Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Allied Health Professionals Function, Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Acta Paediatr. 2020 Aug;109(8):1665-1671. doi: 10.1111/apa.15163. Epub 2020 Feb 3.
To present specific reference values for cardiorespiratory fitness (CRF) in children with obesity and to analyse secular trends of CRF in the studied population.
Cardiorespiratory fitness, the maximal oxygen uptake (VO max), was estimated with the Åstrand-Rhyming submaximal bicycle test, in 705 Swedish children (356 girls, 8-20 years) with obesity according to the International Obesity Task Force (IOTF). Data were collected from 1999 to 2013. Secular trends, analysed with multiple linear regression, were adjusted for age, height and body mass index standard deviation score (BMI SDS).
All children had low CRF compared with normal weight standards but there was a marked variability of CRF in children with obesity, which was possible to quantify with the developed obesity specific CRF reference values. The mean value of absolute VO max (L/min) increased with age and relative VO max (mL/kg/min) decreased with age in both boys and girls. There was a negative secular trend in both sexes (P < .001).
These are the first obesity specific reference values of CRF in children enabling clinical evaluation in childhood obesity treatment. Cardiorespiratory fitness in children with obesity has declined the last decades, indicating that also within this vulnerable group physical activity has gone down.
为肥胖儿童提供心肺功能(CRF)的具体参考值,并分析研究人群中 CRF 的长期变化趋势。
心肺功能的最大摄氧量(VO max)通过 Åstrand-Rhyming 亚极量自行车测试进行评估,共有 705 名瑞典肥胖儿童(356 名女孩,年龄 8-20 岁)符合国际肥胖工作组(IOTF)的肥胖标准。数据于 1999 年至 2013 年收集。使用多元线性回归分析长期变化趋势,并根据年龄、身高和体重指数标准差评分(BMI SDS)进行调整。
所有肥胖儿童的 CRF 均低于正常体重标准,但肥胖儿童的 CRF 存在明显的差异,这可以通过制定的肥胖特异性 CRF 参考值来量化。男孩和女孩的绝对 VO max(L/min)平均值均随年龄增长而增加,相对 VO max(mL/kg/min)随年龄增长而降低。在两性中均存在负向的长期变化趋势(P<.001)。
这是肥胖儿童 CRF 的首个特异性参考值,可用于儿童肥胖治疗中的临床评估。过去几十年肥胖儿童的心肺功能下降,表明即使在这个脆弱的群体中,体力活动也在减少。