Screening for Obesity in Children and Adolescents US Preventive Services Task Force Recommendation Statement
Screening for Obesity in Children and Adolescents US Preventive Services Task Force Recommendation Statement
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DOI：
10.1001/jama.2017.6803
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发表时间：
2017-06-20
影响因子：
120.7
通讯作者：
Tseng, Chien-Wen
中科院分区：
文献类型：
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作者：
Grossman, David C.;Bibbins-Domingo, Kirsten;Tseng, Chien-Wen
根据2000年疾病控制和预防中心的生长图表，美国2至19岁的儿童和青少年中约有17%患有肥胖症，近32%的儿童和青少年超重或肥胖。儿童和青少年肥胖与精神健康和心理问题、哮喘、阻塞性睡眠呼吸暂停、骨科问题以及不良心血管和代谢结果（例如，高血压、血脂水平异常和胰岛素抵抗）等发病率相关。儿童和青少年也可能经历基于体重的戏弄和欺凌行为。儿童和青少年的肥胖可能持续到成年，并导致不良心血管结局或其他肥胖相关的发病率，如2型diabetes.Subpopulation考虑虽然儿童和青少年肥胖的总体比率在过去十年中稳定后，稳步增长了30年，肥胖率继续增加，在某些人群中，如非洲裔美国女孩和西班牙裔男孩。这些肥胖患病率的种族/民族差异可能是遗传和非遗传因素的结果（例如，社会经济地位，含糖饮料和快餐的摄入量，目的更新2010年美国预防服务工作组（USPSTF）的报告，证据审查USPSTF审查了儿童和青少年肥胖筛查的证据研究结果全面，密集的行为干预（>= 26接触小时），在儿童和青少年6岁及以上的肥胖可以导致体重状况的改善长达12个月;有关于不太密集的干预措施的有效性的证据不足。行为干预的危害可以小到没有，而筛查的危害是最小的。因此，USPSTF的结论与适度的确定性，在儿童和青少年肥胖筛查6岁及以上是中等净benefit.Conclusions和建议USPSTF建议，临床医生筛选肥胖儿童和青少年6岁及以上，并提供或转介他们全面，密集的行为干预，以促进改善体重状况。（B建议）
IMPORTANCE Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes.SUBPOPULATION CONSIDERATIONS Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom).OBJECTIVE To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older.EVIDENCE REVIEW The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions.FINDINGS Comprehensive, intensive behavioral interventions (>= 26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF concluded with moderate certainty that screening for obesity in children and adolescents 6 years and older is of moderate net benefit.CONCLUSIONS AND RECOMMENDATION The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)