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先天性心脏病患儿的超重与肥胖:未来风险的叠加?

Overweight and obesity in children with congenital heart disease: combination of risks for the future?

作者信息

Barbiero Sandra Mari, D'Azevedo Sica Caroline, Schuh Daniela Schneid, Cesa Claudia Ciceri, de Oliveira Petkowicz Rosemary, Pellanda Lucia Campos

机构信息

Post-Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia/Fundação Universitária de Cardiologia, Porto Alegre, Brazil.

出版信息

BMC Pediatr. 2014 Oct 16;14:271. doi: 10.1186/1471-2431-14-271.

Abstract

BACKGROUND

Children who have unhealthy lifestyles are predisposed to develop hypertension, dyslipidemia and other complications. The epidemic of obesity is also affecting children with congenital heart disease. The aim of this study is to estimate the prevalence of obesity and describe associated risk factors, including family history in children with congenital heart disease.

METHODS

A cross-sectional study with 316 children and adolescents with congenital heart disease seen in an outpatient clinic of a reference hospital. Collected sociodemographic data included family history of chronic disease, dietary habits, laboratory tests (total cholesterol, HDL and LDL/cholesterol, triglycerides, fasting glucose, CRP, hematocrit and hemoglobin), and anthropometric assessment. Anthropometric data of the caregivers was self-reported.

RESULTS

The prevalence of excess weight was 26.9%. Altered levels of total cholesterol were observed in 46.9%, of HDL in 32.7%, LDL in 23.6% and of triglycerides levels in 20.0%. A higher frequency of family history of obesity (42.6%; p = 0.001), dyslipidemia (48.1%; p = <0.001), diabetes (47.4%; p = 0.002), hypertension (39.2%; p = 0.006) and ischemic disease (43.7%; p = 0.023), as well as significantly higher values of triglycerides (p = 0.017), glycemia (p = 0.004) and C-reactive protein (p = 0.002) were observed among patients with excess weight.

CONCLUSION

The presence of modifiable risk factors and the variables associated to excess weight in this population was similar to that described in the literature for children without congenital disease. As these children already present the risks associated to heart disease, it is particularly important to promote a healthy lifestyle in this group.

摘要

背景

生活方式不健康的儿童易患高血压、血脂异常及其他并发症。肥胖流行也正在影响先天性心脏病患儿。本研究旨在评估先天性心脏病患儿肥胖的患病率,并描述相关危险因素,包括家族史。

方法

在一家参考医院的门诊对316例先天性心脏病儿童及青少年进行横断面研究。收集的社会人口学数据包括慢性病家族史、饮食习惯、实验室检查(总胆固醇、高密度脂蛋白和低密度脂蛋白/胆固醇、甘油三酯、空腹血糖、C反应蛋白、血细胞比容和血红蛋白)以及人体测量评估。照顾者的人体测量数据为自我报告。

结果

超重患病率为26.9%。观察到总胆固醇水平改变的占46.9%,高密度脂蛋白水平改变的占32.7%,低密度脂蛋白水平改变的占23.6%,甘油三酯水平改变的占20.0%。超重患者中肥胖家族史(42.6%;p = 0.001)、血脂异常(48.1%;p = <0.001)、糖尿病(47.4%;p = 0.002)、高血压(39.2%;p = 0.006)和缺血性疾病(43.7%;p = 0.023)的发生率更高,同时甘油三酯(p = 0.017)、血糖(p = 0.004)和C反应蛋白(p = 0.002)的值也显著更高。

结论

该人群中可改变的危险因素及与超重相关的变量与文献中描述的无先天性疾病儿童相似。由于这些儿童已存在与心脏病相关的风险,因此在这一群体中促进健康的生活方式尤为重要。

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