of MetS in children, and promote a comprehensive intervention model based on family, school and community.

Key words： Childhood obesity; Metabolic syndrome; Insulin resistance; Visceral fat; Gut microbiota; Intervention strategies

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