肥胖儿童心血管代谢风险相关的预警指标研究进展

韩琰; 彭璐婷; 李晓南

doi:10.11852/zgetbjzz2020-1285

PDF(569 KB)

中国儿童保健杂志 ›› 2021, Vol. 29 ›› Issue (11) : 1208-1212. DOI: 10.11852/zgetbjzz2020-1285

综述

肥胖儿童心血管代谢风险相关的预警指标研究进展

韩琰, 彭璐婷, 李晓南

作者信息 +

Research progress on the indicators of cardiometabolic risk in obese children

HAN Yan, PENG Lu-ting, LI Xiao-nan

Author information +

文章历史 +

摘要

儿童期肥胖增加血脂异常、高血压、高血糖等心血管代谢风险(CMR),并可持续至成人,使代谢性疾病低龄化。近年发现,尿酸、视黄醇结合蛋白4、维生素D、颈围等与肥胖儿童CMR密切相关,可作为CMR的预警指标,为心血管代谢疾病的早期防治提供新靶标。认识预警指标与代谢风险的关系、作用机制和临床意义,有助于早期识别有CMR相关因素的高危人群并进行干预。

Abstract

Childhood obesity increases the cardiometabolic risks (CMR) such as dyslipidemia,hypertension,and hyperglycemia,and usually persists into adulthood,leading to younger age trend of metabolic diseases. At present,a large number of studies have found that uric acid,retinol-binding protein 4,vitamin D and other factors are related to the CMR in obese children,which can be used as a marker of CMR and provide new ideas for the prevention and treatment of cardiovascular metabolic diseases. Therefore,it is of great importance to understand the relationship and mechanism between indicators and CMR,which is beneficial for early identification and intervention of high-risk groups of cardiovascular and metabolic diseases.

导出引用

韩琰, 彭璐婷, 李晓南. 肥胖儿童心血管代谢风险相关的预警指标研究进展[J]. 中国儿童保健杂志. 2021, 29(11): 1208-1212 https://doi.org/10.11852/zgetbjzz2020-1285

HAN Yan, PENG Lu-ting, LI Xiao-nan. Research progress on the indicators of cardiometabolic risk in obese children[J]. Chinese Journal of Child Health Care. 2021, 29(11): 1208-1212 https://doi.org/10.11852/zgetbjzz2020-1285

中图分类号： R723.14

参考文献

[1] Lin KM,Lu CL,Hung KC,et al. The paradoxical role of uric acid in osteoporosis[J].Nutrients,2019,11(9):2111.
[2] Rocha E,Vogel M,Stanik J,et al. Serum uric acid levels as an indicator for metabolically unhealthy obesity in children and adolescents[J]. Horm Res Paediatr,2018,90(1):19-27.
[3] Viazzi F,Rebora P,Giussani M,et al. Increased serum uric acid levels blunt the antihypertensive efficacy of lifestyle modifications in children at cardiovascular risk[J]. Hypertension,2016,67(5):934-940.
[4] Mazzali M,Hughes J,Kim YG,et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism[J]. Hypertension,2001,38(5):1101-1106.
[5] Lurbe E,Torro M I,Alvarez-Pitti J,et al. Uric acid is linked to cardiometabolic risk factors in overweight and obese youths[J]. J Hypertens,2018,36(9):1840-1846.
[6] de Miranda JA,Almeida GG,Martins RI,et al. The role of uric acid in the insulin resistance in children and adolescents with obesity[J]. Rev Paul Pediatr,2015,33(4):431-436.
[7] Lima WG,Martins-Santos ME,Chaves VE. Uric acid as a modulator of glucose and lipid metabolism[J]. Biochimie,2015,116:17-23.
[8] Kuwabara M,Borghi C,Cicero AFG,et al. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia:A five-year cohort study in Japan[J]. Int J Cardiol,2018,261:183-188.
[9] Mosca A,Nobili V,De Vito R,et al. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents[J]. J Hepatol,2017,66(5):1031-1036.
[10] Genoni G,Menegon V,Secco GG,et al. Insulin resistance,serum uric acid and metabolic syndrome are linked to cardiovascular dysfunction in pediatric obesity[J]. Int J Cardiol,2017,249:366-371.
[11] Yan M,Chen K,He L,et al. Uric acid induces cardiomyocyte apoptosis via activation of calpain-1 and endoplasmic reticulum stress[J]. Cell Physiol Biochem,2018,45(5):2122-2135.
[12] Vedder D,Walrabenstein W,Heslinga M,et al. Dietary interventions for gout and effect on cardiovascular risk factors:a systematic review[J]. Nutrients,2019,11(12):2955.
[13] Takir M,Kostek O,Ozkok A,et al. Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia[J]. J Investig Med,2015,63(8):924-929.
[14] Wu J,Zhang YP,Qu Y,et al. Efficacy of uric acid-lowering therapy on hypercholesterolemia and hypertriglyceridemia in gouty patients[J]. Int J Rheum Dis,2019,22(8):1445-1451.
[15] Harmon DB,Mandler WK,Sipula IJ,et al. Hepatocyte-specific ablation or whole-body inhibition of xanthine oxidoreductase in mice corrects obesity-induced systemic hyperuricemia without improving metabolic abnormalities[J]. Diabetes,2019,68(6):1221-1229.
[16] Castro VMF,Melo AC,Belo VS,et al. Effect of allopurinol and uric acid normalization on serum lipids hyperuricemic subjects:A systematic review with meta-analysis[J]. Clin Biochem,2017,50(18):1289-1297.
[17] Yang Q,Graham TE,Mody N,et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes[J]. Nature,2005,436(7049):356-362.
[18] Li G,Esangbedo IC,Xu L,et al. Childhood retinol-binding protein 4 (RBP4) levels predicting the 10-year risk of insulin resistance and metabolic syndrome:the BCAMS study[J]. Cardiovasc Diabetol,2018,17(1):69.
[19] Liu Y,Chen H,Wang J,et al. Elevated retinol binding protein 4 induces apolipoprotein B production and associates with hypertriglyceridemia[J]. J Clin Endocrinol Metab,2015,100(5):e720-e728.
[20] Porcar-Almela M,Codoner-Franch P,Tuzon M,et al. Left ventricular diastolic function and cardiometabolic factors in obese normotensive children[J]. Nutr Metab Cardiovasc Dis,2015,25(1):108-115.
[21] Morrice N,McIlroy GD,Tammireddy SR,et al. Elevated Fibroblast growth factor 21 (FGF21) in obese,insulin resistant states is normalised by the synthetic retinoid Fenretinide in mice[J]. Sci Rep,2017,7:43782.
[22] Fu J,Han L,Zhao Y,et al. Vitamin D levels are associated with metabolic syndrome in adolescents and young adults:The BCAMS study[J]. Clin Nutr,2019,38(5):2161-2167.
[23] Chandel N,Ayasolla K,Wen H,et al. Vitamin D receptor deficit induces activation of renin angiotensin system via SIRT1 modulation in podocytes[J]. Exp Mol Pathol,2017,102(1):97-105.
[24] Al-Ishaq RK,Kubatka P,Brozmanova M,et al. Health implication of vitamin D on the cardiovascular and the renal system[J]. Arch Physiol Biochem,2019:1-15.
[25] Ekbom K,Marcus C. Vitamin D deficiency is associated with prediabetes in obese Swedish children[J]. Acta Paediatr,2016,105(10):1192-1197.
[26] Moschonis G,Androutsos O,Hulshof T,et al. Vitamin D insufficiency is associated with insulin resistance independently of obesity in primary schoolchildren. The healthy growth study[J]. Pediatr Diabetes,2018,19(5):866-873.
[27] 刘璐. 维生素D3对高脂饲料诱导的小鼠脂肪组织内质网应激以及胰岛素抵抗的影响[J]. 中华内分泌代谢杂志,2017,10(33):861-864.
[28] Censani M,Hammad H T,Christos P J,et al. Vitamin d deficiency associated with markers of cardiovascular disease in children with obesity[J].Glob Pediatr Health,2018,5:2333794X17751773.
[29] Asano L,Watanabe M,Ryoden Y,et al. Vitamin D metabolite,25-hydroxyvitamin d,regulates lipid metabolism by inducing degradation of SREBP/SCAP[J]. Cell Chem Biol,2017,24(2):207-217.
[30] Ning C,Liu L,Lv G,et al. Lipid metabolism and inflammation modulated by Vitamin D in liver of diabetic rats[J]. Lipids Health Dis,2015,14:31.
[31] Mostafa DK,Nasra RA,Zahran N,et al. Pleiotropic protective effects of Vitamin D against high fat diet-induced metabolic syndrome in rats:One for all[J]. Eur J Pharmacol,2016,792:38-47.
[32] Al-Daghri NM,Amer OE,Khattak MNK,et al. Effects of different vitamin D supplementation strategies in reversing metabolic syndrome and its component risk factors in adolescents[J]. J Steroid Biochem Mol Biol,2019,191:105378.
[33] Bassatne A,Chakhtoura M,Saad R,et al. Vitamin D supplementation in obesity and during weight loss:A review of randomized controlled trials [J]. Metabolism,2019,92:193-205.
[34] Preis SR,Massaro JM,Hoffmann U,et al. Neck circumference as a novel measure of cardiometabolic risk:the Framingham Heart study[J]. J Clin Endocrinol Metab,2010,95(8):3701-3710.
[35] Formisano A,Bammann K,Fraterman A,et al. Efficacy of neck circumference to identify metabolic syndrome in 3~10 year-old European children:Results from IDEFICS study[J]. Nutr Metab Cardiovasc Dis,2016,26(6):510-516.
[36] Mangge H,Zelzer S,Pruller F,et al. Branched-chain amino acids are associated with cardiometabolic risk profiles found already in lean,overweight and obese young[J]. J Nutr Biochem,2016,32:123-127.
[37] Yoon MS.The role of mammalian target of rapamycin(mTOR)in insulin signaling[J]. Nutrients,2017,9(11):1176.
[38] Shapiro H,Kolodziejczyk AA,Halstuch D,et al. Bile acids in glucose metabolism in health and disease[J]. J Exp Med,2018,215(2):383-396.
[39] McGlone ER,Bloom SR. Bile acids and the metabolic syndrome[J]. Ann Clin Biochem,2019,56(3):326-337.