体重变化是否会影响肥胖儿童和青少年的认知功能？一项临床试验的二次分析。
Do changes in weight status affect cognitive function in children and adolescents with obesity? A secondary analysis of a clinical trial.
机构信息
Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
出版信息
BMJ Open. 2019 Feb 19;9(2):e021586. doi: 10.1136/bmjopen-2018-021586.
OBJECTIVES
It is unclear whether an association exists between obesity in children/adolescents and cognitive function, and whether the latter can be altered by body mass index (BMI) standard deviation score (SDS) reductions. We aimed to determine whether an association exists between BMI SDS and cognitive function in children/adolescents with obesity engaged in an obesity intervention. Second, we sought to determine if BMI SDS reduction at 12 months was associated with improved cognitive function.
DESIGN
Secondary analysis of a clinical trial.
PARTICIPANTS
Participants (n=69) were recruited from an obesity intervention. Eligible participants (recruited June 2013 to June 2015) were aged 6-16 years, with a BMI ≥98th centile or BMI >91st centile with weight-related comorbidities.
OUTCOME MEASURES
Primary outcome measure was change in BMI SDS from baseline at 12 months. Dependent variables of cognitive functioning and school achievement were assessed at baseline and 12 months, using dependent variables of cognitive functioning (elements of Ravens Standard Progressive Matrices, Wide Range Achievement Test-fourth edition and Wechsler Intelligence Scale for Children-fourth edition).
RESULTS
At baseline, BMI SDS was not associated with all aspects of cognitive function tested (n=69). Reductions in BMI SDS over time did not alter cognitive function overall. However, there was a greater reduction in comprehension standard scores in participants who increased their BMI SDS (adjusted estimated difference -6.1, 95% CI -11.6 to -0.6; p=0.03).
CONCLUSIONS
There were no observed associations between BMI SDS and cognitive function in participants, apart from comprehension in the exploratory analyses, which may have been a random finding. Further studies need to include larger longitudinal cohorts incorporating a wider BMI range at entry to determine whether our findings persist.
TRIAL REGISTRATION NUMBER
ANZCTR12611000862943; Pre-results.
目的
目前尚不清楚儿童/青少年肥胖与认知功能之间是否存在关联，以及体重指数（BMI）标准差评分（SDS）降低是否会改变后者。我们旨在确定肥胖干预中肥胖儿童/青少年的 BMI SDS 与认知功能之间是否存在关联。其次，我们试图确定 BMI SDS 在 12 个月时的降低是否与认知功能的改善相关。
设计
临床试验的二次分析。
参与者
参与者（n=69）从肥胖干预中招募。合格的参与者（2013 年 6 月至 2015 年 6 月招募）年龄在 6-16 岁之间，BMI≥第 98 百分位数或 BMI>第 91 百分位数且伴有与体重相关的合并症。
观察指标
主要观察指标是 BMI SDS 从基线到 12 个月的变化。认知功能和学业成就的因变量在基线和 12 个月时进行评估，使用认知功能的因变量（Ravens 标准渐进矩阵的元素、广域成就测试第四版和韦氏儿童智力量表第四版）。
结果
在基线时，BMI SDS 与所有测试的认知功能方面均无关联（n=69）。随着时间的推移，BMI SDS 的降低并没有改变整体认知功能。然而，在 BMI SDS 增加的参与者中，理解标准分数的降低更大（调整后的估计差异-6.1，95%CI-11.6 至-0.6；p=0.03）。
结论
除了探索性分析中的理解能力外，参与者的 BMI SDS 与认知功能之间没有观察到关联，这可能是一个随机发现。需要进一步的研究纳入更大的纵向队列，在入组时纳入更广泛的 BMI 范围，以确定我们的发现是否持续。
试验注册号
ANZCTR12611000862943；预结果。
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