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体重减轻对肥胖青少年睡眠呼吸紊乱的影响。

The effect of weight loss on sleep-disordered breathing in obese teenagers.

作者信息

Verhulst Stijn L, Franckx Hilde, Van Gaal Luc, De Backer Wilfried, Desager Kristine

机构信息

Department of Pediatrics, University of Antwerp, Antwerp, Belgium.

出版信息

Obesity (Silver Spring). 2009 Jun;17(6):1178-83. doi: 10.1038/oby.2008.673. Epub 2009 Mar 5.

Abstract

The objective of this study was to assess the effect of weight loss on sleep-disordered breathing (SDB) in obese teenagers attending a residential treatment center. We also assessed whether the presence of SDB at the start of the weight management therapy was correlated with the amount of weight loss achieved. Obese teenagers were recruited and underwent anthropometry and sleep screening. Subjects with SDB (apnea hypopnea index (AHI)>or=2) received a follow-up screening after weight loss therapy. Sixty-one obese subjects were included (age=14.8+/-2.3; BMI z score=2.7+/-0.4). Thirty-one subjects were diagnosed with SDB with 38% continuing to have residual SDB after a median weight loss of 24.0 kg. Subjects with SDB had a higher median relative decrease in BMI z score compared to subjects without SDB which was 30.5, 33.6, and 50.4% in the group with AHI of the baseline screening study<2, 2<or=AHI<5, and AHI>or=5, respectively (P=0.02). AHI of the baseline screening study correlated significantly with the relative decrease in BMI z score (partial r=0.37; P=0.003), controlling for gender, age, initial BMI z score, and time between both studies. In conclusion, weight loss was successful in treating SDB in obese teenagers. In addition, there was a positive association between the severity of SDB at the start of the treatment and the amount of weight loss achieved. These findings are in favor of considering weight loss as a first-line treatment for SDB in obese children and adolescents.

摘要

本研究的目的是评估体重减轻对入住寄宿治疗中心的肥胖青少年睡眠呼吸紊乱(SDB)的影响。我们还评估了体重管理治疗开始时SDB的存在是否与实现的体重减轻量相关。招募肥胖青少年并进行人体测量和睡眠筛查。患有SDB(呼吸暂停低通气指数(AHI)≥2)的受试者在体重减轻治疗后接受随访筛查。纳入61名肥胖受试者(年龄=14.8±2.3;BMI z评分=2.7±0.4)。31名受试者被诊断为SDB,在体重中位数减轻24.0 kg后,38%的受试者仍有残余SDB。与无SDB的受试者相比,患有SDB的受试者BMI z评分的中位数相对下降更高,在基线筛查研究中AHI<2、2≤AHI<5和AHI≥5的组中分别为30.5%、33.6%和50.4%(P=0.02)。在控制性别、年龄、初始BMI z评分和两项研究之间的时间后,基线筛查研究的AHI与BMI z评分的相对下降显著相关(偏相关系数r=0.37;P=0.003)。总之,体重减轻成功治疗了肥胖青少年的SDB。此外,治疗开始时SDB的严重程度与实现的体重减轻量之间存在正相关。这些发现支持将体重减轻作为肥胖儿童和青少年SDB的一线治疗方法。

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