患有肠易激综合征和功能性腹痛的儿童的过度活动发生率与健康儿童相似。
The Prevalence of Hypermobility in Children with Irritable Bowel Syndrome and Functional Abdominal Pain Is Similar to that in Healthy Children.
机构信息
Department of Pediatrics, Baylor College of Medicine, Houston, TX; Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
出版信息
J Pediatr. 2020 Jul;222:134-140.e2. doi: 10.1016/j.jpeds.2020.03.033. Epub 2020 May 4.
OBJECTIVES
To test the hypothesis that the prevalence of joint hypermobility is greater in children with irritable bowel syndrome and functional abdominal pain than in healthy control children and is related to gastrointestinal symptoms and psychosocial distress (anxiety, depression, and somatization).
STUDY DESIGN
Children (irritable bowel syndrome, n = 109; functional abdominal pain, n = 31; healthy control, n = 69), 7-12 years of age completed prospective 2-week pain and stooling diaries and child- and parent-reported measures of anxiety, depression, and somatization. Joint hypermobility was determined using Beighton criteria (score of ≥4 or 6). We also examined possible relationships between Beighton score, race, body mass index, gastrointestinal symptoms, and psychosocial distress.
RESULTS
Beighton scores were similar between groups, as was the proportion with joint hypermobility. Scores were higher in girls (3.1 ± 2.4) than boys (2.3 ± 1.8; P = .004) and decreased with age (P < .001; r = -0.25). Race and body mass index did not impact joint hypermobility prevalence. Beighton scores were not related to abdominal pain or stooling characteristics. Participants with a score of ≥4 and ≥6 had greater somatization and depression by child report (P = .017 and P = .048, respectively). No association was seen for anxiety. There was no significant association between joint hypermobility and psychosocial distress measures per parent report.
CONCLUSIONS
Contrary to the adult literature, the prevalence of joint hypermobility does not differ among children with irritable bowel syndrome, functional abdominal pain, or healthy control children. The presence or severity of joint hypermobility does not correlate with abdominal pain or stooling characteristics. Somatization and depression by child report appear to have a relationship with joint hypermobility.
目的
验证以下假说,即肠易激综合征和功能性腹痛患儿的关节过度活动症患病率高于健康对照儿童,且与胃肠道症状和心理社会痛苦(焦虑、抑郁和躯体化)相关。
研究设计
7-12 岁的儿童(肠易激综合征 109 例,功能性腹痛 31 例,健康对照 69 例)完成前瞻性 2 周疼痛和排便日记,以及儿童和家长报告的焦虑、抑郁和躯体化评估。使用 Beighton 标准(得分≥4 或 6)确定关节过度活动症。我们还检查了 Beighton 评分、种族、体重指数、胃肠道症状和心理社会痛苦之间的可能关系。
结果
组间 Beighton 评分相似,关节过度活动症的比例也相似。女孩的评分(3.1±2.4)高于男孩(2.3±1.8;P=0.004),且随年龄降低(P<0.001;r=-0.25)。种族和体重指数对关节过度活动症的患病率没有影响。Beighton 评分与腹痛或排便特征无关。评分≥4 和≥6 的参与者的躯体化和抑郁评分(儿童报告)更高(分别为 P=0.017 和 P=0.048)。焦虑方面未见相关性。Beighton 评分与家长报告的心理社会痛苦评估之间无显著相关性。
结论
与成人文献相反,肠易激综合征、功能性腹痛或健康对照儿童的关节过度活动症患病率并无差异。关节过度活动症的存在或严重程度与腹痛或排便特征无关。儿童报告的躯体化和抑郁与关节过度活动症似乎存在关联。