Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: A need for screening tools to target interventions

被引:192
作者
DeBoer, Mark D. [1 ]
机构
[1] Univ Virginia, Dept Pediat, Charlottesville, VA 22903 USA
基金
美国国家卫生研究院;
关键词
Obesity; Metabolic syndrome; Insulin resistance; Risk; Adolescents; Inflammation; High-sensitivity C-reactive protein; Adiponectin; C-REACTIVE PROTEIN; NUTRITION EXAMINATION SURVEY; INDUCED INSULIN-RESISTANCE; LOW-GRADE INFLAMMATION; BODY-MASS INDEX; METABOLIC-SYNDROME; CHILDHOOD PREDICTORS; CARDIOMETABOLIC RISK; NATIONAL-HEALTH; FASTING INSULIN;
D O I
10.1016/j.nut.2012.07.003
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Cardiovascular disease (CVD) and type 2 diabetes mellitus have their roots in childhood, particularly in obese children and adolescents, raising important opportunities for early lifestyle intervention in at-risk individuals. However, not all obese individuals are at the same risk for disease progression. Accurate screening of obese adolescents may identify those in greatest need for intensive intervention to prevent or delay future disease. One potential screening target is obesity-related inflammation, which contributes to insulin resistance, metabolic syndrome, and CVD. In adults, the inflammatory marker high-sensitivity C-reactive protein (hsCRP) has utility for risk stratification and treatment initiation in individuals of intermediate CVD risk. In adolescents, hsCRP shares many of the associations of hsCRP in adults regarding the degree of insulin resistance, metabolic syndrome, and carotid artery media thickness. However, long-term data linking increased hsCRP levels and increased insulin or decreased adiponectin in childhood to adult disease outcomes are lacking at this time. Future efforts continue to be needed to identify childhood clinical and laboratory characteristics that could be used as screening tests to predict adult disease progression. Such tests may have utility in motivating physicians and patients' families toward lifestyle changes, ultimately improving prevention efforts. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:379 / 386
页数:8
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