Dang Mary P, Hanna Maria, Yang Zhuo Tina, Malone Kendra, Rinzler Elliot S, Zhang Song, Zia Ayesha
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics, University of Texas Southwestern, Dallas, TX.
Res Pract Thromb Haemost. 2025 Mar 13;9(3):102728. doi: 10.1016/j.rpth.2025.102728. eCollection 2025 Mar.
We hypothesized that acute pediatric venous thromboembolism (VTE) is associated with an increase in body mass index (BMI) over time. We posited that if children gain weight following VTE, targeted interventions may be advised clinically or tested in future studies.
The objectives of our study were to investigate BMI changes from VTE diagnosis to 3 and 6 months after diagnosis, identify predictors, and calculate the prevalence of overweight and obesity.
: In this prospective cohort study, we followed 63 participants (mean age, 12.8 years [SD, 5]) for 6 months following first episode of acute VTE. We chose percentage of BMI (%-of-BMI) instead of absolute BMI as a measure of weight to standardize across sex and age and used change in %-of-BMI as a measure of weight change. Δ%-of-BMI was the primary outcome measure documenting change over time, categorized as increased if Δ%-of-BMI was >0, unchanged if Δ%-of-BMI was 0, and decreased if Δ%-of-BMI was <0. To assess BMI changes, we created a prespecified subgroup of participants who required intensive care unit (ICU) vs those who did not.
Sixty-two percent of participants were overweight/obese at diagnosis. Mean %-of-BMI was 102.5% (95% CI, 95-109). The Δ%-of-BMI at 3 and 6 months after diagnosis was, 1.5 (95% CI, -0.8 to 3.6) and 2.2 (95% CI, -0.6 to 5.2), respectively. We identified 3 predictors of weight change: non-ICU stay and longer length of stay predicted weight gain, whereas a higher %-of-BMI at diagnosis in the ICU cohort correlated with decreased BMI.
BMI increases following pediatric VTE except those in the ICU. Weight-based counseling and lifestyle changes represent potential targeted interventions after VTE.
我们假设小儿急性静脉血栓栓塞症（VTE）与体重指数（BMI）随时间增加有关。我们推测，如果儿童在VTE后体重增加，临床上可能建议采取针对性干预措施，或在未来研究中进行测试。
我们研究的目的是调查从VTE诊断到诊断后3个月和6个月时BMI的变化，确定预测因素，并计算超重和肥胖的患病率。
在这项前瞻性队列研究中，我们对63名参与者（平均年龄12.8岁[标准差5]）在首次急性VTE发作后的6个月进行了随访。我们选择BMI百分比（%-of-BMI）而非绝对BMI作为体重衡量指标，以便在性别和年龄间进行标准化，并使用%-of-BMI的变化作为体重变化的衡量指标。Δ%-of-BMI是记录随时间变化的主要结局指标，若Δ%-of-BMI>0则分类为增加，若Δ%-of-BMI=0则为不变，若Δ%-of-BMI<0则为减少。为评估BMI变化，我们创建了一个预先指定的参与者亚组，分为需要重症监护病房（ICU）的参与者和不需要的参与者。
62%的参与者在诊断时超重/肥胖。平均%-of-BMI为102.5%（95%CI，95-109）。诊断后3个月和6个月时的Δ%-of-BMI分别为1.5（95%CI，-0.8至3.6）和2.2（95%CI，-0.6至5.2）。我们确定了体重变化的3个预测因素：非ICU住院和较长住院时间预测体重增加，而ICU队列中诊断时较高的%-of-BMI与BMI降低相关。
小儿VTE后BMI会增加，但ICU中的患者除外。基于体重的咨询和生活方式改变是VTE后潜在的针对性干预措施。
