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罗马尼亚超重儿童的实验室检查结果。

Laboratory Findings in Children with Excess Body Weight in Romania.

机构信息

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

National Institute for Mother and Child Health "Alessandrescu-Rusescu", 020395 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2023 Feb 9;59(2):319. doi: 10.3390/medicina59020319.

Abstract

Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.

摘要

近年来,儿童肥胖问题以令人担忧的速度增加,并在儿科人群中出现非传染性大流行。提高对此问题的认识至关重要,以便尽早采取行动控制体重。

我们在罗马尼亚布加勒斯特的一家三级保健医院的儿科内分泌科对超重或肥胖的门诊患儿进行了回顾性研究,以确定根据年龄和性别发生的实验室变化。共有 268 名儿童纳入分析,中位年龄为 10.9 岁(IQR:8.3,13.3 岁);61.8%为肥胖,38.2%为超重。我们发现了一种亚临床炎症状态,表现为中性粒细胞计数增加(12.7%)和 C 反应蛋白增加(16.4%)。从生化角度来看,尿酸(35.4%)增加幅度最大。研究中纳入的一半以上儿童存在血脂异常特异性变化:低密脂蛋白胆固醇(LDL)升高(50.0%)、高密度脂蛋白胆固醇(HDL)降低(58.9%)和甘油三酯水平升高(12.7%),尤其是体重指数(BMI)百分位超过 95%的儿童。促甲状腺激素(TSH)升高见于 20.3%,甲状腺素(T4)水平降低见于 13.4%,尤其是女性。

需要采取早期措施来控制超重,因为预防肥胖比治疗肥胖更容易。然而,在我们国家,这往往很难做到,因为父母经常直到问题变得严重才意识到问题。此外,医生的准备工作并不总是充分的,有时他们也没有得到卫生系统的支持,无法为有需要的儿童提供适当的护理。在当前有利于儿童肥胖流行率增加的大流行后背景下,应该重新审视教育策略和对问题的认识。通过指出这些客观发现,可以提高有效的沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5427/9964917/0148ad914263/medicina-59-00319-g001.jpg

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