Boston Combined Residency Program, Boston Children's Hospital & Boston Medical Center, Boston, Massachusetts.
Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Acad Nutr Diet. 2023 Feb;123(2):253-262. doi: 10.1016/j.jand.2022.07.017. Epub 2022 Aug 5.
Youth with Down syndrome (DS) have a high prevalence of obesity and dyslipidemia. Diet quality may influence cardiometabolic risk (CMR) in youth.
The aim of this secondary analysis was to investigate the relationship between diet quality (Healthy Eating Index [HEI-2015]) with CMR factors in youth with DS compared with age, sex, race, ethnicity, and body mass index percentile matched, typically developing controls.
Adolescents (aged 10 to 20 years) with DS and controls of comparable age, sex, race, ethnicity, and body mass index percentile were recruited from 2012 to 2017 for a cross-sectional study from two large children's hospitals (Children's Hospital of Philadelphia and the Children's National Health System in Washington, DC).
CMRs in 143 adolescents with DS were compared with 100 controls. Exclusion criteria consisted of major organ-system illnesses.
The average of three 24-hour dietary recalls was used to calculate the HEI-2015. Anthropometrics, blood pressure, and fasting labs were collected.
Group differences were tested using Wilcoxon rank-sum tests. Relationships of CMR factors with HEI-2015 score within DS and controls were tested using linear regression models adjusted for sex, age, race, and body mass index z score.
Compared with controls (n = 100, median age = 14.8 years [interquartile range = 12.2 to 17.3 years]; 41% male; 24% African American; 65% with body mass index ≥85th percentile), adolescents with DS (n = 143, median age = 14.7 years [interquartile range = 11.4 to 17.4 years]; 44% male; 18% African American; 62% with body mass index ≥85th percentile) had higher scores (more aligned with dietary recommendations) for total HEI-2015 (DS: 52.7 [interquartile range = 46.8 to 58.6] vs controls: 45.1 [interquartile range = 39.5 to 55.0]; P < 0.0001). Youth with DS also had higher HEI-2015 component scores for fruits, greens/beans, dairy, refined grains, and saturated fats, but lower whole grains and sodium scores. Within the group with DS, total HEI-2015 was not significantly associated with CMR measures. Whereas HEI-2015 in the DS group was negatively associated with fasting glucose levels, the difference did not meet the set level of statistical significance (-0.14, 95% CI -0.29 to 0.00; P = 0.053).
Adolescents in both the control and DS groups reported low-quality diets, although the DS group had HEI-2015 scores more closely aligned with recommendations. In the DS group, diet quality was not significantly associated with CMR factors. Although further research is needed, these results suggest that dyslipidemia in youth with DS may not be related to dietary intake.
患有唐氏综合征（DS）的年轻人肥胖和血脂异常的患病率很高。饮食质量可能会影响青少年的心血管代谢风险（CMR）。
本二次分析旨在研究与年龄、性别、种族、民族和体重指数百分位匹配的典型发育对照组相比，DS 青少年的饮食质量（健康饮食指数[HEI-2015]）与 CMR 因素之间的关系。
2012 年至 2017 年，从两家大型儿童医院（费城儿童医院和华盛顿特区儿童国家卫生系统）招募了年龄在 10 至 20 岁之间的 DS 青少年和具有相似年龄、性别、种族、民族和体重指数百分位的对照组进行横断面研究。
比较了 143 名 DS 青少年的 CMR 与 100 名对照组。排除标准包括主要器官系统疾病。
使用三个 24 小时膳食回忆的平均值计算 HEI-2015。收集人体测量、血压和空腹实验室数据。
使用 Wilcoxon 秩和检验测试组间差异。使用线性回归模型测试 DS 和对照组中 CMR 因素与 HEI-2015 评分之间的关系，调整了性别、年龄、种族和体重指数 z 分数。
与对照组（n=100，中位数年龄=14.8 岁[四分位间距 12.2 至 17.3 岁]；41%为男性；24%为非裔美国人；65%的体重指数≥第 85 百分位）相比，DS 青少年（n=143，中位数年龄=14.7 岁[四分位间距 11.4 至 17.4 岁]；44%为男性；18%为非裔美国人；62%的体重指数≥第 85 百分位）的总 HEI-2015 评分（更符合饮食建议）更高（DS：52.7[四分位间距 46.8 至 58.6] vs 对照组：45.1[四分位间距 39.5 至 55.0]；P<0.0001）。DS 青少年的水果、蔬菜/豆类、乳制品、精制谷物和饱和脂肪的 HEI-2015 成分评分也更高，但全谷物和钠的评分更低。在 DS 组内，总 HEI-2015 与 CMR 测量值没有显著相关性。尽管 HEI-2015 在 DS 组与空腹血糖水平呈负相关，但差异未达到统计学显著水平（-0.14，95%置信区间-0.29 至 0.00；P=0.053）。
对照组和 DS 组的青少年报告饮食质量低，尽管 DS 组的 HEI-2015 评分更符合建议。在 DS 组中，饮食质量与 CMR 因素无显著相关性。尽管需要进一步研究，但这些结果表明，DS 青少年的血脂异常可能与饮食摄入无关。
