Corvey Kathryn, Menear Kristi S, Preskitt Julie, Goldfarb Samantha, Menachemi Nir
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1720 2nd Ave S., RPHB 330N, Birmingham, AL, 35294, USA.
School of Education, University of Alabama at Birmingham, Birmingham, AL, USA.
Matern Child Health J. 2016 Feb;20(2):466-76. doi: 10.1007/s10995-015-1844-5.
Previous literature using small sample sizes and limited geographic areas report that overweight/obesity and physical inactivity occur at higher rates among children with autism spectrum disorder (ASD) compared to typically developing peers. The purpose of this study was to examine obesity, overweight, physical activity, and sedentary behavior among children and youth with and without ASD using nationally representative data and controlling for secondary conditions, including intellectual and learning disabilities, ADHD, developmental delay, and other mental, physical, and medical conditions, as well as medication use.
Data were collected from the 2011-2012 National Survey of Children's Health, a cross-sectional survey of 65,680 (weighted N = 49,586,134) children aged 6-17 (1385 with ASD, weighted N = 986,352). Logistic regression was used to estimate odds ratios, adjusting for demographics and possible secondary conditions.
Having a diagnosis of ASD was associated with higher odds of obesity (OR 1.76, CI 1.27-2.43; p = <0.001). However, after additional adjustment for possible secondary conditions, ASD diagnosis was no longer associated with obesity. Those with moderate ASD (OR 0.58, CI 0.36-0.93; p = <0.05) reported lower odds of sedentary behavior, but this association failed to achieve significance after adjustment for secondary conditions and medication use. No significant associations between ASD and overweight or physical activity were found.
These findings suggest that ASD diagnosis is not significantly associated with obesity status after adjustment for possible secondary conditions and medication use. Decision makers, clinicians, and researchers developing interventions for children with ASDs should consider how secondary conditions may impact obesity and related activities.
以往使用小样本量和有限地理区域的文献报道，与发育正常的同龄人相比，自闭症谱系障碍（ASD）儿童中超重/肥胖和身体活动不足的发生率更高。本研究的目的是利用全国代表性数据，研究患有和未患有ASD的儿童和青少年的肥胖、超重、身体活动和久坐行为情况，并控制包括智力和学习障碍、注意力缺陷多动障碍（ADHD）、发育迟缓以及其他心理、身体和医疗状况以及药物使用等次要条件。
数据来自2011 - 2012年全国儿童健康调查，这是一项对65,680名（加权N = 49,586,134）6 - 17岁儿童的横断面调查（其中1385名患有ASD，加权N = 986,352）。采用逻辑回归估计比值比，并对人口统计学和可能的次要条件进行调整。
诊断为ASD与肥胖几率较高相关（比值比1.76，置信区间1.27 - 2.43；p = <0.001）。然而，在对可能的次要条件进行进一步调整后，ASD诊断与肥胖不再相关。患有中度ASD的儿童报告久坐行为几率较低（比值比0.58，置信区间0.36 - 0.93；p = <0.05），但在对次要条件和药物使用进行调整后，这种关联未达到显著水平。未发现ASD与超重或身体活动之间存在显著关联。
这些发现表明，在对可能的次要条件和药物使用进行调整后，ASD诊断与肥胖状况无显著关联。为患有ASD的儿童制定干预措施的决策者、临床医生和研究人员应考虑次要条件如何影响肥胖及相关活动。
