Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA.
Department of Pediatrics, Division of Pediatric Cardiology, University of Wisconsin School of Medicine and Public Health, USA.
J Clin Lipidol. 2022 Sep-Oct;16(5):643-648. doi: 10.1016/j.jacl.2022.06.006. Epub 2022 Jun 24.
The COVID-19 pandemic has raised concerns for worsening cardiometabolic health in children.
This study evaluates the impact of the COVID-19 pandemic and subsequent social restrictions on pediatric cardiometabolic health factors.
Retrospective review of patients in a pediatric lipid clinic in the year prior to (3/18/2019-3/17/2020) and during (3/18/2020-3/17/2021) the COVID-19 pandemic was performed. Physical findings (body mass index [BMI], waist circumference [WC], and blood pressure), laboratory markers of cardiometabolic health (lipid panel, insulin resistance, and liver transaminases), self-reported exercise time, and lipid-lowering medications (metformin, statin, omega-3 fatty acids, fenofibrate) were compared.
297 subjects met inclusion criteria. Among subjects prescribed no medications or on stable medication doses (n=241), there were few changes in lipid panels. Among subjects with new or increased medication doses between pre-pandemic and pandemic intervals (n=62), there were increases in triglycerides (p= 0.019) and HgbA1c (p=0.046). There was no change in z-scores for both BMI and WC for either group.
We observed concerning trends in markers of cardiovascular disease health (dyslipidemia, insulin resistance, and diabetes), independent of changes in weight, in at-risk children during the recent COVID pandemic. Our findings suggest that this vulnerable population may benefit from more frequent monitoring and intense management during such events.
COVID-19 大流行引发了人们对儿童心脏代谢健康恶化的担忧。
本研究评估了 COVID-19 大流行及其随后的社会限制对儿科心脏代谢健康因素的影响。
对儿科脂质诊所的患者进行回顾性研究，研究时间为 COVID-19 大流行之前（2019 年 3 月 18 日至 2020 年 3 月 17 日）和期间（2020 年 3 月 18 日至 2021 年 3 月 17 日）。比较身体检查结果（体重指数[BMI]、腰围[WC]和血压）、心脏代谢健康的实验室标志物（血脂谱、胰岛素抵抗和肝转氨酶）、自我报告的运动时间以及降脂药物（二甲双胍、他汀类药物、欧米伽-3 脂肪酸、非诺贝特）。
297 名患者符合纳入标准。在未服用药物或服用稳定剂量药物的患者中（n=241），血脂谱变化不大。在大流行前和大流行期间新服用或增加药物剂量的患者中（n=62），甘油三酯（p=0.019）和 HgbA1c（p=0.046）升高。两组 BMI 和 WC 的 z 评分均无变化。
我们观察到，在最近的 COVID 大流行期间，高危儿童的心血管疾病健康标志物（血脂异常、胰岛素抵抗和糖尿病）出现了令人担忧的趋势，而体重变化不大。我们的研究结果表明，在这种情况下，这种弱势群体可能需要更频繁的监测和强化管理。
