Dalla Valle Marketta, Laatikainen Tiina, Potinkara Hanna, Nykänen Päivi, Jääskeläinen Jarmo
Department of Pediatrics, North Karelia Central Hospital, Joensuu, Finland.
Siun Sote - the Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland.
Front Endocrinol (Lausanne). 2018 Oct 2;9:579. doi: 10.3389/fendo.2018.00579. eCollection 2018.
Childhood obesity exposes individuals to cardiometabolic disturbances. We analyzed how family-based multidisciplinary obesity treatment influenced children's cardiometabolic health. In this retrospective, two-year, follow-up study of 654 2- to 18-year-old children treated for obesity in three Finnish pediatric clinics in 2005-2012, blood pressure (BP), metabolic parameters, and the influence of sex, puberty and a change in body mass index standard deviation score (BMI SDS) were analyzed. At baseline, at least one cardiovascular risk factor was present in 474 (80%) cases. Boys presented with more significant changes in cardiometabolic parameters than girls during the treatment. Boys' total cholesterol (TC) improved by 12 months = 0.009), and their low-density lipoprotein C (LDL-C) and glycosylated hemoglobin ameliorated by 12 months ( = 0.030 and 0.022, respectively) and 24 months ( = 0.043 and 0.025, respectively). Boys' triglycerides, insulin, homeostasis model assessment for insulin resistance (HOMA-IR) and systolic BP deteriorated at 24 months ( < 0.001, 0.004, 0.002, and 0.037, respectively). In all children, the number of acceptable TC, LDL-C, insulin, and HOMA-IR values increased if BMI SDS reduced 0.25 or more by 12 months. Minor cardiometabolic improvements were found during the obesity treatment. These findings indicate the need to assess treatment methods and focus on prevention.
儿童肥胖会使个体面临心脏代谢紊乱的风险。我们分析了基于家庭的多学科肥胖治疗对儿童心脏代谢健康的影响。在这项对2005年至2012年期间在芬兰三家儿科诊所接受肥胖治疗的654名2至18岁儿童进行的为期两年的回顾性随访研究中，分析了血压（BP）、代谢参数，以及性别、青春期和体重指数标准差评分（BMI SDS）变化的影响。在基线时，474例（80%）病例至少存在一种心血管危险因素。在治疗期间，男孩的心脏代谢参数变化比女孩更为显著。男孩的总胆固醇（TC）在12个月时有所改善（ = 0.009），其低密度脂蛋白C（LDL-C）和糖化血红蛋白在12个月时（分别为 = 0.030和0.022）以及24个月时（分别为 = 0.043和0.025）有所改善。男孩的甘油三酯、胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）和收缩压在24个月时恶化（分别为 < 0.001、0.004、0.002和0.037）。在所有儿童中，如果BMI SDS在12个月时降低0.25或更多，则可接受的TC、LDL-C、胰岛素和HOMA-IR值的数量会增加。在肥胖治疗期间发现了轻微的心脏代谢改善。这些发现表明需要评估治疗方法并注重预防。
