从精准医疗看儿童青少年肥胖治疗的个体化干预策略  

Individualized intervention strategies in the treatment of childhood and adolescent obesity based on precision medicine

作　　者：李平 杨凡 刘瀚旻 LI Ping;YANG Fan;LIU Hanmin(Key Laboratory of Birth Defects and Related Maternal and Child Diseases,Ministry of Education,West China Second University Hospital,Chengdu 610041,China;Key Laboratory of Time Biology,National Health Commission,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院儿科、出生缺陷与相关妇儿疾病教育部重点实验室,成都610041 [2]四川大学国家卫生健康委员会时间生物学重点实验室

出　　处：《中国中西医结合儿科学》2025年第1期1-7,共7页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：四川省重点研发项目重大科技专项(2023YFS0034)。

摘　　要：儿童青少年肥胖已成为全球性公共卫生挑战,其高体质量反弹率与代谢并发症风险凸显传统干预策略的局限性。本文系统综述了精准医疗背景下儿童青少年肥胖的个体化干预策略,突破传统“一刀切”模式,整合多组学技术与智慧化管理手段,提出多维度精准干预框架。首先,基于基因组学、影像组学及肠道宏基因组学等多模态数据,构建精准诊断与评估体系,识别遗传易感性、代谢表型及微生物特征,为分层干预奠定基础。其次,结合遗传风险评分、表观遗传调控机制及肠道菌群靶向疗法,制定个性化干预方案:基因导向策略是通过多基因风险评估优化饮食结构;表观遗传干预是利用营养素(如甲基供体、短链脂肪酸)调控DNA甲基化与组蛋白修饰,逆转代谢紊乱;微生物群重塑则通过益生菌、合生元等改善能量代谢平衡。进一步,依托人工智能与可穿戴设备实现多场景动态监测,协同营养学、运动医学及心理学等多学科团队,形成“医院-家庭-社区”联动的智慧管理模式。尽管精准医疗为儿童肥胖治疗提供了突破性方向,仍需解决生物标志物验证、数据整合及长期疗效评估等挑战。本文为提升干预有效性与持久性提供了理论依据与实践路径,强调未来需融合跨学科创新技术,推动儿童肥胖管理向精准化、智能化转型。Childhood and adolescent obesity has become a global challenge in public health.Its high weight regain rate and risks of metabolic complications highlight the limitations of traditional intervention strategies.This review systematically explores individualized intervention strategies for obesity in children and adolescents in the context of precision medicine,breaking the traditional"one-size-fits-all"model.It integrates multi-omics technologies with intelligent management methods,proposing a multidimensional framework for precise intervention.First,a precise diagnosis and evaluation system is constructed based on multi-modal data,including genomics,radiomics,and gut microbiomics,to identify genetic susceptibility,metabolic phenotypes and microbiome characteristics,laying the foundation for stratified interventions.Secondly,individualized intervention plans are developed based on genetic risk scores,epigenetic regulatory mechanisms,and gut microbiome-targeted therapies:gene-guided strategies aim to optimize dietary structure through multi-gene risk assessments;epigenetic interventions aim to regulate DNA methylation and histone modification by taking advantage of nutrients(such as methyl donors and short-chain fatty acids),reversing metabolic dysregulation;microbiome remodeling aims to improve energy metabolism balance through probiotics and synbiotics.Furthermore,artificial intelligence and wearable devices are employed for dynamic monitoring in multiple scenarios.By collaborating with multidisciplinary teams in nutrition,sports medicine,and psychology,a smart management model of"hospital-family-community"network is established.While precision medicine offers groundbreaking directions for childhood obesity treatment,challenges such as biomarker validation,data integration,and long-term efficacy evaluation remain to be addressed.This review provides theoretical foundations and practical pathways for the improvement in the effectiveness and sustainability of interventions,emphasizing the need to integrate interdis

关 键 词：肥胖 精准医疗 表观遗传 肠道微生物 青少年 儿童 

分 类 号：R725.8[医药卫生—儿科]