Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
Res Dev Disabil. 2021 Jul;114:103992. doi: 10.1016/j.ridd.2021.103992. Epub 2021 May 25.
To compare the prevalence and correlates of overweight (OW) and obesity (OB) between autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit-hyperactivity disorder (ADHD) and to investigate which variables significantly contribute to OW/OB in each group.
Of 267 cases (96 with ASD, 80 with ID, and 91 with ADHD) aged 2-18 years, body mass index (BMI) percentiles, birth weight, food reward usage, weekly screen and physical activity time, and psychotropics used were recorded.
OB (OB + OW) prevalence was 22.9 % (36.4 %) in ASD; 22.5 % (40 %) in ID; and 17.6 % (27.5 %) in ADHD. Although the ADHD group had the highest rate of stimulant usage (χ2 = 69.605, p < 0.001), physical activity attendance (χ2 = 49.751, p < 0.001), and the lowest anti-psychotic (χ2 = 69.142, p < 0.001), and anti-depressant usage (χ2 = 7.219, p < 0.001) than ID/DD or ASD, BMI percentile of the participants did not differ between the groups (H(2) = 1.652, p = 0.43). In hierarchical logistic regression analysis, in ASD, food reward (OR = 4.65, 95 %Cl = 1.25-17.19) and the number of psychotropics used (OR = 2.168, 95 %Cl = 1.07-4.36) were significantly related to the risk of OW/OB. In ADHD, each drugs administered and a 1-kilogram elevation in birth weight was associated with a 4.09 and 2.82 increased risk for OW/OB.
OW/OB is prevalent in children with neurodevelopmental disorders regardless of their diagnosis. Our findings showed that food rewards put a higher risk for OW/OB in ASD than administering a psychotropic. It could be better to use other positive reinforcements other than edible ones to prevent OW/OB in these children.
比较自闭症谱系障碍(ASD)、智力障碍(ID)和注意缺陷多动障碍(ADHD)患者中超重(OW)和肥胖(OB)的患病率和相关因素,并探讨哪些变量显著导致每组 OW/OB。
对 267 名年龄在 2-18 岁的患者(96 名 ASD、80 名 ID 和 91 名 ADHD)进行了体重指数(BMI)百分位、出生体重、食物奖励使用情况、每周屏幕和身体活动时间以及使用精神药物的记录。
ASD 组 OB(OB+OW)患病率为 22.9%(36.4%);ID 组为 22.5%(40%);ADHD 组为 17.6%(27.5%)。尽管 ADHD 组兴奋剂使用率最高(χ2=69.605,p<0.001)、身体活动出勤率最高(χ2=49.751,p<0.001)、抗精神病药使用率最低(χ2=69.142,p<0.001)和抗抑郁药使用率(χ2=7.219,p<0.001),但参与者的 BMI 百分位在各组之间无差异(H(2)=1.652,p=0.43)。在分层逻辑回归分析中,ASD 中,食物奖励(OR=4.65,95%Cl=1.25-17.19)和使用精神药物的数量(OR=2.168,95%Cl=1.07-4.36)与 OW/OB 的风险显著相关。在 ADHD 中,每一种药物的使用和出生体重增加 1 公斤,OW/OB 的风险分别增加 4.09 和 2.82。
无论诊断如何,神经发育障碍儿童中 OW/OB 较为常见。我们的研究结果表明,与使用精神药物相比,食物奖励会使 ASD 中 OW/OB 的风险更高。对于这些儿童,最好使用其他非食用性的积极强化物来预防 OW/OB。