Department of Pediatrics, National Taiwan University Hospital, Taipei Cardiac Children's Foundation, Taipei, Taiwan.
Paediatr Perinat Epidemiol. 2012 Jul;26(4):336-43. doi: 10.1111/j.1365-3016.2012.01293.x. Epub 2012 May 9.
In Western countries, obesity is a common problem in children with congenital heart disease (CHD). However, this problem may have racial difference, and little is known about the shift of this trend as patients grow up. The present study sought to investigate the prevalence and trends of being underweight, overweight and obesity in an Asian CHD cohort using a 5-year citywide school survey database.
Patient group consisted of 705 first grade elementary school students (children) and 219 first grade senior high school students (adolescents), while 18753 healthy children and 15014 healthy adolescents served as controls. Body mass index (BMI) percentile was calculated to define underweight (BMI < 15(th) percentile) and overweight (BMI 85(th) -95(th) percentile)/obesity (BMI ≥ 95(th) percentile).
In CHD children, the prevalence of underweight and overweight/obesity was 21.0% (control 16%, P < 0.001) and 14.5% (control 19.8%, P < 0.001), respectively. Children with moderate to severe CHD, especially cyanotic CHD, were more underweight and less overweight/obese than children with non-cyanotic CHD. The prevalence of underweight (23.3%) and overweight/obesity (26.5%) in CHD adolescents became close to that in controls. From childhood to adolescence, different shifts in BMI distribution were noted; controls became more underweight and overweight/obese for males and more underweight and less overweight/obese for females, while CHD patients became more overweight/obese for both genders, including cyanotic CHD.
In this Asian CHD cohort, we demonstrates a shift of BMI distribution from more underweight and less overweight/obese compared with healthy children, to a pattern similar to that in healthy adolescents.
在西方国家，肥胖是患有先天性心脏病（CHD）的儿童中常见的问题。然而，这一问题可能存在种族差异，而且随着患者的成长，人们对这种趋势的转变知之甚少。本研究旨在利用一项为期 5 年的全市性学校调查数据库，调查亚洲 CHD 队列中体重过轻、超重和肥胖的患病率和趋势。
患者组包括 705 名一年级小学生（儿童）和 219 名一年级高中生（青少年），而 18753 名健康儿童和 15014 名健康青少年作为对照组。体重指数（BMI）百分位数用于定义体重过轻（BMI<第 15 百分位数）和超重（BMI 第 85-95 百分位数）/肥胖（BMI≥第 95 百分位数）。
在 CHD 儿童中，体重过轻和超重/肥胖的患病率分别为 21.0%（对照组为 16%，P<0.001）和 14.5%（对照组为 19.8%，P<0.001）。患有中度至重度 CHD 的儿童，特别是发绀型 CHD 的儿童，比非发绀型 CHD 的儿童体重过轻且超重/肥胖的比例更低。CHD 青少年的体重过轻（23.3%）和超重/肥胖（26.5%）的患病率与对照组相近。从儿童期到青春期，BMI 分布的变化不同；对照组男性体重过轻和超重/肥胖的比例增加，女性体重过轻和超重/肥胖的比例减少，而 CHD 患者无论性别，超重/肥胖的比例都增加，包括发绀型 CHD。
在这个亚洲 CHD 队列中，我们发现 BMI 分布从与健康儿童相比体重过轻和超重/肥胖的比例较低，转变为与健康青少年相似的模式。
