Quadri Maheen, Ariza Adolfo J, Tucker Jared M, Bea Jennifer W, King Eileen C, Kirk Shelley, Sweeney Brooke R, Santos Melissa, Silver Lucie, Roberts Karyn J, Binns Helen J
Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Child Obes. 2025 Jan;21(1):50-64. doi: 10.1089/chi.2023.0201. Epub 2024 Aug 26.
Factors associated with change in percent body fat (%BF) of children in pediatric weight management (PWM) care may differ from those associated with change in weight status. To describe %BF and weight status at initial visits to 14 PWM sites, identify differences by sex, and evaluate factors associated with change over 6 months. Initial visits of 2496 males and 2821 females aged 5-18 years were evaluated. %BF was measured using bioelectrical impedance analysis. Sex-specific logistic regressions [806 males (32.3%), 837 females (29.7%)] identified associations with primary outcomes: lower %BF and metabolically impactful ≥5-point drop in percent of the 95th BMI percentile (%BMIp95) over 6 months. At the initial visit, males had lower %BF and higher %BMIp95 than females. Over 6 months, males had significantly ( < 0.001) greater median drop in %BF (-1.4% vs. -0.4%) and %BMIp95 (-3.0% vs. -1.9%) and a higher frequency of decreased %BF (68.9% vs. 57.8%), but similar percentage with ≥5-point %BMIp95 drop (36.5% vs. 32.4%; = 0.080). For males, factors significantly associated with decreased %BF (older age, ≥6 visits, lack of developmental or depression/anxiety concerns) were not related to having a ≥5-point %BMIp95 drop. For females, lack of depression/anxiety concern was significantly associated with decreased %BF but was not associated with ≥5-point %BMIp95 drop. There are differences by sex in initial visit %BF and %BMIp95 and in characteristics associated with changes in these measures. PWM interventions should consider evaluating body composition and sex-stratifying outcomes.
儿童体重管理（PWM）护理中与儿童体脂百分比（%BF）变化相关的因素可能与体重状况变化相关因素不同。为了描述14个PWM站点初次就诊时的%BF和体重状况，按性别识别差异，并评估6个月内变化的相关因素。对2496名5至18岁男性和2821名女性的初次就诊情况进行了评估。使用生物电阻抗分析测量%BF。特定性别的逻辑回归分析[806名男性（32.3%），837名女性（29.7%）]确定了与主要结局的关联：较低的%BF以及6个月内第95百分位BMI百分比（%BMIp95）代谢影响性下降≥5分。初次就诊时，男性的%BF低于女性，%BMIp95高于女性。在6个月内，男性的%BF中位数下降幅度显著更大（<0.001）（-1.4%对-0.4%），%BMIp95下降幅度也更大（-3.0%对-1.9%），且%BF下降频率更高（68.9%对57.8%），但%BMIp95下降≥5分的比例相似（36.5%对32.4%；P = 0.080）。对于男性，与%BF下降显著相关的因素（年龄较大、就诊≥6次、无发育或抑郁/焦虑问题）与%BMIp95下降≥5分无关。对于女性，无抑郁/焦虑问题与%BF下降显著相关，但与%BMIp95下降≥5分无关。初次就诊时的%BF和%BMIp95以及这些指标变化相关特征存在性别差异。PWM干预应考虑评估身体成分并按性别分层结果。
