Clinical Effectiveness Team, Leeds and York Partnership NHS Foundation Trust, Leeds, UK.
Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
Obes Rev. 2019 Oct;20(10):1341-1349. doi: 10.1111/obr.12904. Epub 2019 Jul 24.
Evidence for the health impact of obesity has largely focussed on adults. We estimated the population prevalence and prevalence ratio of obesity-associated comorbidities in children and adolescents aged 5 to 18 years. Five databases were searched from inception to 14 January 2018. Population-based observational studies reporting comorbidity prevalence by weight category (healthy weight/overweight/obese) in children and adolescents aged 5 to 18 years from any country were eligible. Comorbidity prevalence, stratified by weight category, was extracted and prevalence ratios (relative to healthy weight) estimated using random effects meta-analyses. Of 9183 abstracts, 52 eligible studies (1 553 683 participants) reported prevalence of eight comorbidities or risk markers including diabetes and nonalcoholic fatty liver disease (NAFLD). Evidence for psychological comorbidities was lacking. Meta-analyses suggested prevalence ratio for prediabetes (fasting glucose ≥ 100 mg/dL) for those with obesity relative to those of a healthy weight was 1.4 (95% confidence interval [CI], 1.2-1.6) and for NAFLD 26.1 (9.4-72.3). In the general population, children and adolescents with overweight/obesity have a higher prevalence of comorbidities relative to those of a healthy weight. This review provides clinicians with information when assessing children and researchers a foundation upon which to build a comprehensive dataset to understand the health consequences of childhood obesity.
肥胖对健康的影响的证据主要集中在成年人身上。我们估计了 5 至 18 岁儿童和青少年中与肥胖相关的合并症的人群患病率和患病率比值。从建库到 2018 年 1 月 14 日，我们对 5 个数据库进行了检索。本研究纳入了所有国家的报告了 5 至 18 岁儿童和青少年体重类别（健康体重/超重/肥胖）相关合并症患病率的基于人群的观察性研究。提取按体重类别分层的合并症患病率，并使用随机效应荟萃分析估计与健康体重相比的患病率比值（相对值）。在 9183 篇摘要中，有 52 项符合条件的研究（1553683 名参与者）报告了 8 种合并症或风险标志物的患病率，包括糖尿病和非酒精性脂肪性肝病（NAFLD）。缺乏心理合并症的证据。荟萃分析表明，肥胖者的空腹血糖（≥100mg/dL）糖尿病前期患病率比值相对健康体重者为 1.4（95%置信区间[CI]，1.2-1.6），NAFLD 患病率比值为 26.1（9.4-72.3）。在普通人群中，超重/肥胖的儿童和青少年与健康体重者相比，合并症的患病率更高。本综述为临床医生在评估儿童肥胖症时提供了信息，为研究人员提供了一个基础，以便建立一个全面的数据集，以了解儿童肥胖症的健康后果。
