Texas Children's Hospital, Houston, TX, USA.
Baylor College of Medicine, Houston, TX, USA.
Pediatr Cardiol. 2023 Aug;44(6):1251-1261. doi: 10.1007/s00246-023-03148-3. Epub 2023 Mar 24.
The prevalence of obesity in children with congenital heart disease (CHD) is greater than 25%, putting these patients at-risk for increased surgical morbidity and mortality. Our goal was to determine the association between CHD complexity, sociodemographic factors, and obesity. Our hypothesis was that among CHD patients, the odds of obesity would be highest in older children with simple CHD, and in all children with a lower socioeconomic status. We conducted a retrospective cohort study, reviewing electronic medical records of children aged 2-17 years from over 50 outpatient pediatric clinics in Houston, TX. Children were classified as simple or moderate/complex CHD, and obesity was defined by BMI ≥ 95th percentile for age and sex. Logistic regression was used to determine the association between sociodemographic factors and CHD complexity with obesity. We identified 648 CHD and 369,776 non-CHD patients. Children with simple CHD had a similar odds of obesity as non-CHD children. Children with CHD had a higher prevalence of obesity if they were older, male, Black, Hispanic, and publicly insured. Children with moderate/complex CHD had lower odds of obesity [OR 0.24 (95% CI 0.07-0.73)], however their predicted probability of obesity approached that of the general population as they aged. Additionally, there was an incremental relationship with poverty and obesity [1.01 (1.01-1.01)]. Awareness of which patients with CHD are at highest risk of obesity may help in targeting interventions to assist at-risk patients maintain a healthy lifestyle.
先天性心脏病（CHD）患儿肥胖的患病率超过 25%，使这些患者面临手术发病率和死亡率增加的风险。我们的目标是确定 CHD 复杂性、社会人口因素与肥胖之间的关系。我们的假设是，在 CHD 患者中，肥胖的几率在患有简单 CHD 的大龄儿童和所有社会经济地位较低的儿童中最高。我们进行了一项回顾性队列研究，对来自德克萨斯州休斯顿的 50 多个儿科门诊的 2-17 岁儿童的电子病历进行了回顾。儿童分为简单或中度/复杂 CHD，肥胖定义为 BMI≥年龄和性别的第 95 百分位。使用逻辑回归来确定社会人口因素和 CHD 复杂性与肥胖之间的关联。我们确定了 648 名 CHD 患儿和 369776 名非 CHD 患儿。患有简单 CHD 的儿童肥胖的几率与非 CHD 儿童相似。如果 CHD 患儿年龄较大、男性、黑人、西班牙裔和公共保险，他们肥胖的患病率更高。患有中度/复杂 CHD 的儿童肥胖的几率较低[OR 0.24（95%CI 0.07-0.73)]，但是随着年龄的增长，他们肥胖的预测概率接近普通人群。此外，贫困与肥胖之间存在递增关系[1.01（1.01-1.01)]。了解哪些 CHD 患者肥胖风险最高，可能有助于针对高危患者实施干预措施，帮助他们保持健康的生活方式。
