患有胎儿酒精谱系障碍的儿童和青少年中的超重与肥胖问题。
Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders.
作者信息
Fuglestad Anita J, Boys Christopher J, Chang Pi-Nian, Miller Bradley S, Eckerle Judith K, Deling Lindsay, Fink Birgit A, Hoecker Heather L, Hickey Marie K, Jimenez-Vega Jose M, Wozniak Jeffrey R
机构信息
Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
出版信息
Alcohol Clin Exp Res. 2014 Sep;38(9):2502-8. doi: 10.1111/acer.12516. Epub 2014 Aug 26.
BACKGROUND
Because prenatal alcohol exposure is associated with growth deficiency, little attention has been paid to the potential for overweight and obesity in children with fetal alcohol spectrum disorders (FASD). This study examined the prevalence of overweight/obesity (body mass index [BMI]) in a large clinical sample of children with FASD.
METHODS
Children, aged 2 to 19 years, who were evaluated for FASD at University Clinics, included 445 with an FASD diagnosis and 171 with No-FASD diagnosis. Prevalence of overweight/obesity (BMI ≥ 85 percentile) was compared to national and state prevalence. BMI was examined in relation to FASD diagnosis, gender, and age. Dietary intake data were examined for a young subsample (n = 42).
RESULTS
Thirty-four percent with any FASD diagnosis were overweight or obese, which did not differ from the No-FASD group or U.S. prevalence. Underweight was prevalent in those with fetal alcohol syndrome (FAS) (17%). However, increased rates of overweight/obesity were seen in those with partial FAS (40%). Among adolescents, those with any FASD diagnosis had increased overweight/obesity (42%), particularly among females (50%). The rate in adolescent females with FASD (50%) was nearly 3 times higher than state prevalence for adolescent females (17 to 18%), p < 0.001. In the young subsample, those who were overweight/obese consumed more calories, protein, and total fat per day than those who were not overweight or obese.
CONCLUSIONS
Rates of overweight/obesity are increased in children with partial FAS. In adolescents, rates are increased for any FASD diagnosis (particularly in females). Results are suggestive of possible metabolic/endocrine disruption in FASD-a hypothesis for which there is evidence from animal models. These data suggest that clinicians may consider prenatal alcohol exposure as a risk factor for metabolic/endocrine disruption, should evaluate diet as a risk in this population, and may need to target interventions to females prior to puberty to effect changes in overweight-related outcomes.
背景
由于产前酒精暴露与生长发育迟缓有关，胎儿酒精谱系障碍（FASD）患儿超重和肥胖的可能性很少受到关注。本研究调查了一大组FASD患儿临床样本中超重/肥胖（体重指数[BMI]）的患病率。
方法
在大学诊所接受FASD评估的2至19岁儿童，包括445例FASD诊断患儿和171例非FASD诊断患儿。将超重/肥胖（BMI≥第85百分位数）的患病率与全国和州患病率进行比较。研究了BMI与FASD诊断、性别和年龄的关系。对一个年轻子样本（n = 42）的饮食摄入数据进行了检查。
结果
任何FASD诊断患儿中超重或肥胖的比例为34%，与非FASD组或美国患病率无差异。胎儿酒精综合征（FAS）患儿中体重过轻很常见（17%）。然而，部分FAS患儿中超重/肥胖率有所增加（40%）。在青少年中，任何FASD诊断患儿中超重/肥胖率都有所增加（42%），尤其是女性（50%）。FASD青少年女性的患病率（50%）几乎是该州青少年女性患病率（17%至18%）的3倍，p < 0.001。在年轻子样本中，超重/肥胖者每天摄入的卡路里、蛋白质和总脂肪比非超重或肥胖者更多。
结论
部分FAS患儿中超重/肥胖率增加。在青少年中，任何FASD诊断患儿（尤其是女性）的超重/肥胖率都有所增加。结果提示FASD可能存在代谢/内分泌紊乱——动物模型中有证据支持这一假设。这些数据表明，临床医生可能应将产前酒精暴露视为代谢/内分泌紊乱的一个风险因素，评估该人群的饮食风险，并且可能需要在青春期前针对女性进行干预，以改变与超重相关的结局。
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