Departments of Pediatrics, University of California, San Diego, La Jolla, CA 92037, USA.
Pediatrics. 2013 May;131(5):e1435-42. doi: 10.1542/peds.2012-2204. Epub 2013 Apr 1.
Clinic-based programs for childhood obesity are not available to a large proportion of the population. The purpose of this study was to evaluate the efficacy of a guided self-help treatment of pediatric obesity (GSH-PO) compared with a delayed treatment control and to evaluate the impact of GSH-PO 6-months posttreatment.
Fifty overweight or obese 8- to 12-year-old children and their parents were randomly assigned to immediate treatment or to delayed treatment. The GSH-PO includes 12 visits over 5 months and addresses key components included in more intensive clinic-based programs. Children and parents in the immediate treatment arm were assessed at time 1 (T1), participated in GSH-PO between T1 and T2, and completed their 6-month posttreatment assessment at T3. Children and parents in the delayed treatment arm were assessed at T1, participated in GSH-PO between T2 and T3, and completed their 6-month posttreatment assessment at T4. The main outcome measures were BMI, BMI z score, and percentage overweight (%OW).
Children in the immediate treatment GSH-PO arm decreased their BMI significantly more than did the delayed treatment arm (BMI group × time = -1.39; P < .001). Similar results were found for BMI z score and %OW. At the 6-month posttreatment assessment, changes resulting from GSH-PO were maintained for BMI z score and %OW but not BMI (BMI time effect = -0.06, not significant; BMI z score time effect = -0.10, P < .001; %OW time effect = -4.86, P < .05).
The GSH-PO showed initial efficacy in decreasing BMI for children in this study. Additional efficacy and translational studies are needed to additionally evaluate GSH-PO.
基于诊所的儿童肥胖症项目无法覆盖大部分人群。本研究旨在评估小儿肥胖自助治疗（GSH-PO）与延迟治疗对照相比的疗效，并评估其治疗后 6 个月的影响。
将 50 名 8-12 岁超重或肥胖儿童及其父母随机分为即刻治疗组或延迟治疗组。GSH-PO 包括 5 个月内的 12 次就诊，针对更密集的诊所项目中的关键组成部分。即刻治疗组的儿童和家长在 T1 时进行评估，在 T1 至 T2 之间参加 GSH-PO，并在 T3 时完成 6 个月的治疗后评估。延迟治疗组的儿童和家长在 T1 时进行评估，在 T2 至 T3 之间参加 GSH-PO，并在 T4 时完成 6 个月的治疗后评估。主要结局指标为 BMI、BMI z 评分和超重百分比（%OW）。
即刻治疗 GSH-PO 组的儿童 BMI 显著下降，明显优于延迟治疗组（BMI 组×时间=-1.39；P<.001）。BMI z 评分和%OW 也有类似的结果。在治疗后 6 个月的评估中，GSH-PO 产生的变化在 BMI z 评分和%OW 方面得以维持，但 BMI 方面没有（BMI 时间效应=-0.06，无显著意义；BMI z 评分时间效应=-0.10，P<.001；%OW 时间效应=-4.86，P<.05）。
GSH-PO 在本研究中显示出对儿童 BMI 降低的初步疗效。需要进行更多的疗效和转化研究来进一步评估 GSH-PO。
