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Review
. 2020 Mar;2(3):223-232.
doi: 10.1038/s42255-020-0183-z. Epub 2020 Mar 16.

Childhood obesity and the associated rise in cardiometabolic complications

Sonia Caprio  1 , Nicola Santoro  2 , Ram Weiss  3
Affiliations
Review

Childhood obesity and the associated rise in cardiometabolic complications

Sonia Caprio et al. Nat Metab. 2020 Mar.

Abstract

Childhood obesity is one of the most serious global public-health challenges of the twenty-first century. Over the past four decades, the number of children and adolescents with obesity has risen more than tenfold. Worldwide, an increasing number of youth are facing greater exposure to obesity throughout their lives, and this increase will contribute to the early development of type 2 diabetes, fatty liver and cardiovascular complications. Herein, we provide a brief overview of trends in the global shifts in, and environmental and genetic determinants of, childhood obesity. We then discuss recent progress in the elucidation of the central role of insulin resistance, the key element linking obesity and cardiovascular-risk-factor clustering, and the potential mechanisms through which ectopic lipid accumulation leads to insulin resistance and its associated cardiometabolic complications in obese adolescents. In the absence of effective prevention and intervention programs, childhood obesity will have severe public-health consequences for decades to come.

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Conflict of interest statement

Competing interests

The authors declare no competing interests.

Figures

Fig. 1 |
Fig. 1 |. Trends in the number of children and adolescents with obesity and with moderate and severe underweight by region.
Image reprinted with permission from ref. under a Creative Commons license CC BY 4.0.
Fig. 2 |
Fig. 2 |. Trends in the prevalence of childhood obesity in the United States from 1963 to 2016.
Image reprinted with permission from ref., National Center for Health Statistics.
Fig. 3 |
Fig. 3 |. Proposed pathophysiological mechanisms linking NAFLD to IR and cardiac dysfunction in obese adolescents.
NAFLD is a result of genetics and environmental factors (dietary habits, IR, increased de novo lipogenesis and adipose tissue lipolysis). FFAs, free fatty acids; FA, fatty acid, VLDL, very low-density lipoprotein; TG, triglyceride; DNL, de novo lipogenesis; FGF21, fibroblast growth factor 21; SREBP1c, sterol regulatory element–binding protein 1c. Image adapted with permission from ref., American Association for the Study of Liver Diseases.
See this image and copyright information in PMC

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