1986～1996年儿童期单纯肥胖症研究

Childhood obesity in China

目的介绍我国部分儿科工作者１９８６～１９９６年在儿童期单纯肥胖症领域内的研究进展。方法流行学、生理学、心理行为、分子生物学研究。结果学龄前期（０～７岁）单纯肥胖症检出率长期居高不下（全国平均２０％，有的地区高达１７５％），年增长率失控（全国平均９１％，有的地区高达３０％）。脂肪重聚年龄过早（５岁）和脂肪重聚比过高（２０～３２）。肥胖超重比过高（全国平均２０，有的年龄组３９，有的地区高达５２）。肥胖在儿童期即已损伤儿童心肺功能，妨碍有氧能力发育。根据中国儿童有氧能力制订的运动处方，有效地提高有氧能力和运动能力，并有效地将饱感中枢过高的阈值降至正常生理水平，降低过量进食。对心理行为研究表明，肥胖儿童存在着深层的心理冲突，精神压力和行为异常。此种损伤过去知之甚少，是肥胖控制难以持续和反跳的主要原因。肥胖儿童行为治疗方案要采取多种方法，家长，教师共同参与。肥胖的分子生物学研究已取得初步结果，从儿童脂肪细胞中提取总ＲＮＡ，经逆转录聚合酶链反应（ＲＴＰＣＲ）获得了人肥胖相关基因的部分ｃＤＮＡ片段。通过体外ＤＮＡ重组技术，以ｐＢＶ２２０为表达载体构建表达质粒ｐＢＶ２２０肥胖抑素（Ｌｅｐｔｉｎ）?

Objective To review studies on childhood obesity in China during 1986～1996. Methods Epidemiological, physiological, psycologybehavioral and molecular studies were reviewed in this article. Results A peak prevalence (2.0% average and 17.5% in some areas) and sharp increase rate (9.0% average and 30.0% in some areas) of obesity in children 07 yr in China showed a trend that needs urgent control. The adiposity rebound age (ARA) of 5 yr is too early. The adiposity rebound ratio (ARR, ARA1 3.2 and ARA2 2.0) suggested that a high morbidity and mortality of obesity, hypertension, etc, would soon appear in the next decade. The obesity to overweight ratio (OOR. 2.0 average, 3.9 in some age groups and 5.2 in some areas) showed that the weight control is a longterm task in China. The physiology study on childhood obesity indicated that obesity has already damaged the lung and heart function and the aerobic capacity and physical performance of childhood. The exercise prescription improved the physical fitness, enhanced physical performance and adjusted the threshold level of satiety of hypothalamus to normal physiological level. The behavioral research illustrated that psychological and behavioral impairment existed deeply in obese children and is an obstacle against treatment of over weight. The behavioral modificantion protocol should combine multidimensional methods and involve the parents, especially grandparents in China. The molecular study on childhood obesity has obtained good preliminary results. The human leptin cDNA fragment was obtained by RTPCR and total RNA was extracted from human adiposity tissue and the recombinant plasmid expressing pBv220leptin was constructed. Conclusion The childhood obesity has already become a severe health and social problem, especially in the recent decade. The prevention and control of childhood obesity should start from preschool age group, it is necessary to use combined methods of exercise prescription and behavioral modification (changing life style) to prevent and control childhood obesity.