Daniels Z S, Nick T G, Liu C, Cassedy A, Glauser T A
Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2015, Cincinnati, OH 45229-3039, USA.
Neurology. 2009 Sep 1;73(9):658-64. doi: 10.1212/WNL.0b013e3181ab2b11. Epub 2009 May 27.
This study aimed to determine the frequency and factors associated with obesity in a cohort of children and adolescents with newly diagnosed untreated epilepsy.
Body mass index (BMI) Z-scores and percentiles, both adjusted for age, were used as measures for obesity. Potential covariates associated with these BMI measures included age, etiology (cryptogenic, idiopathic, symptomatic), seizure type (generalized, partial, unclear), concomitant medications (stimulants, nonstimulants, none), and insurance status (privately insured, Medicaid). The primary analysis compared the epilepsy patients' BMI Z-scores to Centers for Disease Control and Prevention data for healthy children. The secondary analysis compared the epilepsy patients' BMI Z-scores to those of a regional healthy control group. Additional analyses incorporated the secondary outcome measure BMI percentiles indexed for age.
Children with newly diagnosed untreated epilepsy had higher BMI Z-scores compared to standard CDC growth charts (p < 0.0001) and the healthy control cohort (p = 0.0002) specifically at both of the 2 tail ends of the distribution. Overall, 38.6% of the epilepsy cohort were overweight or obese (BMI > or =85th percentile for age). Differences in age, etiology, and concomitant nonepilepsy medications were significantly associated with variability in age-adjusted BMI Z-score. Patients in adolescence had higher adjusted BMI Z-scores than younger patients. Patients with symptomatic epilepsy had lower adjusted BMI Z-scores than patients with idiopathic epilepsy. Patients on stimulant psychotropics exhibited lower adjusted BMI Z-scores than patients on no medication.
Obesity is a common comorbidity in children with newly diagnosed untreated epilepsy and correlates with increasing age, idiopathic etiology, and absence of concomitant medication.
本研究旨在确定新诊断的未经治疗的癫痫患儿及青少年队列中肥胖症的发生率及其相关因素。
采用根据年龄调整的体重指数(BMI)Z评分和百分位数作为肥胖的衡量指标。与这些BMI指标相关的潜在协变量包括年龄、病因(隐源性、特发性、症状性)、癫痫发作类型(全身性、部分性、不明)、伴随用药情况(兴奋剂、非兴奋剂、未用药)以及保险状况(私人保险、医疗补助)。主要分析将癫痫患者的BMI Z评分与疾病控制和预防中心的健康儿童数据进行比较。次要分析将癫痫患者的BMI Z评分与一个地区健康对照组的评分进行比较。额外分析纳入了根据年龄索引的次要结局指标BMI百分位数。
与疾病控制和预防中心的标准生长图表相比(p < 0.0001)以及与健康对照队列相比(p = 0.0002),新诊断的未经治疗的癫痫患儿的BMI Z评分在分布的两个尾端均显著更高。总体而言,38.6%的癫痫队列超重或肥胖(BMI大于或等于年龄的第85百分位数)。年龄、病因以及伴随的非癫痫药物的差异与年龄调整后的BMI Z评分的变异性显著相关。青少年患者的调整后BMI Z评分高于较年轻患者。症状性癫痫患者的调整后BMI Z评分低于特发性癫痫患者。服用兴奋性精神药物的患者的调整后BMI Z评分低于未用药的患者。
肥胖是新诊断的未经治疗的癫痫患儿中常见的合并症,且与年龄增长、特发性病因以及未伴随用药相关。