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唐氏综合征儿童和青少年的超重与肥胖——患病率、决定因素、后果及干预措施:一项文献综述

Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review.

作者信息

Bertapelli Fabio, Pitetti Ken, Agiovlasitis Stamatis, Guerra-Junior Gil

机构信息

CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020, Brazil; Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-887, Brazil.

Department of Physical Therapy, College of Health Professions, Wichita State University, Wichita, KS 67260-0043, USA.

出版信息

Res Dev Disabil. 2016 Oct;57:181-92. doi: 10.1016/j.ridd.2016.06.018. Epub 2016 Jul 19.

Abstract

BACKGROUND

Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS.

AIMS

To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined.

METHODS AND PROCEDURES

A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015.

OUTCOMES AND RESULTS

The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss.

CONCLUSIONS AND IMPLICATIONS

Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS.

摘要

背景

与无唐氏综合征(DS)的普通青少年人群相比,唐氏综合征患儿超重或肥胖的可能性更高。

目的

回顾唐氏综合征青少年中超重和肥胖的患病率及其决定因素。还研究了健康后果和干预措施的有效性。

方法和程序

使用MEDLINE、Embase、科学引文索引、Scopus、护理学与健康领域数据库、心理学文摘数据库、体育与运动医学文摘数据库、拉丁美洲及加勒比地区健康科学数据库和考克兰图书馆进行检索。在总共4280项研究中,我们纳入了1988年至2015年间发表的45篇原创研究文章。

结果

超重和肥胖的综合患病率在不同研究中从23%到70%不等。唐氏综合征青少年超重和肥胖的发生率高于无唐氏综合征的青少年。肥胖的可能决定因素包括瘦素增加、静息能量消耗减少、合并症、不良饮食和低身体活动水平。肥胖与阻塞性睡眠呼吸暂停、血脂异常、高胰岛素血症和步态障碍呈正相关。肥胖预防和控制干预主要基于运动项目,不足以实现体重减轻或脂肪减少。

结论和启示

需要开展基于人群的研究,以确定风险因素,并支持采取多因素策略来降低唐氏综合征儿童和青少年的超重和肥胖率。

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