Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders.
Overweight and obesity among children and adolescents with fetal alcohol spectrum disorders.
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DOI：
10.1111/acer.12516
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发表时间：
2014-09
期刊：
影响因子：
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通讯作者：
Wozniak JR
中科院分区：
文献类型：
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作者：
Fuglestad AJ;Boys CJ;Chang PN;Miller BS;Eckerle JK;Deling L;Fink BA;Hoecker HL;Hickey MK;Jimenez-Vega JM;Wozniak JR
由于产前酒精暴露与生长缺陷有关，很少有人关注胎儿酒精谱系障碍（FASD）儿童超重和肥胖的可能性。本研究在一个大的临床样本中检测了FASD儿童超重/肥胖（体重指数[BMI]）的患病率。在大学诊所接受FASD评估的2至19岁儿童包括445名FASD诊断和171名无FASD诊断。将超重/肥胖（BMI ≥85百分位数）的患病率与国家和州的患病率进行比较。研究BMI与FASD诊断、性别和年龄的关系。膳食摄入量数据进行了检查的年轻子样本（n = 42）。34%的FASD诊断为超重或肥胖，与非FASD组或美国患病率没有差异。体重不足在胎儿酒精综合征（FAS）中普遍存在（17%）。然而，超重/肥胖率增加见于部分FAS（40%）。在青少年中，有任何FASD诊断的人超重/肥胖增加（42%），特别是女性（50%）。患有FASD的青少年女性的比率（50%）几乎是青少年女性的国家患病率（17 - 18%）的3倍，p < 0.001。在年轻的子样本中，那些超重/肥胖的人每天消耗的卡路里，蛋白质和总脂肪比那些不超重或肥胖的人多。部分FAS儿童的超重/肥胖率增加。在青少年中，任何FASD诊断的发生率都有所增加（特别是女性）。结果提示FASD可能存在代谢/内分泌干扰，这是一种有动物模型证据的假设。这些数据表明，临床医生可能会考虑产前酒精暴露作为代谢/内分泌干扰的风险因素，应评估饮食作为该人群的风险，并可能需要针对青春期前的女性进行干预，以影响超重相关结局的变化。
Because prenatal alcohol exposure is associated with growth deficiency, little attention has been paid to the potential for overweight and obesity in children with fetal alcohol spectrum disorders (FASD). This study examined the prevalence of overweight/obesity (body mass index [BMI]) in a large clinical sample of children with FASD. Children, aged 2 to 19 years, who were evaluated for FASD at University Clinics, included 445 with an FASD diagnosis and 171 with No-FASD diagnosis. Prevalence of overweight/obesity (BMI ≥85 percentile) was compared to national and state prevalence. BMI was examined in relation to FASD diagnosis, gender, and age. Dietary intake data were examined for a young subsample (n = 42). Thirty-four percent with any FASD diagnosis were overweight or obese, which did not differ from the No-FASD group or U.S. prevalence. Underweight was prevalent in those with fetal alcohol syndrome (FAS) (17%). However, increased rates of overweight/obesity were seen in those with partial FAS (40%). Among adolescents, those with any FASD diagnosis had increased overweight/obesity (42%), particularly among females (50%). The rate in adolescent females with FASD (50%) was nearly 3 times higher than state prevalence for adolescent females (17 to 18%), p < 0.001. In the young subsample, those who were overweight/obese consumed more calories, protein, and total fat per day than those who were not overweight or obese. Rates of overweight/obesity are increased in children with partial FAS. In adolescents, rates are increased for any FASD diagnosis (particularly in females). Results are suggestive of possible metabolic/endocrine disruption in FASD—a hypothesis for which there is evidence from animal models. These data suggest that clinicians may consider prenatal alcohol exposure as a risk factor for metabolic/endocrine disruption, should evaluate diet as a risk in this population, and may need to target interventions to females prior to puberty to effect changes in overweight-related outcomes.