Dalla Valle Marketta, Laatikainen Tiina, Kalliokoski Tomi, Nykänen Päivi, Jääskeläinen Jarmo
a Department of Pediatrics , North Karelia Central Hospital , Joensuu , Finland ;
b Department of Pediatrics , University of Eastern Finland , Kuopio , Finland ;
Ann Med. 2015;47(8):639-54. doi: 10.3109/07853890.2015.1083118. Epub 2015 Nov 16.
One in three obese adults is classified as metabolically healthy, but there is less evidence in obese children. We studied the overall clinical presentation of Finnish obese children and the prevalence of cardiometabolic risk factors with child-specific cut-offs.
This is a cross-sectional register-based study of 2-18-year-old children (n = 900) evaluated for obesity in three hospitals in 2005-2012. Clinical and metabolic data were related to sex, age, puberty, and obesity grade and analyzed using chi-square and non-parametric tests.
In 80% of cases at least one cardiovascular risk factor was present. Only 3% of subjects for whom complete metabolic data were available (n = 360) had no metabolic disorder. Systolic blood pressure was hypertensive in 50.2% and diastolic in 14.5% of the children. The youngest children had highest body mass index SD score. Obesity was more severe in boys than girls (p < 0.001). Hypertensive systolic blood pressure values (p = 0.012), prediabetes (p < 0.001), fatty liver (p < 0.001), and dyslipidemia (p = 0.025) were more prevalent in 15-18-year-old boys than girls.
Most obese children in specialist care have cardiovascular risk factors; this indicates that earlier intervention is needed.
三分之一的肥胖成年人被归类为代谢健康，但肥胖儿童中的相关证据较少。我们研究了芬兰肥胖儿童的总体临床表现以及采用儿童特异性临界值的心血管代谢危险因素的患病率。
这是一项基于登记册的横断面研究，研究对象为2005年至2012年在三家医院接受肥胖评估的2至18岁儿童（n = 900）。临床和代谢数据与性别、年龄、青春期和肥胖等级相关，并使用卡方检验和非参数检验进行分析。
80%的病例至少存在一种心血管危险因素。在可获得完整代谢数据的受试者中（n = 360），只有3%没有代谢紊乱。50.2%的儿童收缩压高血压，14.5%的儿童舒张压高血压。年龄最小的儿童体重指数标准差得分最高。男孩的肥胖比女孩更严重（p < 0.001）。15至18岁男孩的高血压收缩压值（p = 0.012）、糖尿病前期（p < 0.001）、脂肪肝（p < 0.001）和血脂异常（p = 0.025）比女孩更普遍。
接受专科护理的大多数肥胖儿童都有心血管危险因素；这表明需要更早进行干预。
