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儿科肥胖症的治疗在儿童较年轻时、动机较强且没有黑棘皮病时效果更好。

Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans.

机构信息

Department of Paediatrics, North Karelia Central Hospital, Joensuu, Finland.

Department of Paediatrics, University of Eastern Finland, Kuopio, Finland.

出版信息

Acta Paediatr. 2017 Nov;106(11):1842-1850. doi: 10.1111/apa.13953. Epub 2017 Jul 18.

Abstract

AIM

This study evaluated the efficacy of a paediatric obesity treatment programme and explored the factors that contributed to the outcome.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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