Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.
Obesity (Silver Spring). 2010 Sep;18(9):1768-74. doi: 10.1038/oby.2009.491. Epub 2010 Jan 7.
The objectives of this study were to evaluate outcomes of a comprehensive care clinic (CCC) for children with hypothalamic obesity due to treatment for brain tumors by assessing weight parameters; health-related quality of life (HRQoL); and perception of health status, disease burden, care satisfaction, and physical activity. Thirty-nine patients (16 males) were reviewed. While attending the CCC the median %weight gain and percent ideal body weight (%IBW) of patients was lower (8.5%/year (range -3 to -14) and -4%/year (141.7-34), respectively) than the median %weight gain and %IBW (21.4% (15.8-32.0) and 19.9% (-18.7 to 149.2)) while treated in standard care. Rate of increase in %BMI slowed (4.5 kg/m(2) %/year (-17.8 to 8.4) vs. 8.4 kg/m(2) %/year (-3.1 to 28.1)) in patients attending the clinic compared to their before treatment in standard care. There was no change in blood pressure, fasting glucose, triglycerides or low-density lipoprotein cholesterol, and a significant increase in high-density lipoprotein cholesterol (1.09 +/- 0.33 to 1.24 +/- 0.04). After attending the CCC for a year, significant increases for child reported total HRQoL (63.7 +/- 18.4-71.3 +/- 13.3; P < 0.017), physical functioning (65.3 +/- 15.9-69.5 +/- 15.9; P < 0.045) and school functioning (61.1 +/- 21.0-71.1 +/- 16.5; P < 0.051) were found. Parents reported no significant change in HRQoL over the same period. Parents had significantly improved responses in areas of coordination of health care and understanding of their child's disease. Patients attending the CCC gained less weight while attending the clinic and exhibited improved HRQoL. Parents noticed improvements in various areas of their child's medical care.
本研究的目的是通过评估体重参数、健康相关生活质量（HRQoL）以及对健康状况、疾病负担、护理满意度和身体活动的感知，来评估综合护理诊所（CCC）对因脑肿瘤治疗而导致下丘脑肥胖的儿童的治疗效果。共回顾了 39 名患者（16 名男性）。在 CCC 就诊期间，患者的体重增加百分比和理想体重百分比（%IBW）中位数（每年 8.5%（范围-3 至-14）和-4%/年（141.7-34））低于标准护理期间的中位数（每年 21.4%（15.8-32.0）和 19.9%（-18.7 至 149.2））。在 CCC 就诊的患者中，BMI 的增长率减慢（每年 4.5kg/m2%（-17.8 至 8.4）与标准护理前每年 8.4kg/m2%（-3.1 至 28.1））。患者的血压、空腹血糖、甘油三酯或低密度脂蛋白胆固醇没有变化，而高密度脂蛋白胆固醇显著增加（1.09 +/- 0.33 至 1.24 +/- 0.04）。在 CCC 就诊一年后，儿童报告的总 HRQoL（63.7 +/- 18.4-71.3 +/- 13.3；P < 0.017）、身体功能（65.3 +/- 15.9-69.5 +/- 15.9；P < 0.045）和学业功能（61.1 +/- 21.0-71.1 +/- 16.5；P < 0.051）显著增加。在此期间，父母报告 HRQoL 无显著变化。父母在协调医疗保健和了解孩子疾病方面的反应明显改善。在 CCC 就诊的患者在就诊期间体重增加较少，并且 HRQoL 得到改善。父母注意到孩子医疗保健各个方面的改善。
