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当前,儿童肥胖成了一种严重的健康问题,它与多种代谢和心血管疾病(CVD)的发病有关。胰岛素抵抗是儿童肥胖的一个常见特征,它被认为是肥胖者患上2型糖尿病和CVD的重要原因。胰岛素抵抗是代谢综合征的主要特征之一,其在儿童和青少年中的发病率正逐渐升高,特别是在肥胖的儿童和青少年当中更是如此。几种风险因素在肥胖相关性胰岛素抵抗的发病过程中扮演着重要角色,这些风险因素包括:血中游离脂肪酸及脂肪组织释放的很多激素和细胞因子增多。当前有两种最常用的评价胰岛素抵抗的方法,分别是高胰岛素正葡萄糖钳夹技术和极小模型技术。但是,两者操作起来都比较困难,不但费时,又昂贵且有损伤性。比较简单的评估胰岛素抵抗的方法是通过口服葡萄糖耐量试验(OGTT)或空腹胰岛素和葡萄糖检测结果进行评估,这些方法被证明适用于评估儿童和青少年胰岛素抵抗,因此在这些群体中广为使用。由于肥胖、胰岛素抵抗与代谢综合征及心血管疾病的发病具有强相关性,因此,预防和治疗儿童肥胖对于预防胰岛素抵抗及相关并发症的发生非常重要。
At present, childhood obesity has become a serious health problem, which is associated with a variety of metabolic and cardiovascular diseases (CVD). Insulin resistance is a common feature of childhood obesity and is considered to be an important cause of obesity in people with type 2 diabetes and CVD. Insulin resistance is one of the main features of the metabolic syndrome and its incidence in children and adolescents is gradually rising, especially in obese children and adolescents. Several risk factors play an important role in the pathogenesis of obesity-related insulin resistance, including many hormones and cytokines released from blood free fatty acids and adipose tissue. There are currently two of the most commonly used methods of assessing insulin resistance, namely the hyperinsulinemic positive glucose clamp technique and the minie model technique. However, both are more difficult to operate, not only time-consuming, expensive and damaging. The simpler method of assessing insulin resistance is assessed by oral glucose tolerance test (OGTT) or fasting insulin and glucose testing, and these methods have proven to be useful in assessing insulin resistance in children and adolescents and are therefore widely used in these populations. Because obesity, insulin resistance and metabolic syndrome and the incidence of cardiovascular disease has a strong correlation, therefore, prevention and treatment of childhood obesity is very important for the prevention of insulin resistance and related complications.