Hurvitz Edward A, Green Liza B, Hornyak Joseph E, Khurana Seema R, Koch Lauren Gerard
Department of Physical Medicine and Rehabilitation, University of Michigan Health Systems, Ann Arbor, Michigan, USA.
Am J Phys Med Rehabil. 2008 May;87(5):395-403. doi: 10.1097/PHM.0b013e3181617736.
To investigate the prevalence of overweight in a clinic-based population of children with cerebral palsy (CP) and its association with gross motor function status.
Retrospective chart review. We calculated body mass index (BMI; kg/m2) from charted height and weight and recorded Gross Motor Function Classification Scale (GMFCS levels I-V) on the basis of clinical descriptions in clinic notes for 137 children (2-18 yrs old) with CP seen in a pediatric rehabilitation clinic at an academic medical center. BMI percentiles were reported according to sex-specific age group standards for growth set by the U.S. Centers for Disease Control and Prevention (CDC). Associations were modeled by Pearson's chi2 distribution.
Out of the total CP subject group, 29.1% were considered overweight (>95th percentile) or at risk for overweight (85th to 95th percentile). Ambulatory children (GMFCS levels I and II) showed a trend (Pearson's chi2, P = 0.06) toward higher prevalence of overweight (22.7%) compared with nonambulatory children (levels IV and V, 9.6%). Underweight was more prevalent in nonambulatory children (P < 0.01). Logistic regression analysis did not identify any significant predictors for overweight.
In our patient population, analysis of BMI suggests that children with CP have a high rate of overweight and are at risk of overweight, particularly among ambulatory children. More study is needed, using measures more accurate than BMI, to clarify risk.
调查以门诊为基础的脑瘫（CP）患儿超重的患病率及其与粗大运动功能状态的关系。
回顾性病历审查。我们根据病历记录的身高和体重计算体重指数（BMI；kg/m²），并根据一所学术医疗中心儿科康复门诊137名2至18岁CP患儿病历中的临床描述记录粗大运动功能分类量表（GMFCS I - V级）。根据美国疾病控制与预防中心（CDC）制定的特定性别年龄组生长标准报告BMI百分位数。通过Pearson卡方分布对相关性进行建模。
在整个CP研究对象组中，29.1%被认为超重（>第95百分位数）或有超重风险（第85至95百分位数）。与非步行儿童（IV级和V级，9.6%）相比，步行儿童（GMFCS I级和II级）超重患病率有升高趋势（Pearson卡方检验，P = 0.06）（22.7%）。非步行儿童中体重过轻更为常见（P < 0.01）。逻辑回归分析未发现超重的任何显著预测因素。
在我们的患者群体中，对BMI的分析表明CP患儿超重率高且有超重风险，尤其是在步行儿童中。需要使用比BMI更准确的测量方法进行更多研究以明确风险。
