Department of Epidemiology and Biostatistics, University of Georgia (MD Claridy), Athens, Ga.
Department of Surgery, Massachusetts General Hospital and Harvard Medical School (NP Perez), Boston, Mass.
Acad Pediatr. 2023 Jan-Feb;23(1):102-108. doi: 10.1016/j.acap.2022.04.009. Epub 2022 May 6.
The objectives of this study were to 1) examine the prevalence of prescription medication use overall and 2) examine the association between weight promoting medication (WPM) use by therapeutic class and weight status among a nationally representative sample of the children and adolescents in the United States. This study also further investigated antidepressant medication use among this population.
This cross-sectional study used data from the National Health and Nutrition Examination Survey from 2013 to 2018. Children and adolescents ages 2 to 19 years were included in this study.
Of the 68,057,468 derived participants (34,507,154 [50.7%] male; 33,564,059 [49.3%] aged 2-10 years; 34,905,058 [51.3%] non-Hispanic White), 14,895,618 (22.2%) used a prescription medication in the prior 30 days, 21.7% (3,235,323) of which were considered weight promoting. There was no significant difference between weight status and WPM use for overall prescription medication use. Nevertheless, for overall antidepressant medication use, those with obesity were less likely to be prescribed antidepressant WPM when compared to those with normal weight (adjusted odds ratios 0.4; 95% confidence interval 0.2-0.7).
These findings suggest that although there was no significant association between WPM use and weight status overall when examining the association by therapeutic class, most children with obesity were not using antidepressant WPM. This is reassuring and potentially an active attempt at avoiding the use of medications that have an exacerbating effect on weight gain. When choosing antidepressant medications, providers, parents, and patients consider the WPM effects and appropriately choose a medication best suited to the child's health status.
本研究旨在:1)检查总体处方药物使用情况;2)检查美国儿童和青少年全国代表性样本中按治疗类别划分的促进体重增加的药物(WPM)使用与体重状况之间的关系。本研究还进一步调查了该人群中使用抗抑郁药物的情况。
本横断面研究使用了 2013 年至 2018 年国家健康和营养检查调查的数据。本研究纳入了年龄在 2 至 19 岁的儿童和青少年。
在 68,057,468 名参与者中(34,507,154 名男性[50.7%];33,564,059 名年龄为 2-10 岁的儿童[49.3%];34,905,058 名非西班牙裔白人[51.3%]),有 14,895,618 名(22.2%)在过去 30 天内使用了处方药物,其中 21.7%(3,235,323 名)被认为是促进体重增加的药物。总体而言,处方药物使用情况与 WPM 使用之间的体重状况无显著差异。然而,对于总体抗抑郁药物使用情况,与体重正常者相比,肥胖者服用抗抑郁 WPM 的可能性较低(调整后的优势比为 0.4;95%置信区间为 0.2-0.7)。
这些发现表明,尽管在按治疗类别检查关联时,WPM 使用与体重状况之间没有显著关联,但大多数肥胖儿童并未使用抗抑郁 WPM。这令人欣慰,并且可能是在积极避免使用会加重体重增加的药物。在选择抗抑郁药物时,提供者、家长和患者会考虑 WPM 的影响,并选择最适合儿童健康状况的药物。