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治疗肥胖儿童和青少年:儿科体重管理项目早期退出的预测因素。

Treating Children and Adolescents with Obesity: Predictors of Early Dropout in Pediatric Weight-Management Programs.

作者信息

Luppino Giovanni, Wasniewska Malgorzata, Casto Celeste, Ferraloro Chiara, Li Pomi Alessandra, Pepe Giorgia, Morabito Letteria Anna, Alibrandi Angela, Corica Domenico, Aversa Tommaso

机构信息

Department of Human Pathology of Adulthood and Childhood, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy.

Pediatric Unit, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy.

出版信息

Children (Basel). 2024 Feb 5;11(2):205. doi: 10.3390/children11020205.

Abstract

BACKGROUND

Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up.

METHODS

The retrospective, single-center study, involved 489 patients followed for obesity in the period 2016-2020. Patients' auxological data and blood samples were collected during the first (V1) and last visit (V2). Dropout was defined as a follow-up of less than 12 months and/or including less than one visit every 6 months. Patients were divided into two groups and compared: Group A of dropout (297 patients) and Group B of non-dropout (192 patients).

RESULTS

In the follow-up period, which had a mean duration of 24 months, the dropout rate was 60.7%. In Group A, the percentage of patients with BMI ≥ 3 SD at V2 was significantly higher than that in Group B. In Group B, the percentage of patients with pathological HOMA-IR and with fasting glucose >100 mg/dL was higher than group A. The probability of dropout was positively associated with pubertal stage and negatively with impaired fasting glycemia and pathological insulinemia at V1.

CONCLUSION

The study demonstrated a high dropout rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations.

摘要

背景

小儿肥胖症可能的治疗失败受高辍学率影响。本研究的目的是评估随访24个月期间的辍学率和体重减轻率。

方法

这项回顾性单中心研究纳入了2016年至2020年期间因肥胖症接受随访的489例患者。在首次就诊(V1)和末次就诊(V2)时收集患者的体格学数据和血样。辍学定义为随访时间少于12个月和/或每6个月就诊次数少于一次。患者分为两组进行比较:A组为辍学组(297例患者)和B组为未辍学组(192例患者)。

结果

在平均持续24个月的随访期内,辍学率为60.7%。在A组中,V2时BMI≥3SD的患者百分比显著高于B组。在B组中,病理HOMA-IR和空腹血糖>100mg/dL的患者百分比高于A组。辍学概率与青春期阶段呈正相关,与V1时空腹血糖受损和病理性胰岛素血症呈负相关。

结论

该研究表明随访期间辍学率较高,主要发生在青少年和无糖代谢改变的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c7/10887674/57c5f1e5f01d/children-11-00205-g001.jpg

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