Arch Dis Child：肥胖儿童患心脏病发病风险升高

近日，刊登在国际杂志Archives of Diseases in Childhood上的一篇研究报告指出， 三个过度肥胖的孩子中有两个都会存在发生心脏脏疾病的风险。目前儿童肥胖的流行和严重性正在急剧上升，但是很少有研究关于过重儿童所带来的自身健康问题。研究者的研究数据基于2005-2007年的荷兰儿童监督机构。在这期间，研究者调查了肥胖儿童他们父母患心血管疾病风险的情况。

严重肥胖的定义是2岁时BMI值为20.5，12岁时BMI值为31，18岁时BMI值为35。过去三年中，儿科医生每个月将治疗的肥胖儿童信息上报至监督机构，目前总共有500个儿童的信息。其中有307个孩子被分类为严重肥胖，其中一半都为男孩，他们在年轻阶段趋向于肥胖。在所有孩子中，其中2/3的孩子至少存在心血管疾病风险，其中一半存在高血压风险，1/7有高血糖风险，1%的孩子有II型糖尿病。

研究者表示，12岁及以下的孩子中有2/3的孩子都有高的心血管疾病风险，而且高血压和脂质异常的流行或许会引发年轻人心血管疾病的发生。最后研究者表示，国际上公认的严重肥胖和早期检测方针、治疗方法目前迫切需要制定。

编译自：Two out of three very obese kids already have heart disease risk factors

doi:10.1136/archdischild-2012-301877
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High cardiovascular risk in severely obese young children and adolescents

Nathalie M A van Emmerik1, Carry M Renders2, Marije van de Veer1, Stef van Buuren3,4, Olga H van der Baan-Slootweg5, Joana E Kist-van Holthe1, Remy A HiraSing1

Objective To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents. Methods A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2–18-year-old children to the Dutch Paediatric Surveillance Unit. Severe obesity is defined by gender and age-dependent cut-off points for body mass index based on Dutch National Growth Studies corresponding to the adult cut-off point of 35 kg/m2. Paediatricians were asked to complete a questionnaire for every severely obese child regarding socio-demographic characteristics and cardiovascular risk factors (blood pressure, fasting blood glucose and lipids). Results In 2005, 2006 and 2007, 94%, 87% and 87%, respectively, of paediatricians in the Netherlands responded to the monthly request from the Dutch Paediatric Surveillance Unit and 500 children with newly diagnosed severe obesity were reported. 72.6% (n=363) of paediatricians responded to a subsequent questionnaire. Cardiovascular risk factor data were available in 255/307 (83%) children who were correctly classified as severely obese. 67% had at least one cardiovascular risk factor (56% hypertension, 14% high blood glucose, 0.7% type 2 diabetes and up to 54% low HDL-cholesterol). Remarkably, 62% of severely obese children aged ≤12 years already had one or more cardiovascular risk factors. Conclusion A high number (2/3) of severely obese children have cardiovascular risk factors. Internationally accepted criteria for defining severe obesity and guidelines for early detection and treatment of severe obesity and comorbidity are urgently needed.