儿童的肥胖和机能性肠障碍

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

儿童肥胖和机能性肠障碍（FBD）很常见，有共同的危险因素。然而，最近人们对这些状态之间的可能关系进行了研究，结果并不明确。因此，对儿童肥胖与机能性肠障碍关系的文献资料进行归纳，探讨可能的介导其的病理生理机制是有意义的。文献表明，肥胖和机能性肠障碍可能是相关的条件。儿童肥胖和肠易激综合征之间存在着重要的联系，这已被所有有关这一问题的研究证实。还有很多证据表明，儿童肥胖与便秘有关。但是，应该指出的是，这方面的研究很少。研究的参与者组成和使用的诊断标准是异质的，在大多数情况下，它们没有针对潜在的混杂因素进行调整。肥胖与机能性肠障碍之间的关系可以通过饮食、饮食习惯和心理因素来调节。但研究这些条件之间的联系，最有希望的方向可能是对肠道菌群的研究。肠道菌群的变化可导致肠道免疫功能受损、慢性低水平炎症的发生、肠道通透性增加、运动性受损和内脏超敏反应。到目前为止，还没有足够的数据来自信地谈论儿童患者的肥胖和机能性肠障碍之间的关系的存在和本质，但这个方向的研究可以为发展病理学上合理的治疗策略提供重要的信息、预防和早期诊断这两类疾病。

全文:

受限制的访问

作者简介

Anna Pogodina

Scientific Center for Family Health and Human Reproduction Problems

编辑信件的主要联系方式.
Email: pogodina_av@inbox.ru

MD, PhD, Dr. Sci. (Med.), Project Leader, Pediatric Department

俄罗斯联邦, Irkutsk

Anastasia Romanitsa

Scientific Center for Family Health and Human Reproduction Problems

Email: ranzypel93@gmail.com

Postgraduate Student, Pediatric Department

俄罗斯联邦, Irkutsk

Lyubov Rychkova

Scientific Center for Family Health and Human Reproduction Problems

Email: iphr@sbamsr.irk.ru

MD, PhD, Dr. Sci. (Med.), Director, Pediatric Department

俄罗斯联邦, Irkutsk

参考

  1. Бельмер С.В., Хавкин А.И., Печкуров Д.В. Запоры функционального происхождения у детей (взгляд через призму римского консенсуса IV) // Лечащий врач. – 2017. – Т. 2. – С. 54–58. [Bel’mer SV, Havkin AI, Pechkurov DV. Zapory funkcional’nogo proishozhdenija u detej (vzgljad cherez prizmu rimskogo konsensusa IV). Lechashhij vrach. 2017;2:54-58. (In Russ.)]
  2. Гурова М.М., Новикова В.П., Хавкин А.И. Состояние кишечной микробиоты и клинико-метаболические особенности у детей с избыточной массой тела и ожирением // Доказательная гастроэнтерология. – 2018. – Т. 7. – № 3. – С. 4–10. [Gurova MM, Novikova VP, Khavkin AI. The state of gut microbiota and clinical-metabolic features in children with overweight and obesity. Russian Journal of Evidence-based Gastroenterology. 2018;7(3):4–10. (In Russ.)] https://doi.org/10.17116/dokgastro201870314.
  3. Долгих В.В., Рычкова Л.В., Мандзяк Т.В. Состояние здоровья детского населения в связи с сочетанным воздействием факторов окружающей среды // Вопросы современной педиатрии. – 2005. – Т. 4, S1. – С. 154. [Dolgih VV, Rychkova LV, Mandzjak TV. Sostojanie zdorov’ja detskogo naselenija v svjazi s sochetannym vozdejstviem faktorov okruzhajushhej sredy. Current Pediatrics. 2005;4(S1):154. (In Russ.)]
  4. Драпкина О.М., Корнеева О.Н. Кишечная микробиота и ожирение. Патогенетические взаимосвязи и пути нормализации кишечной микрофлоры // Терапевтический архив. – 2016. – Т. 88. – № 9. – С. 135–142. [Drapkina OM, Korneeva ON. Gut microbiota and obesity: pathogenetic relationships and ways to normalize the intestinal microflora. Terpavticheskij arhiv. 2016;88(9):135-142. (In Russ.)] https://doi.org/10.17116/terarkh2016889135-142
  5. Загорский С.Э. Функциональные гастроинтестинальные расстройства: дети старше 4 лет и подростки — что изменилось с принятием Римских критериев IV // Педиатрия. Восточная Европа. – 2017. – Т. 5. – № 1. – С. 94–110. [Zagorski SE. Functional gastrointestinal disorders: children over 4 years and teenagers — what has changedwith initiation of Rome criteria IV. Paediatrics Eastern Europe. 2017;5(1):94-110. (In Russ.)]
  6. Ларина Н.Г. Особенности пищевого поведения, образа жизни и психологического статуса у подростков с ожирением и вегетативной дисфункцией // Вестник Новгородского государственного университета им. Ярослава Мудрого. – 2017. – Т. 8. – № 106. – С. 58–61. [Larina NG. Food behaviour, lifestyle, and psychological status of adolescents with obesity and autonomic dysfunction. Vestnik Novgorodskogo gosudarstvennogo universiteta im. Jaroslava Mudrogo. 2017;89(106):58-61. (In Russ.)]
  7. Налетов А.В., Вьюниченко Ю.С. Использование диеты low-FODMAP — важный этап терапии детей с синдромом раздраженного кишечника // Педиатр. – 2017. – Т. 8. – № 6. – С. 94–98. [Nalyotov AV, Vunichenko YS. The using of low-FODMAP diet is an important step in the treatment of children with irritable bowel syndrome. Pediatrician. 2017;8(6):94-98. (In Russ.)] https://doi.org/10.17816/PED8694-98
  8. Павловская Е.В., Строкова Т.В., Сурков А.Г., и др. Характеристика фактического питания у детей с избыточной массой тела и ожирением // Вопросы питания. – 2015. – Т. 84, S5. – С. 58. [Pavlovskaja EV, Strokova TV, Surkov AG, et al. Harakteristika fakticheskogo pitanija u detej s izbytochnoj massoj tela i ozhireniem. Problems of Nutrition. 2015;84(S5):58. (In Russ.)]
  9. Рыбочкина А.В., Дмитриева Т.Г., Иннокентьева Н.Н. Патология органов пищеварения у детей с ожирением Республики Саха (Якутия) // Вестник Северо-Восточного федерального университета им. М.К. Аммосова. Серия: Медицинские науки. – 2017. – Т. 4. – № 9. – С. 85–88. [Rybochkina AV, Dmitrieva TG, Innokentieva NN. Рathology of digestive organs in children with obesity of the Sakha republic of Sakha (Yakutia). Vestnik Severo-Vostochnogo federal’nogo universiteta im. M.K. Ammosova. Serija: Medicinskie nauki. 2017;4(9):85-88. (In Russ.)]
  10. Тутельян В.Л., Батурин А.К., Конь И.Я., и др. Распространенность ожирения и избыточной массы тела среди детского населения РФ: мультицентровое исследование // Педиатрия им. А.Н. Сперанского. – 2014. – Т. 93. – № 5. – С. 28–31. [Tutel’jan VL, Baturin AK, Kon’ IJ, et al. Rasprostranennost’ ozhirenija i izbytochnoj massy tela sredi detskogo naselenija RF: mul’ticentrovoe issledovanie. Pediatria. Journal named after G.N. Speransky. 2014;93(5):28-31. (In Russ.)]
  11. Хавкин А.И., Файзуллина Р.А., Бельмер С.В., и др. Диагностика и тактика ведения детей с функциональными запорами (рекомендации Общества детских гастроэнтерологов) // Вопросы детской диетологии. – 2014. – Т. 12. – № 4. – С. 49–63. [Khavkin AI, Fayzullina RA, Belmer SV, et al. Diagnosis and tactics of treatment of children with functional constipation (recommendations of the society of paediatric gastroenterologists). Pediatric Nutrition. 2014;12(4):49-63. (In Russ.)]
  12. Belkova NL, Nemchenko UM, Pogodina AV, et al. Composition and structure of gut microbiome in adolescents with obesity and different breastfeeding duration. Bull Exp Biol Med. 2019;167(6):759-762. https://doi.org/10.1007/s10517-019-04617-7
  13. Bonilla S, Wang D, Saps M. Obesity predicts persistence of pain in children with functional gastrointestinal disorders. Int J Obes (Lond). 2011;35:517-521. https://doi.org/10.1038/ijo.2010.245
  14. Bouchoucha M, Fysekidis M, Rompteaux P, et al. Influence of age and body mass index on total and segmental colonic transit times in constipated subjects. J Neurogastroenterol Motil. 2019;25(2):258-266. https://doi.org/10.5056/jnm18167
  15. Çağan Appak Y, Karakoyun M, Koru T, Baran M. Dietary properties and anthropometric findings of children with functional constipation: a cross-sectional study. Arch Argent Pediatr. 2019;117(3): e224-e231. https://doi.org/10.5546/aap.2019.eng.e224
  16. Chien LY, Liou YM, Chang P. Low defaecation frequency in Taiwanese adolescents: association with dietary intake, physical activity and sedentary behaviour. J Paediatr Child Health. 2011;47(6):381-386. https://doi.org/10.1111/j.1440-1754.2010.01990.x
  17. Chumpitazi BP, Shulman RJ. Underlying molecular and cellular mechanisms in childhood irritable bowel syndrome. Mol Cell Pediatr. 2016;3(1):1-9. https://doi.org/10.1186/s40348-016-0036-8
  18. Corazziari E. Definition and epidemiology of functional gastrointestinal disorders. Best Pract Res Clin Gastroenterol. 2004;18:613-631. https://doi.org/10.1016/j.bpg.2004.04.012
  19. Costa ML, Oliveira JN, Tahan S, Morais MB. Overweight and constipation in adolescents. BMC Gastroenterol. 2011;17(11):40. https://doi.org/10.1186/1471-230X-11-40
  20. Da Silva CC, Monteil MA, Davis EM. Overweight and obesity in children are associated with an abundance of Firmicutes and reduction of Bifidobacterium in their gastrointestinal microbiota. Child Obes. 2020;16(3):204-210. https://doi.org/10.1089/chi.2019.0280
  21. de Meij TGJ, de Groot EFJ, Eck A, et al. Characterization of microbiota in children with chronic functional constipation. PLoS ONE. 2016;11(10): e0164731. https://doi.org/10.1371/journal.pone. 0164731
  22. Decaluwe V, Braet C, Fairburn CG. Binge eating in obese children and adolescents. Int J Eat Disord. 2003;33:78-84. https://doi.org/10.1038/sj.ijo.0802233
  23. Delgado-Aros S, Camilleri M, Garcia MA, et al. High body mass alters colonic sensory-motor function and transit in humans. Am J Physiol Gastrointest Liver Physiol. 2008;295: G382-388. https://doi.org/10.1152/ajpgi.90286.2008
  24. Dinan TG, Quigley EM, Ahmed SM, et al. Hypothalamic-pituitary-gut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker? Gastroenterology. 2006;130:304-311. https://doi.org/10.1053/j.gastro.2005.11.033
  25. Feinle-Bisset C, Azpiroz F. Dietary lipids and functional gastrointestinal disorders. Am J Gastroenterol. 2013;108:737-747. https://doi.org/10.1038/ajg. 2013.76
  26. Fishman L, Lenders C, Fortunato C, et al. Increased prevalence of constipation and fecal soiling in a population of obese children. J Pediatr. 2004;145:253-254. https://doi.org/10.1016/j.jpeds.2004.04.022
  27. Galai T, Moran-Lev H, Cohen S, et al. Higher prevalence of obesity among children with functional abdominal pain disorders. BMC Pediatr. 2020;20(1):1-6. https://doi.org/10.1186/s12887-020-02106-9
  28. Afshin A, Forouzanfar MH, Reitsma MB, et al; GBD2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13-27. https://doi.org/10.1056/NEJMoa1614362
  29. Giannetti E, de’Angelis G, Turco R, et al. Subtypes of irritable bowel syndrome in children: prevalence at diagnosis and at follow-up. J Pediatr. 2014;164(5):1099-1103. https://doi.org/10.1016/j.jpeds.2013.12.043
  30. Giannetti E, Maglione M, Alessandrella A, et al. A mixture of 3 Bifidobacteria decreases abdominal pain and improves the quality of life in children with irritable bowel syndrome: a multicenter, randomized, double-blind, placebo-controlled, crossover trial. J Clin Gastroenterol. 2017;51: e5-e10. https://doi.org/10.1097/MCG.0000000000000528
  31. Guandalini S, Magazzu G, Chiaro A, et al. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study. J Pediatr Gastroenterol Nutr. 2010;51:24-30. https://doi.org/10.1097/MPG.0b013e3181ca4d95
  32. He J, Cai Z, Fan X. Prevalence of binge and loss of control eating among children and adolescents with overweight and obesity: An exploratory meta- analysis. Int J Eat Disord. 2017;50(2):91-103. https://doi.org/10.1002/eat.22661
  33. Ho W, Spiegel BM. The relationship between obesity and functional gastrointestinal disorders: causation, association, or neither? Gastroenterol Hepatol (NY). 2008;4(8):572-578.
  34. Horvath A, Dziechciarz P, Szajewska H. Meta-analysis: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood. Aliment Pharmacol Ther. 2011;33(12):1302-1310. https://doi.org/10.1111/j.1365-2036.2011.04665.x
  35. Iovino P, Tremolaterra F, Boccia G, et al. Irritable bowel syndrome in childhood: visceral hypersensitivity and psychosocial aspects. Neurogastroenterol Motil. 2009;21(9):940-e974. https://doi.org/10.1111/j.1365-2982.2009.01303.x
  36. Kavehmanesh Z, Saburi A, Maavaiyan A. Comparison of body mass index on children with functional constipation and healthy controls. J Fam Med Prim care. 2013;2(3):222-226. https://doi.org/10.4103/2249-4863.120715
  37. Kiefte-de Jong JC, de Vries JH, Escher JC, et al. Role of dietary patterns, sedentary behaviour and overweight on the longitudinal development of childhood constipation: the Generation R study. Matern Child Nutr. 2013;9(4):511-523. https://doi.org/10.1111/j.1740-8709.2011.00395.x
  38. Koloski NA, Jones M, Kalantar J, et al. The brain-gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. Gut. 2012;61(9):1284-1290. https://doi.org/10.1136/gutjnl-2011-300474
  39. Koppen IJ, Kuizenga-Wessel S, Saps M, et al. Functional defecation disorders and excessive body weight: a systematic review. Pediatrics. 2016;138(3): e20161417. https://doi.org/10.1542/peds.2016-1417
  40. Koppen IJ, Velasco-Benítez CA, Benninga MA, et al. Is there an association between functional constipation and excessive bodyweight in children? J Pediatr. 2016;171:178-182.e1. https://doi.org/10.1016/j.jpeds.2015.12.033
  41. Levy RL, Linde JA, Feld KA, et al. The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants. Clin Gastroenterol Hepatol. 2005;3(10):992-996. https://doi.org/10.1016/s1542-3565(05)00696-8
  42. Macêdo MIP, Albuquerque MDFM, Tahan S, de Morais MB. Is there any association between overweight, physical activity, fat and fiber intake with functional constipation in adolescents? Scand J Gastroenterol. 2020;55(4):414-420. https://doi.org/10.1080/00365521.2020.1749878
  43. Malaty H, Abudayyeh S, Fraley K, et al. Recurrent abdominal pain in school children: effect of obesity and diet. Acta Paediatr. 2007;96:572-576. https://doi.org/10.1111/j.1651-2227.2007.00230.x
  44. Misra S, Lee A, Gensel K. Chronic constipation in overweight children. J Parenter Enteral Nutr. 2006;30(2):81-84. https://doi.org/10. 1177/014860710603000281
  45. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-781. https://doi.org/10.1016/S0140-6736(14)60460-8
  46. Nurko S, Di Lorenzo C. Functional abdominal pain: time to get together and move forward. J Pediatr Gastroenterol Nutr. 2008;47:679-680. https://doi.org/10.1097/MPG.0b013e31818936d1
  47. Ozaki RKF, Speridião PDGL, Soares ACF, de Morais MB. Intestinal fructose malabsorption is associated with increased lactulose fermentation in the intestinal lumen. J Pediatr (Rio J). 2018;94(6):609-615. https://doi.org/10.1016/j.jped.2017.08.006
  48. Pashankar DS, Loening-Baucke V. Increased prevalence of obesity in children with functional constipation evaluated in an academic medical center. Pediatrics. 2005;116(3): e377-e380. https://doi.org/10.1542/peds.2005-0490
  49. Pawłowska K, Umławska W, Iwańczak B. A link between nutritional and growth states in pediatric patients with functional gastrointestinal disorders. J Pediatr. 2018;199:171-177. https://doi.org/10.1016/j.jpeds. 2018.02.069
  50. Phatak UP, Pashankar DS. Prevalence of functional gastrointestinal disorders in obese and overweight children. Int J Obes (Lond). 2014;38(10):1324-1327. https://doi.org/10.1038/ijo.2014.67
  51. de Mello PP, Eifer DA, de Mello DE. Use of fibers in childhood constipation treatment: Systematic review with meta-analysis. J Pediatr. 2018;94:460-470. https://doi.org/10.1016/j.jped.2017.10.014
  52. Rajilic-Stojanovic M, Biagi E, Heilig HG, et al. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology. 2011;141:1792-1801. https://doi.org/10.1053/j.gastro.2011.07.043
  53. Rankin J, Matthews L, Cobley S, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016;7:125-146. https://doi.org/10.2147/AHMT.S101631
  54. Saulnier DM, Riehle K, Mistretta TA, et al. Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. J Gastroenterology. 2011;141(5):1782-1791. https://doi.org/10.1053/j.gastro.2011.06.072
  55. Schnabel L, Buscail C, Sabate J-M, et al. Association between ultra-processed food consumption and functional gastrointestinal disorders: results from the French NutriNet-Santé cohort. Am J Gastroenterol. 2018;113(8):1217-1228. https://doi.org/10.1038/s41395-018-0137-1
  56. Schneck AS, Anty R, Tran A, et al. Increased prevalence of irritable bowel syndrome in a cohort of French morbidly obese patients candidate for bariatric surgery. Obes Surg. 2016;26(7);1525-1530. https://doi.org/10.1007/s11695-015-1907-0
  57. Tambucci R, Quitadamo P, Ambrosi M, et al. Association between obesity/overweight and functional gastrointestinal disorders in children. J Pediatr Gastroenterol Nutr. 2019;68(4):517-520. https://doi.org/10.1097/MPG.0000000000002208
  58. Teitelbaum JE, Sinha P, Micale M, et al. Obesity is related to multiple functional abdominal diseases. J Pediatr. 2009;154(3):444-446. https://doi.org/10.1016/j.jpeds.2008.09.053
  59. vd Baan-Slootweg OH, Liem O, Bekkali N, et al. Constipation and colonic transit times in children with morbid obesity. J Pediatr Gastroenterol Nutr. 2011;52(4):442-445. https://doi.org/10.1097/MPG.0b013e3181ef8e3c
  60. Wojtyniak K, Szajewska H. Systematic review: probiotics for functional constipation in children. Eur J Pediatr. 2017;176(9):1155-1162. https://doi.org/10.1007/s00431-017-2972-2
  61. Wouters MM, Boeckxstaens GE. Is there a causal link between psychological disorders and functional gastrointestinal disorders? Expert Rev Gastroenterol Hepatol. 2016;10:5-8. https://doi.org/10.1586/17474124.2016.1109446
  62. Zhu L, Liu W, Alkhouri R, et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 2014;46:679-686. https://doi.org/10.1152/physiolgenomics.00082. 2014

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Pogodina A., Romanitsa A., Rychkova L., 2021

Creative Commons License
此作品已接受知识共享署名 4.0国际许可协议的许可
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 69634 от 15.03.2021 г.


##common.cookie##