儿童肥胖患病率的上升与肥胖相关的代谢并发症的增加平行。从长远来看,这大大增加了心血管疾病发病率的人口负担。通过适当的筛查策略早期发现肥胖相关的代谢并发症是肥胖管理的重要方面。我们对儿童肥胖管理的国际和国家指南进行了范围审查,以评估筛查代谢并发症的建议。即,高血压,糖尿病,血脂异常,和非酒精性脂肪性肝病。包括30条准则,其中23例(76.7%)对代谢并发症的筛查有一定的指导。然而,这些代谢并发症筛查建议的范围和细节存在显著差异.关于体重指数(BMI)阈值尚未达成共识,发病年龄,频率,和推荐用于检测高血压的筛查测试,糖尿病,血脂异常,和非酒精性脂肪性肝病之间的指南。根据地理位置或人口种族,这些差异似乎没有两极分化。我们根据指南中的证据强度提供了关于代谢筛查的建议,还纳入了主要儿童高血压的建议,糖尿病,和脂质指南。适当实施筛查策略对于改善代谢并发症的检测至关重要。为受影响的肥胖儿童提供更早或更强化的干预措施。
The rise in prevalence of childhood obesity is paralleled by an increase in obesity-related metabolic complications, which add significantly to the population burden of cardiovascular morbidity in the long term. Early detection of obesity-related metabolic complications through appropriate screening strategies forms a crucial aspect of obesity management. We performed a scoping review of international and national
guidelines on the management of pediatric obesity to evaluate the recommendations on screening for metabolic complications, namely, hypertension, diabetes, dyslipidemia, and non-alcoholic fatty liver disease. Thirty
guidelines were included, 23 (76.7%) of which had some guidance on screening for metabolic complications. However, there were significant variations in the extent and details of recommendations for screening for these metabolic complications. There has been no
consensus on the body mass index (BMI) thresholds, age of onset, frequency, and screening tests recommended for detecting hypertension, diabetes, dyslipidemia, and non-alcoholic fatty liver disease between guidelines. These variations did not appear to be polarized based on geographical location or population ethnicity. We provide our recommendations on metabolic screening based on the strength of evidence in the
guidelines, also incorporating recommendations from key childhood hypertension, diabetes, and lipid
guidelines. Appropriate implementation of screening strategies is crucial to improve detection of metabolic complications, to allow for earlier or more intensified interventions for affected children with obesity.