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通过针对肥胖儿童和青少年的综合护理计划进行多学科干预的临床和代谢效应。

Clinical and metabolic effect of a multidisciplinary intervention through a comprehensive care program for children and adolescents with obesity.

作者信息

Zuluaga Nora Alejandra, Osorno Adriana, Lozano Alba, Villada Oscar

机构信息

Programa de Obesidad Infantil, Hospital Universitario de San Vicente Fundación, Medellín, Colombia.

Programa de Obesidad Infantil, Hospital Universitario de San Vicente Fundación, Medellín, Colombia; Dirección de Investigaciones, Hospital Universitario de San Vicente Fundación, Medellín, Colombia.

出版信息

Biomedica. 2020 Mar 1;40(1):166-184. doi: 10.7705/biomedica.4593.

Abstract

Introduction: The approach to childhood obesity requires multidisciplinary programs including all the dimensions susceptible to management. Objective: To describe the clinical and metabolic changes in patients with obesity after a comprehensive care program for childhood obesity. Materials and methods: We conducted a retrospective observational and analytical study in a cohort of patients between 6 and 17 years old treated in the obesity program at the Hospital Universitario San Vicente Fundación (2012-2015). We carried out multidisciplinary care and educational intervention. Anthropometric and laboratory variables were evaluated both at admission to the program and in the last evaluation and statistical differences were sought according to the follow-up time. Results: We evaluated 53 patients, of whom 52.8% were men, with an average age of 11 ± 2 years. The follow-up extended for 18 ± 6 months though 30% of the patients were followed for 31 to 36 months. There was a decrease in the BMI (Z score) between admission (2.75 ± 0.58 and the last control (2.32 ± 0.63) with a p-value of 0.000 (95% CI: 0.27 -0.58); 79.25% of the patients reduced the BMI Z score. This decrease was significant regardless of the follow-up time. The proportion of patients with a BMI Z score >3 decreased from 33.4% to 14.6%. The number of positive criteria for metabolic syndrome decreased in the follow-up. Triglycerides and HbA1c were the metabolic variables that improved significantly. Conclusions: The management of childhood obesity with an interdisciplinary intervention associated with continuous group educational support can significantly impact on clinical and metabolic changes. It is necessary to continue monitoring over time to prevent relapse.

摘要

引言

儿童肥胖的治疗需要多学科项目,包括所有易于管理的方面。目的:描述儿童肥胖综合护理项目后肥胖患者的临床和代谢变化。材料与方法:我们对圣维森特基金会大学医院肥胖项目(2012 - 2015年)治疗的6至17岁患者队列进行了回顾性观察分析研究。我们开展了多学科护理和教育干预。在项目入院时和最后一次评估时评估人体测量和实验室变量,并根据随访时间寻找统计差异。结果:我们评估了53例患者,其中52.8%为男性,平均年龄为11±2岁。随访时间延长至18±6个月,尽管30%的患者随访了31至36个月。入院时BMI(Z评分)为2.75±0.58,最后一次对照时为2.32±0.63,p值为0.000(95%置信区间:0.27 - 0.58);79.25%的患者BMI Z评分降低。无论随访时间如何,这种降低都是显著 的。BMI Z评分>3的患者比例从33.4%降至14.6%。随访中代谢综合征阳性标准的数量减少。甘油三酯和糖化血红蛋白是显著改善的代谢变量。结论:采用与持续小组教育支持相关的跨学科干预管理儿童肥胖可对临床和代谢变化产生显著影响。有必要长期持续监测以预防复发。

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