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暴食和冲动:使用自我管理的 Dykens 问卷和内部冲动问卷来描述严重和早发性肥胖儿童的饮食行为。

Hyperphagia and impulsivity: use of self-administered Dykens' and in-house impulsivity questionnaires to characterize eating behaviors in children with severe and early-onset obesity.

机构信息

Pediatric Nutrition and Gastroenterology Department, French Reference Center for Prader-Willi Syndrome and Other Rare Obesities (PRADORT), Assistance Publique Hôpitaux de Paris, Trousseau Hospital, 26 Avenue du Dr Netter, 75012, Paris, France.

INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, Paris, France.

出版信息

Orphanet J Rare Dis. 2024 Feb 23;19(1):84. doi: 10.1186/s13023-024-03085-1.

Abstract

BACKGROUND

The determinants of early-onset obesity (< 6 years) are not completely elucidated, however eating behavior has a central role. To date no study has explored eating behavior in children with severe, early-onset obesity. Self-administered questionnaire data from these children were examined to evaluate eating behavior and the etiology of early-onset obesity.

METHODS

Children with severe, early-onset obesity (body mass index [BMI] > International Obesity Task Force [IOTF] 30) of different etiologies (hypothalamic obesity [HO], intellectual disability with obesity [IDO], common polygenic obesity [CO]) were prospectively included. BMI history and responses from the Dykens' Hyperphagia Questionnaire and an in-house Impulsivity Questionnaire at first visit were compared between groups.

RESULTS

This cohort of 75 children (39 girls; mean age ± standard deviation [SD] 10.8 ± 4.4 years) had severe, early-onset obesity at an age of 3.8 ± 2.7 years, with a BMI Z-score of 4.9 ± 1.5. BMI history varied between the 3 groups, with earlier severe obesity in the HO group versus 2 other groups (BMI > IOTF40 at 3.4 ± 1.6 vs. 4.6 ± 1.6 and 8.4 ± 4.1 years for the IDO and CO groups, respectively [P < 0.01]). Absence of adiposity rebound was more prevalent in the HO group (87% vs. 63% and 33% for the IDO and CO groups, respectively [P < 0.01]). The Dykens' mean total score for the cohort was 22.1 ± 7.2 with no significant between-group differences. Hyperphagia (Dykens' score > 19) and impulsivity (score > 7) were found in 50 (67%) and 11 children (15%), respectively, with no difference between the HO, IDO and CO groups regarding the number of patients with hyperphagia (10 [67%], 14 [74%], and 26 [63%] children, respectively) or impulsivity (2 [13%], 1 [7%], and 8 [19%] children, respectively). Children with food impulsivity had significantly higher total and severity scores on the Dykens' Questionnaire versus those without impulsivity.

CONCLUSION

The Dykens' and Impulsivity questionnaires can help diagnose severe hyperphagia with/without food impulsivity in children with early-onset obesity, regardless of disease origin. Their systematic use can allow more targeted management of food access control in clinical practice and monitor the evolution of eating behavior in the case of innovative therapeutic targeting hyperphagia.

摘要

背景

早发性肥胖(<6 岁)的决定因素尚不完全清楚,但是饮食行为起着核心作用。迄今为止,尚无研究探讨过患有严重早发性肥胖的儿童的饮食行为。对这些儿童的自我管理问卷数据进行了检查,以评估饮食行为和早发性肥胖的病因。

方法

前瞻性纳入具有不同病因(下丘脑性肥胖[HO]、肥胖伴智力障碍[IDO]、常见多基因肥胖[CO])的严重早发性肥胖(体重指数[BMI]>国际肥胖工作组[IOTF]30)的儿童。在首次就诊时,比较了 BMI 病史和 Dykens 食欲量表和内部冲动问卷的应答。

结果

该队列的 75 名儿童(39 名女孩;平均年龄±标准差[SD]10.8±4.4 岁)在 3.8±2.7 岁时患有严重早发性肥胖,BMI 为 4.9±1.5。3 组的 BMI 史不同,HO 组的肥胖程度比其他 2 组更早(HO 组 BMI>IOTF40 的年龄为 3.4±1.6 岁,而 IDO 和 CO 组分别为 4.6±1.6 岁和 8.4±4.1 岁[P<0.01])。HO 组肥胖反弹缺失更为普遍(87%比 IDO 和 CO 组的 63%和 33%[P<0.01])。该队列的 Dykens 平均总分为 22.1±7.2,组间无显著差异。50 名(67%)和 11 名儿童(15%)存在贪食症(Dykens 评分>19)和冲动性(评分>7),HO、IDO 和 CO 组中存在贪食症的患者数量无差异(10[67%]、14[74%]和 26[63%]名儿童)或冲动性(2[13%]、1[7%]和 8[19%]名儿童)。有食物冲动性的儿童在 Dykens 问卷上的总分和严重程度评分明显高于没有冲动性的儿童。

结论

无论疾病起源如何,Dykens 和冲动性问卷都可以帮助诊断早发性肥胖儿童的严重贪食症伴/不伴食物冲动性。在临床实践中,系统使用它们可以更有针对性地控制食物获取,并且可以监测治疗贪食症的创新疗法中饮食行为的演变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c816/10893692/3cbad7d8edf7/13023_2024_3085_Fig1_HTML.jpg

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