Department of Paediatrics, North Karelia Central Hospital, Joensuu, Finland.
Department of Paediatrics, University of Eastern Finland, Kuopio, Finland.
Acta Paediatr. 2017 Nov;106(11):1842-1850. doi: 10.1111/apa.13953. Epub 2017 Jul 18.
This study evaluated the efficacy of a paediatric obesity treatment programme and explored the factors that contributed to the outcome.
We recorded the body mass index standard deviation scores (BMI SDS) of 654 children aged 2-18 years who were treated for obesity in 2005-2012 in three Finnish hospitals, one year before treatment and up to three years after treatment. The family-based multidisciplinary treatment included nutritional advice, exercise and behavioural counselling. The BMI SDS changes, and their contributors, were explored with mixed-model and logistic regression analyses.
BMI SDS increased before baseline and decreased at six, 12 and 24 months (all p < 0.001) and 36 months (p = 0.005). Younger age (p < 0.001), higher BMI SDS at baseline (p = 0.001), motivation (p = 0.013), adherence to the protocol (p = 0.033) and lack of acanthosis nigricans (p < 0.001) improved the outcome. The BMI SDS of children aged 2-6 decreased best from baseline to 12 (-0.35), 24 (-0.58) and 36 months (-0.64) (all p < 0.001).
Paediatric obesity treatment was most effective at a younger age. Good motivation and adherence contributed to favourable outcomes, while acanthosis nigricans was associated with a poor outcome.
本研究评估了儿童肥胖治疗方案的疗效,并探讨了影响治疗效果的因素。
我们记录了 2005 年至 2012 年在芬兰的 3 家医院接受肥胖治疗的 654 名 2-18 岁儿童的体重指数标准差评分(BMI SDS),治疗前一年和治疗后 3 年。家庭为基础的多学科治疗包括营养咨询、运动和行为咨询。使用混合模型和逻辑回归分析探讨 BMI SDS 的变化及其影响因素。
BMI SDS 在基线前增加,在 6、12 和 24 个月(均 p < 0.001)和 36 个月(p = 0.005)时降低。年龄较小(p < 0.001)、基线时 BMI SDS 较高(p = 0.001)、动机(p = 0.013)、对方案的依从性(p = 0.033)和无黑棘皮病(p < 0.001)改善了治疗效果。2-6 岁儿童的 BMI SDS 从基线到 12、24 和 36 个月时下降幅度最大(分别为-0.35、-0.58 和-0.64,均 p < 0.001)。
儿童肥胖治疗在较小年龄时效果最佳。良好的动机和依从性有助于取得良好的效果,而黑棘皮病则与不良的结果相关。