Pediatric Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila.
Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome.
J Pediatr Gastroenterol Nutr. 2019 Apr;68(4):517-520. doi: 10.1097/MPG.0000000000002208.
Although emerging data indicate that obese/overweight children are more likely to develop functional gastrointestinal disorders (FGIDs) than normal-weight peers, contrasting results have been reported. The present observational, case-control study aimed at estimating the prevalence of FGIDs in obese/overweight children compared to normal-weight peers.
Consecutive obese and overweight children aged 4 to 18 years attending the obesity outpatient clinic were enrolled as study cases. Normal-weight children were enrolled as comparison group. All the enrolled patients received a thorough health examination from both a pediatric endocrinologist and gastroenterologist. Moreover, they were asked to fill out the Rome III questionnaire for the diagnosis of FGIDs. Data were analyzed to compare the prevalence of FGIDs between cases and controls.
Throughout the study period we enrolled 103 cases and 115 controls. No significant age and sex differences were found between the 2 groups. FGIDs were significantly more prevalent in obese/overweight compared to normal-weight children (47.57% vs 17.39%; P < 0.0001). Increased prevalence was observed for functional constipation (18.44% vs 7.82%; P = 0.025), functional dyspepsia (23.33% vs 6.95%; P = 0.001), and irritable bowel syndrome (10.67% vs 2.60%; P = 0.024), whereas no difference was observed for functional abdominal pain (1.94% vs 2.60%; P = 1.00).
Our data suggest that there is a link between excess body fat and FGIDs in children. This finding may offer a model of patients in which the effects of food and nutritional substances, the gut microbial environment, and psychosocial factors are fitting well with the emerging biopsychosocial conceptual model for FGIDs.
尽管有新数据表明肥胖/超重儿童比正常体重儿童更易患功能性胃肠疾病（FGIDs），但也有相反的结果报告。本观察性病例对照研究旨在估计肥胖/超重儿童与正常体重儿童相比 FGIDs 的患病率。
连续招募了年龄在 4 至 18 岁之间的肥胖和超重门诊患儿作为研究病例。正常体重儿童被招募为对照组。所有纳入的患者均由儿科内分泌医生和胃肠病医生进行全面的健康检查。此外，他们还被要求填写罗马 III 问卷以诊断 FGIDs。分析数据以比较病例组和对照组 FGIDs 的患病率。
在整个研究期间，我们共招募了 103 例病例和 115 例对照。两组在年龄和性别方面无显著差异。与正常体重儿童相比，肥胖/超重儿童 FGIDs 的患病率显著更高（47.57%比 17.39%；P<0.0001）。功能性便秘（18.44%比 7.82%；P=0.025）、功能性消化不良（23.33%比 6.95%；P=0.001）和肠易激综合征（10.67%比 2.60%；P=0.024）的患病率增加，而功能性腹痛（1.94%比 2.60%；P=1.00）的患病率无差异。
我们的数据表明，儿童体内脂肪过多与 FGIDs 之间存在关联。这一发现可能为患者提供了一种模型，其中食物和营养物质、肠道微生物环境和心理社会因素的影响与新兴的 FGIDs 生物心理社会概念模型非常吻合。
