Steinbeck K, Baur L, Cowell C, Pietrobelli A
Department of Endocrinology and Adolescent Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Int J Obes (Lond). 2009 Jan;33(1):2-7. doi: 10.1038/ijo.2008.263. Epub 2008 Dec 9.
Adolescent medicine is relatively young, compared to paediatric or adult medicine. Descriptive and observational studies have dominated the adolescent literature, including those studies published in the International Journal of Obesity. In addition, many studies have combined child and adolescent age groups, making it difficult to determine adolescent-specific outcomes. It is important that high quality intervention studies in adolescents occur. Adolescence is a time of extraordinary plasticity. Habits, attitudes and physical morbidity that develop during adolescence set up trajectories that have a profound influence on health and wellbeing for the long term. Overweight and obesity are an excellent example of the need for high quality intervention studies and yet in the last two decades there have been very few randomized, controlled trials of overweight and obesity management in adolescents. There are a number of complexities in adolescent research that create additional challenges to those that accompany any clinical research. These include recruitment and retention, issues around consent and confidentiality and the central role that parents play in supporting the research protocol. Pubertal stage is a potential confounder and needs to be accurately measured. This is certainly true for studies in overweight and obesity where excess adiposity influences pubertal and other hormones. The opportunities to undertake quality research in adolescents are likely to be enhanced by the use of novel approaches which acknowledge the unique features of adolescents and their world.
与儿科或成人医学相比，青少年医学相对年轻。描述性和观察性研究在青少年文献中占主导地位，包括发表在《国际肥胖杂志》上的那些研究。此外，许多研究将儿童和青少年年龄组合并在一起，这使得难以确定青少年特有的结果。开展高质量的青少年干预研究很重要。青春期是一个具有非凡可塑性的时期。在青春期形成的习惯、态度和身体疾病会设定轨迹，对长期的健康和幸福产生深远影响。超重和肥胖是需要高质量干预研究的一个很好的例子，但在过去二十年里，针对青少年超重和肥胖管理的随机对照试验却很少。青少年研究存在一些复杂性，给任何临床研究带来了额外的挑战。这些包括招募和留住参与者、同意和保密问题以及父母在支持研究方案中所起的核心作用。青春期阶段是一个潜在的混杂因素，需要准确测量。在超重和肥胖研究中确实如此，因为过多的脂肪会影响青春期及其他激素。采用承认青少年及其世界独特特征的新方法，可能会增加开展青少年高质量研究的机会。
