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识别肥胖和发育障碍青少年的特征和结果。

Identifying characteristics and outcomes in youth with obesity and developmental disabilities.

机构信息

Tulane University School of Medicine, New Orleans, LA, USA.

Nemours Children's Primary Care, Orlando, FL, USA.

出版信息

Disabil Health J. 2021 Apr;14(2):100988. doi: 10.1016/j.dhjo.2020.100988. Epub 2020 Sep 10.

Abstract

BACKGROUND

Youth with developmental disability are at increased risk of obesity; literature focusing on the two is rare.

OBJECTIVE

To identify characteristics and outcomes of youth presenting for obesity care having a disability as compared to without.

METHODS

A medical record review of youth aged 2-18 years initiating obesity care 2013-2015 at a tertiary care obesity management program. Youth were grouped by disability status to identify differences in presenting characteristics and factors associated with a reduction in body mass index (BMI) percent of the 95th BMI percentile (BMIp95) over 12 months. Logistic regression (LR) models examined associations with BMIp95 drop (<5-points versus ≥5-points) for each disability group.

RESULTS

Of 887 subjects, 253 (28.5%) had a disability. At presentation, youth with disability were more often (p < 0.01) male (58.5% versus 47.9%), had birth weight <2500 g (14.1% versus 8.4%), had a father who was not obese (61.6% versus 47.4%), and were on weight influencing medications. Overall, 182 subjects (20.5%) completed 12-month follow-up. At follow-up, the with disability group (n = 63) had mean -2.3 (SD 10.7) BMIp95 change (p = 0.679); youth having a motor disability less often had ≥5-point BMIp95 drop (odds ratio 0.15, 95% confidence interval 0.04-0.59). At follow-up, the no disability group (n = 119) had mean -2.9 (SD 8.5) BMIp95 change; youth identified as having initial severe obesity status and not having a parent with diabetes more often had ≥5-point BMIp95 drop.

CONCLUSION

Youth with developmental disabilities were as successful in obesity care as those without disabilities. Predictors of success differed between the groups.

摘要

背景

患有发育障碍的年轻人肥胖风险增加;针对这两者的文献很少。

目的

确定患有残疾和没有残疾的年轻人就诊肥胖治疗的特征和结果。

方法

对 2013 年至 2015 年在一家三级保健肥胖管理项目中开始肥胖治疗的 2-18 岁青少年进行病历回顾。根据残疾状况将青少年分组,以确定就诊特征的差异,并确定与 12 个月内体重指数(BMI)百分比第 95 百分位数(BMIp95)降低相关的因素(<5 点与≥5 点)。逻辑回归(LR)模型检查了每个残疾组 BMIp95 下降(<5 点与≥5 点)的关联。

结果

在 887 名受试者中,253 名(28.5%)有残疾。就诊时,残疾组青少年更常为男性(58.5%与 47.9%),出生体重<2500g(14.1%与 8.4%),父亲不肥胖(61.6%与 47.4%),并使用影响体重的药物。总体而言,182 名受试者(20.5%)完成了 12 个月的随访。在随访时,有残疾组(n=63)的 BMIp95 平均变化为-2.3(10.7 SD)(p=0.679);患有运动障碍的青少年 BMIp95 下降≥5 点的比例较低(比值比 0.15,95%置信区间 0.04-0.59)。在随访时,无残疾组(n=119)的 BMIp95 平均变化为-2.9(8.5 SD);被确定为初始严重肥胖状态且父母无糖尿病的青少年 BMIp95 下降≥5 点的比例更高。

结论

患有发育障碍的年轻人在肥胖治疗中与无残疾的年轻人一样成功。两组的成功预测因素不同。

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