Wentz Elisabet, Björk Anna, Dahlgren Jovanna
Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden.
Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Göteborg, Sweden.
Obesity (Silver Spring). 2017 Jan;25(1):178-184. doi: 10.1002/oby.21693. Epub 2016 Nov 22.
To investigate prevalence of neurodevelopmental disorders in children with obesity and to compare body mass index (BMI) and metabolic profile in the children.
Seventy-six children (37 girls, 39 boys) were consecutively recruited from a university outpatient clinic specialized in severe obesity. Neurodevelopmental disorders including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental coordination disorder (DCD) were assessed using interviews and questionnaires. Neurodevelopmental diagnoses were collected retrospectively in medical records.
BMI ranged between 1.9 and 5.9 SDS and age between 5.1 and 16.5 years. In 13.2% and 18.4% ASD and ADHD was assigned, respectively. In addition, 25% screened positive for DCD, 31.6% had at least one neurodevelopmental disorder, and 18.4% had a parent who screened positive for adult ADHD. Girls with ASD/ADHD had higher BMI SDS than girls without neurodevelopmental disorder (P = 0.006).
One third of children with obesity referred to specialist centers have a neurodevelopmental disorder including deviant motor skills, and these problems may deteriorate weight status. One fifth of the parents exhibit ADHD symptomatology which could partly explain the poor adherence by some families in obesity units. Future obesity therapy could benefit from incorporating a neurodevelopmental treatment approach.
调查肥胖儿童神经发育障碍的患病率,并比较这些儿童的体重指数(BMI)和代谢状况。
从一家专门治疗重度肥胖的大学门诊连续招募了76名儿童(37名女孩,39名男孩)。使用访谈和问卷对包括注意力缺陷多动障碍(ADHD)、自闭症谱系障碍(ASD)和发育性协调障碍(DCD)在内的神经发育障碍进行评估。神经发育诊断通过回顾病历收集。
BMI在1.9至5.9标准差评分(SDS)之间,年龄在5.1至16.5岁之间。分别有13.2%和18.4%的儿童被诊断为ASD和ADHD。此外,25%的儿童DCD筛查呈阳性,31.6%的儿童至少有一种神经发育障碍,18.4%的儿童有一位家长成人ADHD筛查呈阳性。患有ASD/ADHD的女孩比没有神经发育障碍的女孩BMI SDS更高(P = 0.006)。
转诊至专科中心的肥胖儿童中有三分之一患有包括运动技能异常在内的神经发育障碍,这些问题可能会使体重状况恶化。五分之一的家长表现出ADHD症状,这可能部分解释了一些家庭在肥胖治疗机构依从性差的原因。未来的肥胖治疗可能会受益于纳入神经发育治疗方法。