儿童肥胖：对身体和心理合并症风险增加的综述。
Childhood obesity: a review of increased risk for physical and psychological comorbidities.
机构信息
Department of Pediatrics, Division of Clinical Psychology, University of Miami Miller School of Medicine, Miami, FL, USA.
出版信息
Clin Ther. 2013 Jan;35(1):A18-32. doi: 10.1016/j.clinthera.2012.12.014.
BACKGROUND
Worldwide estimates of childhood overweight and obesity are as high as 43 million, and rates continue to increase each year. Researchers have taken interest in the childhood obesity epidemic and the impact of this condition across health domains. The consequences of childhood and adolescent obesity are extensive, including both medical and psychosocial comorbidities.
OBJECTIVE
The purpose of this review was to consolidate and highlight the recent literature on the comorbidities associated with childhood obesity, both nationally and internationally.
METHODS
PubMed and PsychINFO searches were conducted on childhood obesity and comorbidities.
RESULTS
The initial search of the terms obesity and comorbidity yielded >5000 published articles. Limits were set to include studies on children and adolescents that were published in peer-reviewed journals from 2002 to 2012. These limits narrowed the search to 938. Review of those articles resulted in 79 that are included in this review. The major medical comorbidities associated with childhood obesity in the current literature are metabolic risk factors, asthma, and dental health issues. Major psychological comorbidities include internalizing and externalizing disorders, attention-deficit hyperactivity disorder, and sleep problems.
CONCLUSIONS
The high prevalence rates of childhood obesity have resulted in extensive research in this area. Limitations to the current childhood obesity literature include differential definitions of weight status and cut-off levels for metabolic risk factors across studies. Additionally, some results are based on self-report of diagnoses rather than chart reviews or physician diagnosis. Even so, there is substantial support for metabolic risk factors, internalizing disorders, attention-deficit hyperactivity disorder, and decreased health-related quality of life as comorbidities to obesity in childhood. Additional investigations on other diseases and conditions that might be associated with childhood obesity are warranted and intervention research in this area is critical.
背景
全世界儿童超重和肥胖的估计数高达 4300 万，且每年的发病率还在持续上升。研究人员对儿童肥胖症的流行情况及其对健康领域的影响产生了兴趣。儿童和青少年肥胖的后果是广泛的，包括医疗和社会心理合并症。
目的
本综述的目的是整合并突出近年来国内外有关儿童肥胖相关合并症的文献。
方法
在 PubMed 和 PsychINFO 上对儿童肥胖症和合并症进行了检索。
结果
对肥胖症和合并症这两个术语的初步搜索产生了超过 5000 篇已发表的文章。将研究范围限制为在同行评议的期刊上发表的关于儿童和青少年的研究，且发表时间为 2002 年至 2012 年。这些限制将搜索范围缩小到 938 篇文章。对这些文章的回顾导致其中 79 篇文章被纳入本综述。目前文献中与儿童肥胖相关的主要医学合并症包括代谢风险因素、哮喘和牙齿健康问题。主要的心理合并症包括内化和外化障碍、注意力缺陷多动障碍和睡眠问题。
结论
儿童肥胖的高流行率导致了该领域的广泛研究。目前儿童肥胖文献的局限性包括不同的体重状态定义以及不同研究中代谢风险因素的临界值不同。此外，一些结果是基于自我报告的诊断，而不是病历审查或医生诊断。即便如此，代谢风险因素、内化障碍、注意力缺陷多动障碍和健康相关生活质量下降作为肥胖的合并症仍得到了大量支持。需要对可能与儿童肥胖相关的其他疾病和病症进行进一步研究，并且该领域的干预研究至关重要。
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