Schwartz Sara, Olsen Morten, Woo Jessica G, Madsen Nicolas
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark, Europe.
Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
BMJ Paediatr Open. 2017 Sep 28;1(1):e000127. doi: 10.1136/bmjpo-2017-000127. eCollection 2017.
We examined the prevalence of underweight and obesity in children with congenital heart disease (CHD) compared with the general population.
Using the Danish National Patient Registry, we identified individuals born and diagnosed with CHD in Denmark during 1996-2012 who were alive at 1 year of age. A unique personal identifier enabled identification of CHD subjects, as well as birth year and sex-matched (1:10) general population controls. The Children's Database has recorded height and weight measured by clinical providers at preventive health checks offered to all children in Denmark. Data recording were made mandatory in 2011. Obesity was defined as body mass index (BMI) above the 95thpercentile and underweight as BMI below the fifth percentile for age and sex. We determined the prevalence of underweight and obesity at study subjects' first height and weight recording. For those underweight at age 1 year, prevalence of underweight and obesity at later recordings was assessed.
We identified 9194 children with CHD of which 2679 (29%) had at least one recording of height and weight. The control cohort demonstrated a similar portion of anthropometric data: 30 047 (31%) of 96 585 controls. The prevalence of underweight and obesity at CHD study subjects' first height and weight recording was 9.7% (95% CI 8.7 to 11) and 4.1% (95% CI 3.4 to 4.9), respectively. Among individuals with CHD who were underweight at age 1 year (n=78), 51 (65%) had additional BMI recordings between ages 2 and 5 years with a subsequently diminished prevalence of underweight of 27% (95% CI 20 to 35) and none were obese.
The CHD population had an increased prevalence of underweight compared with the general population. Data indicated potential for BMI normalisation among those initially underweight at age 1 year. The prevalence of obesity in children with CHD was comparable with that of the general population.
我们研究了先天性心脏病（CHD）患儿与普通人群相比体重过轻和肥胖的患病率。
利用丹麦国家患者登记处的数据，我们确定了1996年至2012年期间在丹麦出生并被诊断为CHD且1岁时仍存活的个体。一个独特的个人标识符能够识别CHD受试者以及出生年份和性别匹配（1:10）的普通人群对照。儿童数据库记录了丹麦所有儿童在预防性健康检查时由临床医护人员测量的身高和体重。数据记录于2011年成为强制性要求。肥胖定义为体重指数（BMI）高于第95百分位数，体重过轻定义为BMI低于年龄和性别的第5百分位数。我们在研究对象首次记录身高和体重时确定体重过轻和肥胖的患病率。对于1岁时体重过轻的儿童，评估其在后续记录中体重过轻和肥胖的患病率。
我们确定了9194名CHD患儿，其中2679名（29%）至少有一次身高和体重记录。对照队列的人体测量数据比例相似：96585名对照中有30047名（31%）。CHD研究对象首次记录身高和体重时体重过轻和肥胖的患病率分别为9.7%（95%CI 8.7至11）和4.1%（95%CI 3.4至4.9）。在1岁时体重过轻的CHD患儿（n = 78）中，51名（65%）在2至5岁之间有额外的BMI记录，随后体重过轻的患病率降至27%（95%CI 20至35），且无肥胖者。
与普通人群相比，CHD人群体重过轻的患病率更高。数据表明，1岁时最初体重过轻的儿童有BMI恢复正常的可能性。CHD患儿的肥胖患病率与普通人群相当。
