Kirk Shelley, Zeller Meg, Claytor Randal, Santangelo Megan, Khoury Philip R, Daniels Stephen R
Division of Cardiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Obes Res. 2005 May;13(5):876-82. doi: 10.1038/oby.2005.101.
To evaluate the clinical outcomes of patients participating in an outpatient program for managing childhood and adolescent obesity.
Based on a retrospective chart review, 394 physician-referred obese youth (BMI > 95th percentile), 5 to 19 years of age, were treated in an interdisciplinary, family-centered, behavioral weight management program in a hospital-based outpatient setting. Treatment included group exercise, parent education, and behavioral intervention therapies to improve diet and physical activity.
A total of 177 (45%) completed the initial phase of treatment (mean duration = 5.6 months). For the completion group, there were significant improvements (all p < 0.001) in weight (-2.0 +/- 4.9 kg), BMI (-1.7 +/- 1.9 kg/m(2)), and BMI z score (-0.15 +/- 0.15), without interfering with growth (height, 2.2 +/- 1.3 cm; p < 0.001). Significant improvement was also found for blood pressure, total cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, insulin, and aerobic fitness. At onset of treatment, 134 (84%) patients had abnormal fasting insulin concentration, 88 (50%) had abnormal total cholesterol, 14 (8%) had abnormal diastolic blood pressure, and 69 (40%) had abnormal LDL-cholesterol. At the end of treatment, a significant proportion of patients with baseline abnormal blood pressure, total cholesterol, and LDL-cholesterol had normal values (p < 0.001). A decrease in BMI z score was associated with significant improvements in insulin and lipid values (all p < 0.05).
We have demonstrated that a modest decrease in BMI in an ongoing clinical pediatric weight management program is accompanied by significant improvements in related health measures. These results may be helpful in counseling families with overweight children and adolescents.
评估参与儿童及青少年肥胖门诊管理项目患者的临床结局。
基于回顾性病历审查，394名年龄在5至19岁、由医生转诊的肥胖青少年（BMI>第95百分位数）在一家医院门诊环境中接受了一个跨学科、以家庭为中心的行为体重管理项目治疗。治疗包括团体运动、家长教育以及改善饮食和身体活动的行为干预疗法。
共有177名（45%）患者完成了初始治疗阶段（平均持续时间=5.6个月）。对于完成治疗组，体重（-2.0±4.9千克）、BMI（-1.7±1.9千克/平方米）和BMI z评分（-0.15±0.15）有显著改善（所有p<0.001），且未影响生长（身高，2.2±1.3厘米；p<0.001）。血压、总胆固醇、低密度脂蛋白（LDL）胆固醇、甘油三酯、胰岛素和有氧适能也有显著改善。治疗开始时，134名（84%）患者空腹胰岛素浓度异常，88名（50%）患者总胆固醇异常，14名（8%）患者舒张压异常，69名（40%）患者LDL胆固醇异常。治疗结束时，基线血压、总胆固醇和LDL胆固醇异常的患者中有很大比例恢复正常（p<0.001）。BMI z评分的降低与胰岛素和血脂值的显著改善相关（所有p<0.05）。
我们已经证明，在一个正在进行的临床儿科体重管理项目中，BMI适度下降伴随着相关健康指标的显著改善。这些结果可能有助于为超重儿童和青少年的家庭提供咨询。
