2014, Número S1
<< Anterior Siguiente >>
Rev Med Inst Mex Seguro Soc 2014; 52 (S1)
Obesidad infantil y dislipidemia
Gómez-Díaz RA, Wacher-Rodarte NH
Idioma: Español
Referencias bibliográficas: 30
Paginas: 102-108
Archivo PDF: 129.25 Kb.
RESUMEN
En todos los niños o adolescentes con sobrepeso u
obesidad debe buscarse de manera intencionada la
presencia de dislipidemias que sean secundarias a
la obesidad, con el fin de poder prevenir un evento
cardiovascular. Las dislipidemias son un grupo de
enfermedades asintomáticas que comúnmente son
causadas por concentraciones anormales de las
lipoproteínas sanguíneas; son una comorbilidad
que es común en la obesidad, independientemente
de la edad del paciente. De estas enfermedades, la
que tiene mayor prevalencia es la hipertrigliceridemia.
Identificar anormalidades en el perfil de lípidos
de la población pediátrica permite seleccionar la
intensidad y el tipo de tratamiento para el paciente
y su familia. El manejo inicial que debe recibir todo
niño y adolescente con obesidad y dislipidemia debe
basarse en la promoción de un estilo de vida saludable
con la dieta y el ejercicio. Para que la adherencia
al tratamiento sea exitosa, es fundamental la participación
del médico en combinación con un equipo
multidisciplinario. Con el tratamiento se pueden reducir
los riesgos de complicaciones. La participación
del especialista en el manejo del paciente pediátrico
obeso con dislipidemias debe limitarse a los casos
con dislipidemias severas o a aquellos en los que se
busque prevenir una pancreatitis.
REFERENCIAS (EN ESTE ARTÍCULO)
Dietz WH. Health consequences of obesity in youth: childhood predictors of adulthood disease. Pediatrics 1998;101 (Suppl 3):518-25.
Kwiterovich PO. Primary and secundary disorders of lipid metabolism in pediatrics. Pediatr Endocrinol Rev. 2008;5(Suppl 2):727-38.
Beswick A, Brindle P. Risk scoring in the assessment of cardiovascular risk. Cur Opinion Lipidol. 2006;17:375-86.
Reis EC, Kip KE, Marroquin OC, Kiesau M, Hipps L Jr, Peters RE, et al. Screening children to identify families at increased risk for cardiovascular diseases. Child Risk-Factor Defi nitions. Pediatrics 2006;118:1789-97.
Bao A, Srinivassan SR, Valdez R, Greenlund K, Wattigney WA, Berenson GS. Longitudinal changes in cardiovascular risk from childhood to young adulthood in offspring of parents with coronary artery disease. JAMA. 1997;278:1749-54.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood fromchildhood and parental obesity. New England Journal of Medicine. 1997;337:869-73.
Caprio S. Insulin resistance in childhood obesity. J Pediatr Endocrinol Metab. 2002;15:487-92.
Morino K, Petersen KF, Dufour S, Befroy D, Frattini J, Shatzkes N, et al. Reduced mitocondrial density and increased IRS-1 serine phosphorylation in muscle of insulin-resistance offspring of type 2 diabetes parents. J Clin Invest. 2005;115:3587-93.
Bacha F, Saad R, Gungor N, Janosky J, Arslanian SA. Obesity, regional fat distribution, and syndrome X in obese black versus white adolescents: race differential in diabetogenic and atherogenic risk factors. J Clin Endocrinol Metab. 2003;88(6):2534-40.
Lumeng CN, Saltiel AR. Infl ammatory links between obesity and metabolic disease. J Clin Invest. 2011;121:2111-7.
Skinner AC, Steiner MJ, Henderson FW, Perrin EM. Multiple markers of infl ammation and weight status: cross-sectional analyses throughout childhood. Pediatrics. 2010;125(4):e801-9.
Zeev H, Riggs S, Vaz R, Flanagan P, Harel D, Machan JT. Isolated low HDL cholesterol emerges as the most common lipid abnormality among obese adolescents. Clinical Pediatrics. 2010;49(1):29-34.
American Academy of Pediatrics, Committee on Nutrition. Cholesterol in childhood. Pediatrics. 1998;101:141-47.
National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics. 1996;98:649-58.
McCrindle BW. Assesment and management of hypertension in children and adolescents. Nat Rev Cardiol. 2010;7(3):155-63.
National Center for Health Statistics National Health and Nutrition examination survey. CDC Growth Charts: Body Mass index for Age. United States; 2000.
Gómez-Díaz RA, Martínez-Hernández AJ, Aguilar- Salinas CA, Violante R, López-Alarcón M, Jiménez- Villarruel M, et al. Percentiles distribution of the waist circumference among Mexican pre-adolescents of a primary school in Mexico city. Diabetes Obes Metab. 2005;7:716-21.
Kavey RE, Allada V, Daniels SR, Hayman L, Mc- Crindle B, Newburger J, et al. Cardiovascular Risk Reduction in High-Risk Pediatric Patients. A Scientifi c Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: American Academy of Pediatrics. Circulation. 2006;114:2710-38.
Kavey RE, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. J Pediatr. 2003;142:368-72.
Weintraub WS, Daniels SR, Burke LE, Frankin BA, Goff DC Jr, Hayman LL, et al. Value of primordial and primary prevention for cardiovascular disease: a policy statement from the American Heart Association. Circulation. 2011;124:967-90.
Gómez-Díaz RA, Rábago-Rodríguez R, Castillo- Sotelo JE, Vázquez-Estupiñan F, Barba-Ostria R, Castell-López A et al. Tratamiento del niño obeso. Bol Med Hosp Inf Mex. 2008;65:528.
Owen GC, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005;115:1367-77.
Daniels SR, Jacobson SM, McCrindle BW, Eckel RH, Sanner BM. American Heart Association Childhood Obesity Research Summit report. Circulation. 2009;119(15):e489-517.
Manlhiot C, Larsson P, Gurofsky RC, Smith RW, Fillingham C, Clarizia NA, et al. Spectrum and management of hypertriglyceridemia among children in clinical practice. Pediatrics. 2009;123:458-65.
Kolansky DM, Cuchel M, Clark BJ, Paridon S, Mc- Crindle BW, Wiegers SE, et al. Longitudinal evaluation and assessment of cardiovascular disease in patients with homozygous familial hypercholesterolemia. Am J Cardiol. 2008;102(11):1438-43.
McCrindle BW, Helden E, Cullen-Dean G, Conner WT. A randomized crossover trial of combination pharmacologic therapy in children with familial hyperlipidemia. Pediatr Res. 2002;51(6):715-21.
McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP, et al. Drug therapy of high risk lipid abnormalities in children and adolescents. A scientifi c statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Young Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation. 2007;115(14):1948-67.
McCrindle BW, for the Writing Group. Summary of the American Heart Association’s Scientifi c Statement on Drug Therapy of High-risk Lipid Abnormalities in Children and Adolescents. Arterioscler Thromb Vasc Biol. 2007;27:982-5.
Kusters DM, Vissers MN, Wiegman A, Kastelein JJ, Hutten BA. Treatment of dyslipidemia in childhood. Expert Opin Pharmacother. 2010;11(5):739-53.
Ten S, Maclaren N. Insulin resistance syndrome in children. J Clin Endocrinol Metab. 2004;89(6):2526-39.