Peer Nasheeta, Sewlall Janice, Balakrishna Yusentha, Tayob Shafeeka, Kengne Andre-Pascal, Ganie Yasmeen
Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa.
Department of Medicine, University of Cape Town, Cape Town, South Africa.
Obes Pillars. 2025 May 24;15:100182. doi: 10.1016/j.obpill.2025.100182. eCollection 2025 Sep.
To describe the distribution of childhood obesity and their related comorbidities in <12-year-old children assessed at a South African tertiary hospital from 2012 to 2022.
In this retrospective electronic chart review, data extracted comprised socio-demographic and lifestyle histories, physical examination and biochemical analyses. World Health Organisation child growth reference defined obesity as z-score ≥2 standard deviations (SD) for 5-19-year-olds, and z-score ≥3 SD for <5-year-olds. Systolic blood pressure and/or diastolic blood pressure ≥95th percentile and 90-94th percentile for age, gender and height, defined hypertension and prehypertension, respectively. Type 2 diabetes and prediabetes diagnoses were based on oral glucose tolerance tests or random blood glucose levels. Dyslipidaemia was deemed present with any abnormality of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol or triglycerides.
Among 430 participants, 52.1 % (n = 224) male, 27.9 % (n = 120) ≤5-years-old and 64.7 % black African, unhealthy lifestyle behaviours were prevalent: 42.3 % spent <30 min/day on physical activity, 43.5 % spent >2 h/day on screen time and 47.9 % consumed soft drinks daily. Family history of obesity (41.9 %), diabetes (40.5 %) and hypertension (40.0 %) was common. Among participants, hypertension (46.1 %) and prehypertension (12.8 %) were high. Type 2 diabetes was low at 1.6 % but prediabetes was 3.3 %. Any dyslipidaemia was prevalent at 30.2 %.
The high burden of cardiometabolic comorbidities in children with obesity warrants concerted interventions at young ages to prevent worsening of comorbidities and the reversal of prehypertension and prediabetes. Unhealthy dietary habits, low activity levels and sedentary behaviours in children need to be urgently targeted to reduce obesity and its comorbidities.
描述2012年至2022年在南非一家三级医院接受评估的12岁以下儿童的儿童肥胖症分布情况及其相关合并症。
在这项回顾性电子病历审查中，提取的数据包括社会人口统计学和生活方式史、体格检查和生化分析。世界卫生组织儿童生长参考标准将5至19岁儿童的肥胖定义为z评分≥2个标准差（SD），5岁以下儿童的肥胖定义为z评分≥3个标准差。收缩压和/或舒张压≥年龄、性别和身高的第95百分位数和第90至94百分位数分别定义为高血压和高血压前期。2型糖尿病和糖尿病前期诊断基于口服葡萄糖耐量试验或随机血糖水平。血脂异常定义为总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇或甘油三酯有任何异常。
在430名参与者中，52.1%（n = 224）为男性，27.9%（n = 120）年龄≤5岁，64.7%为非洲黑人，不健康的生活方式行为普遍存在：42.3%的人每天进行体育活动的时间<30分钟，43.5%的人每天看屏幕的时间>2小时，47.9%的人每天饮用软饮料。肥胖家族史（41.9%）、糖尿病家族史（40.5%）和高血压家族史（40.0%）很常见。在参与者中，高血压（46.1%）和高血压前期（12.8%）的比例较高。2型糖尿病的比例较低，为1.6%，但糖尿病前期的比例为3.3%。任何血脂异常的患病率为30.2%。
肥胖儿童中心血管代谢合并症的高负担需要在年轻时采取协同干预措施，以防止合并症恶化以及高血压前期和糖尿病前期的逆转。需要紧急针对儿童不健康的饮食习惯、低活动水平和久坐行为，以减少肥胖及其合并症。
