青少年代谢综合征诊断的不稳定性
Elizabeth Goodman1, Stephen R Daniels, James B Meigs
1Floating Hospital for Children at Tufts-New England Medical Center, Boston, Mass, MA, USA. egoodman@tufts-nemc.org
Circulation
|April 11, 2007
概括
代谢风险因素在青少年中经常聚集,但代谢综合征的诊断是不稳定的,许多青少年随着时间的推移获得或失去诊断. 这表明,在这个年龄组中,在治疗决策中使用诊断是需要谨慎的.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 代谢健康 代谢健康
- 青少年医学 青少年医学
背景情况:
- 代谢综合征的危险因素在青少年和成人中表现出类似的潜在结构.
- 青春期涉及显著的生理变化,提出了关于代谢综合征结构和诊断的稳定性的问题.
- 以前的研究表明潜在的稳定性,但临床分类在这个发育期仍然不确定.
研究的目的:
- 评估青少年代谢综合征的基本因子结构的稳定性.
- 为了评估代谢综合征的临床分类在青少年队列的时间上的一致性.
- 为了确定不同的代谢综合征诊断标准是否会在年轻人中产生类似的稳定性模式.
主要方法:
- 分析了普林斯顿学区研究中的1098名青少年的数据,追踪了3年.
- 在基线和随访时对8种代谢风险进行了因子分析,以检查因子模式的稳定性.
- 应用三种不同的代谢综合征定义:美国心脏协会 (AHA),儿科AHA和国际糖尿病联合会 (IDF) 的指南.
主要成果:
- 代谢风险的因素结构在基线和随访之间保持一致.
- 代谢综合征的临床分类显示出显著的不稳定性,大约50%的青少年失去或获得诊断.
- 在所有三个诊断标准 (儿科AHA,AHA,IDF) 中都观察到不稳定性,累计发病率从3.8%到5.2%不等.
结论:
- 代谢风险因素聚类在青春期是稳定的.
- 代谢综合征的分类诊断在青少年中非常不稳定,其特点是经常获得和失去诊断.
- 代谢综合征诊断的不稳定性表明,在青春期临床实用性有限,并引发了对青少年过早使用综合征特异性药物治疗的担忧.
相关概念视频
Erikson's Theory on Socioemotional Development during Adolescence
1.7K
Erik Erikson's fifth stage of psychosocial development, "identity versus role confusion," is crucial during adolescence (ages 12 to 18). In this stage, adolescents face the developmental task of forging a distinct personal identity, a process influenced by social, psychological, and biological changes typical of this period. Adolescents naturally explore different roles, behaviors, and ideologies as they navigate complex questions of self-concept, asking, "Who am I?" and "What is my place in...
1.7K
Diabetes: Symptoms, Diagnosis, and Complications
2.6K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
2.6K
Overview of Lipid Metabolism
6.4K
Lipid metabolism is a crucial process in the human body that involves the synthesis and degradation of lipids. This process is essential for energy production, cell membrane formation, and hormone production, among other functions.
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
6.4K
Inborn Errors of Metabolism
985
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
985
Obesity
1.5K
The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
1.5K
Overview of Carbohydrate Metabolism
4.1K
Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
4.1K


