Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.
Obes Facts. 2023;16(3):282-292. doi: 10.1159/000529560. Epub 2023 Feb 9.
Children and adolescents with overweight and obesity have an impaired health-related quality of life (HRQoL). However, it is unclear which of these children are most affected in their physical, psychological, and social functioning. Therefore, this study aimed to evaluate HRQoL in treatment-seeking children and adolescents with overweight, obesity, and severe obesity.
A cross-sectional study was performed at the Centre for Overweight Adolescent and Children's Healthcare (COACH). Children and adolescents (8-17 years) with overweight, obesity, and severe obesity were included. The primary outcome was the self-reported HRQoL measured with the KIDSCREEN-27.
A total of 419 participants with overweight (N = 121), obesity (N = 182), and severe obesity (N = 116) were included. One-way ANOVA analysis showed that children and adolescents with severe obesity reported significantly lower physical well-being (41.25 ± 13.14) compared to those with overweight (47.91 ± 12.53; p < 0.001) and obesity (46.74 ± 11.93; p < 0.001). Furthermore, impaired psychological well-being was found in the group with severe obesity (45.14 ± 13.27) in comparison to the group with overweight (50.90 ± 9.48; p < 0.001) and obesity (49.71 ± 10.95; p = 0.002). Multivariable linear regression analysis, while correcting for age, sex, cardio metabolic health risk, and ethnicity, revealed similar results. Additionally, children and adolescents with severe obesity scored lower regarding autonomy and parent relation than those with overweight (B = 3.95; p = 0.009). In almost all groups and dimensions of the KIDSCREEN-27, caregivers scored lower compared to the children and adolescents themselves. Furthermore, a low child-caregiver agreement seemed to exist, especially in the children and adolescents with overweight.
The HRQoL of treatment-seeking children and adolescents with overweight and obesity was most affected in children and adolescents with the most severe grade of obesity. Following these findings, lifestyle intervention programs targeting childhood obesity should be aware of this even more vulnerable group so that treatments can be tailored according to their needs.
超重和肥胖的儿童和青少年的健康相关生活质量（HRQoL）受损。然而，目前尚不清楚这些儿童中哪些在身体、心理和社会功能方面受影响最大。因此，本研究旨在评估寻求治疗的超重、肥胖和重度肥胖儿童和青少年的 HRQoL。
这是一项在青少年超重和儿童保健中心（COACH）进行的横断面研究。纳入超重（N=121）、肥胖（N=182）和重度肥胖（N=116）的儿童和青少年。主要结局是用 KIDSCREEN-27 自评 HRQoL。
共纳入 419 名超重（N=121）、肥胖（N=182）和重度肥胖（N=116）的参与者。单因素方差分析显示，重度肥胖儿童和青少年的身体幸福感显著低于超重（47.91 ± 12.53；p<0.001）和肥胖（46.74 ± 11.93；p<0.001）者。此外，重度肥胖组的心理幸福感受损（45.14 ± 13.27），与超重组（50.90 ± 9.48；p<0.001）和肥胖组（49.71 ± 10.95；p=0.002）相比。多变量线性回归分析校正年龄、性别、心血管代谢健康风险和种族后，得出了类似的结果。此外，与超重者相比，重度肥胖儿童和青少年在自主性和父母关系方面的得分较低（B=3.95；p=0.009）。在 KIDSCREEN-27 的几乎所有组别和维度中，照顾者的评分均低于儿童和青少年本人。此外，儿童和青少年与照顾者之间似乎存在低的一致性，尤其是在超重者中。
寻求治疗的超重和肥胖儿童和青少年的 HRQoL 受影响最大的是肥胖程度最严重的儿童和青少年。基于这些发现，针对儿童肥胖的生活方式干预项目应更加关注这一更为脆弱的群体，以便根据他们的需求调整治疗方案。
