Jasik Carolyn Bradner, King Eileen C, Rhodes Erinn, Sweeney Brooke, Mietus-Snyder Michele, Grow H Mollie, Harris J Mitchell, Lostocco Lynne, Estrada Elizabeth, Boyle Katie, Tucker Jared M, Eneli Ihuoma U, Woolford Susan J, Datto George, Stratbucker William, Kirk Shelley
1 UCSF Benioff Children's Hospitals , Oakland, CA.
2 Cincinnati Children's Hospital , Cincinnati, OH.
Child Obes. 2015 Oct;11(5):630-7. doi: 10.1089/chi.2015.0053.
There are no existing multisite national data on obese youth presenting for pediatric weight management. The primary aim was to describe BMI status and comorbidities among youth with obesity presenting for pediatric weight management (PWM) at programs within the Pediatric Obesity Weight Evaluation Registry (POWER).
Data were collected from 2009-2010 among 6737 obese patients ages 2-17. Patients were classified in three groups by BMI (kg/m(2)) cutoffs and percent of the 95th percentile for BMI: (1) obesity; (2) severe obesity class 2; and (3) severe obesity class 3. Weighted percentages are presented for baseline laboratory tests, blood pressure, and demographics. Generalized logistic regression with clustering was used to examine the relationships between BMI status and comorbidities.
Study youth were 11.6 ± 3.4 years of age, 56% female, 31% black, 17% Hispanic, and 53% publicly insured. Twenty-five percent of patients had obesity (n = 1674), 34% (2337) had severe obesity class 2, and 41% (2726) had severe obesity class 3. Logistic regression revealed that males (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.5-2.0), blacks (OR, 1.7; 95% CI, 1.5-2.0), age <6 years (OR, 2.0; 95% CI, 1.5-2.6), and public insurance (OR, 1.8; 95% CI, 1.5-2.0) had a higher odds of severe obesity class 3. Severe obesity class 3 was associated with higher odds of laboratory abnormalities for hemoglobin A1c (OR, 1.7; 95% CI, 1.3-2.2), alanine aminotransferase ≥40 U/L (OR, 1.9; 95% CI, 1.3-2.6), and elevated systolic blood pressure (OR, 2.5; 95% CI, 2.0-3.0).
Youth with obesity need earlier access to PWM given that they are presenting when they have severe obesity with significant comorbidities.
目前尚无关于寻求儿科体重管理的肥胖青少年的多中心全国性数据。主要目的是描述在儿科肥胖体重评估登记处（POWER）项目中寻求儿科体重管理（PWM）的肥胖青少年的BMI状况和合并症。
收集了2009年至2010年期间6737名2至17岁肥胖患者的数据。根据BMI（kg/m²）临界值和BMI第95百分位数的百分比将患者分为三组：（1）肥胖；（2）重度肥胖2级；（3）重度肥胖3级。给出了基线实验室检查、血压和人口统计学特征的加权百分比。使用带有聚类的广义逻辑回归来检验BMI状况与合并症之间的关系。
研究对象的年龄为11.6±3.4岁，56%为女性，31%为黑人，17%为西班牙裔，53%有公共保险。25%的患者为肥胖（n = 1674），34%（2337）为重度肥胖2级，41%（2726）为重度肥胖3级。逻辑回归显示，男性（优势比[OR]，1.8；95%置信区间[CI]，1.5 - 2.0）、黑人（OR，1.7；95% CI，1.5 - 2.0）、年龄<6岁（OR，2.0；95% CI，1.5 - 2.6）以及有公共保险（OR，1.8；95% CI，1.5 - 2.0）的患者患重度肥胖3级的几率更高。重度肥胖3级与糖化血红蛋白实验室异常几率更高（OR，1.7；95% CI，1.3 - 2.2）、丙氨酸氨基转移酶≥40 U/L（OR，1.9；95% CI，1.3 - 2.6）以及收缩压升高（OR，2.5；95% CI，2.0 - 3.0）相关。
鉴于肥胖青少年在出现重度肥胖并伴有严重合并症时才寻求儿科体重管理，他们需要更早地获得相关服务。
