Department of Pediatric Gastroenterology and Nutrition. Facultad de Medicina. Pontificia Universidad Católica de Chile & Hospital Josefina Martínez.
Department of Pediatric Gastroenterology and Nutrition. Facultad de Medicina. Pontificia Universidad Católica de Chile.
Nutr Hosp. 2020 Aug 27;37(4):685-691. doi: 10.20960/nh.03009.
Background: obesity and associated cardiometabolic complications are increasing among adults with cerebral palsy (CP). Information in children is scarce, and there is no consensus definition of obesity. Objectives: to describe the frequency of obesity and metabolic complications in children and adolescents with CP. Methods: a descriptive, cross-sectional study performed in two outpatient pediatric special needs centers. Demographic, anthropometric (Brooks 2011), and motor function (GMFCS) data, as well as antiepileptic use, were recorded. Fasting triglycerides (TG), total cholesterol (TC), vitamin D (25OHD), glycemia (GLY), and insulinemia levels were measured. The HOMA index was calculated. Results: sixty-five patients were enrolled. Aage was 10.8 ± 4.9 years; 63.1 % were male; 81.6 % had GMFCS IV-V; 43.5 % had a gastrostomy; and 83.1 % were on antiepileptics. According to their BMI, 15.4 % were underweight (< 10th percentile) and 10.8 % overweight (> 75th percentile). Overall, 6.1 % had TC ≥ 200 mg/dL, 21.4 % had TG ≥ 110 or 130 mg/dL, 4.6 % had GLY ≥ 100 mg/dL, 16.9 % had HOMA ≥ 3, and 76.9 % had 25OHD < 30 ng/mL. Children with BMI ≥ 75th percentile had higher HOMA and insulin resistance rates than those with BMI < 75th percentile. Elevated TGs were associated with high motor impairment and low vitamin D. HOMA was associated to feminine gender and BMI ≥ 75th percentile. Conclusions: the frequency of cardiometabolic risk factors was high in this sample of pediatric patients with CP, associated with overweight, low mobility, and vitamin D deficiency. We propose a BMI > 75th percentile as cutoff point for metabolic risk factors.
肥胖症及相关代谢并发症在脑瘫（CP）患者中日益普遍。儿童相关信息有限，且肥胖症尚无共识定义。目的：描述 CP 患儿和青少年肥胖症及代谢并发症的发生频率。方法：在两家儿科特殊需求门诊进行描述性、横断面研究。记录人口统计学、人体测量学（Brooks 2011 年）和运动功能（GMFCS）数据，以及抗癫痫药物使用情况。测量空腹甘油三酯（TG）、总胆固醇（TC）、维生素 D（25OHD）、血糖（GLY）和胰岛素水平。计算 HOMA 指数。结果：共纳入 65 例患者。年龄为 10.8 ± 4.9 岁；63.1%为男性；81.6%为 GMFCS IV-V 级；43.5%有胃造口术；83.1%使用抗癫痫药物。根据 BMI，15.4%为体重不足（<第 10 百分位数），10.8%为超重（>第 75 百分位数）。总体而言，6.1%的 TC≥200mg/dL，21.4%的 TG≥110 或 130mg/dL，4.6%的 GLY≥100mg/dL，16.9%的 HOMA≥3，76.9%的 25OHD<30ng/mL。BMI≥75 百分位数的儿童的 HOMA 和胰岛素抵抗发生率高于 BMI<75 百分位数的儿童。升高的 TG 与较高的运动障碍和较低的维生素 D 相关。HOMA 与女性性别和 BMI≥75 百分位数相关。结论：在 CP 儿科患者中，心血管代谢危险因素的发生率较高，与超重、运动能力差和维生素 D 缺乏有关。我们提出 BMI>75 百分位数作为代谢危险因素的切点。
