儿童及青少年肥胖已成为全球性的重大公共卫生挑战,呈现发病率持续上升且低龄化的趋势。儿童肥胖显著增加2型糖尿病、高血压、非酒精性脂肪肝、哮喘及阻塞性睡眠呼吸暂停等并发症的风险,并增加远期心血管疾病风险。目前,以营养、运动和行为矫正为核心的生活方式干预是国内外指南推荐的一线体重管理策略,其中运动干预是关键环节。然而,肥胖儿童普遍存在体力活动水平低、久坐时间长、运动参与不足等困境,严重限制了干预效果。本综述系统阐述了运动在儿童肥胖体重管理中的核心作用与内在生理机制。运动通过增加总能量消耗、增强骨骼肌脂肪氧化、改善胰岛素敏感性、促进脂肪分解及调节食欲相关激素等途径,直接对抗能量正平衡与脂肪堆积。此外,规律运动能有效改善肥胖相关的慢性低度炎症状态,通过降低C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等促炎因子水平,并促进IL-10等抗炎因子以及鸢尾素、IL-15等有益肌细胞因子的释放,从代谢与免疫层面协同发挥健康促进作用。综上所述,运动是儿童肥胖防治中不可或缺的非药物干预手段,具有双重健康效益。
Abstract
Childhood and adolescent obesity has become a major global public health challenge, with a continuously rising prevalence and a trend toward younger age of onset. The escalating rates of childhood obesity significantly increase the risk of various complications, including type 2 diabetes, hypertension, non-alcoholic fatty liver disease (NAFLD), asthma, and obstructive sleep apnea, substantially elevating the long-term risk of cardiovascular diseases. Currently, lifestyle interventions centered on nutrition, physical activity, and behavioral modification are the first-line weight management strategies recommended by both domestic and international guidelines, with exercise intervention being a critical component. However, obese children commonly face challenges such as low levels of physical activity, prolonged sedentary time, and insufficient exercise participation, which severely limit intervention effectiveness. This review systematically elucidates the core role and underlying physiological mechanisms of exercise in weight management for obese children. First, exercise directly counteracts positive energy balance and fat accumulation through multiple pathways: increasing total energy expenditure, enhancing skeletal muscle fat oxidation capacity, improving insulin sensitivity, promoting lipolysis, and regulating appetite-related hormones. Second, regular exercise effectively ameliorates obesity-related chronic low-grade inflammation by reducing levels of pro-inflammatory factors such as C-reactive protein (CRP),interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), while promoting the release of anti-inflammatory factors like IL-10 and beneficial myokines including irisin and IL-15, thereby exerting synergistic health-promoting effects at both metabolic and immune levels. In conclusion, exercise represents an indispensable non-pharmacological intervention with dual benefits for the prevention and management of childhood obesity.
关键词
儿童肥胖 /
运动 /
体重管理 /
能量代谢 /
炎症 /
肌细胞因子
Key words
childhood obesity /
exercise /
weight management /
energy metabolism /
inflammation /
myokines
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基金
国家自然科学基金(82373594);西安交通大学第二附属医院临床研究基金(T007)
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