Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany.
Acta Paediatr. 2009 Dec;98(12):1950-5. doi: 10.1111/j.1651-2227.2009.01484.x. Epub 2009 Aug 13.
To assess the association between peer relationship problems and childhood overweight and obesity.
Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.
The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4-3.0; OR for obesity 2.6; 95% CI: 1.3-5.0]. Among boys the adjusted odds ratio were lower and no longer significant.
The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.
评估同伴关系问题与儿童超重和肥胖的相关性。
在巴伐利亚州的义务入学体检中,获取了 4718 名学龄前儿童的数据。采用《长处与困难问卷》(Strengths and Difficulties Questionnaire)评估儿童的同伴关系问题(“正常”“边缘”或“异常”)。超重和肥胖根据年龄和性别特异性 BMI 切点来定义。采用多元逻辑回归分析控制潜在的混杂因素。
与“正常”儿童相比,“边缘”或“异常”同伴关系问题儿童的超重和肥胖患病率更高。对于女孩,“异常”同伴关系问题的相关性在最终的逻辑回归模型中仍然显著[超重的优势比(OR)为 2.0;95%置信区间(CI):1.4-3.0;肥胖的 OR 为 2.6;95%CI:1.3-5.0]。对于男孩,调整后的比值比较低且不再显著。
同伴关系问题儿童的超重和肥胖患病率显著增加,这不能用混杂因素来解释。显然,学龄前儿童的同伴关系问题和肥胖之间存在相关的共病现象,这表明需要采取干预措施,既要关注身体健康,也要关注心理健康。