Dynamics of Obesity and Chronic Health Conditions Among Children and Youth
Dynamics of Obesity and Chronic Health Conditions Among Children and Youth
复制标题
DOI：
10.1001/jama.2010.104
复制
发表时间：
2010-02-17
影响因子：
120.7
通讯作者：
Perrin, James M.
中科院分区：
文献类型：
--
作者：
Van Cleave, Jeanne;Gortmaker, Steven L.;Perrin, James M.
近几十年来，肥胖和其他儿童慢性病的发病率有所增加。条件如何随着时间的推移而变化的模式还没有被广泛examined.Objective评估肥胖和其他慢性疾病在美国儿童的患病率的变化，包括发病率，缓解，和prevalence.Design，设置，和参与者前瞻性研究，使用全国纵向调查的青年儿童队列（1988-2006）的3个全国代表性的队列儿童。每个研究阶段开始时，儿童的年龄为2至8岁，从1988年至1994年，队列随访6年（队列1，n=2337），1994年至2000年（队列2，n=1759），和2000年至2006年（n=905）。主要结果测量父母报告的儿童有健康状况，限制活动或上学或需要药物，特别设备或专门的保健服务，并持续至少12个月。肥胖定义为体重指数等于或高于年龄的第95百分位数。慢性疾病分为4类：肥胖、哮喘、其他身体状况和行为/学习问题。结果研究结束时任何慢性健康状况的患病率为12.8%（95%置信区间[CI]，11.2%-14.5%），1994年队列1，25.1%（95% CI，22.7%-27.6%），2006年队列3为26.6%（95% CI，23.5%-29.9%）。慢性病患者的更替率很高：7.4%（95% CI，6.5%-8.3%）所有队列中的参与者在研究开始时患有慢性疾病，并持续到研究结束，9.3%（95% CI，8.3%-10.3%）在开始时报告的疾病在6年内消退，13.4%（95% CI，12.3%-14.6%）在6年研究期间出现新的疾病。在6年研究期间的任何部分，队列3的慢性病患病率最高（51.5%，95%CI，47.3%~ 55.0%），男性高于女性（校正比值比[AOR]，1.24; 95% CI，1.07-1.42），西班牙裔（AOR，1.36; 95% CI，1.11-1.67），黑人（AOR，1.60; 95%CI，1.35-1.90）youth.Conclusions儿童和青年慢性病患病率从1988年到2006年增加。然而，这些疾病的存在在每个6年队列中是动态的。美国医学会杂志2010; 303（7）：623-630 www.jama.com
Context Rates of obesity and other childhood chronic conditions have increased over recent decades. Patterns of how conditions change over time have not been widely examined.Objective To evaluate change in prevalence of obesity and other chronic conditions in US children, including incidence, remission, and prevalence.Design, Setting, and Participants Prospective study using the National Longitudinal Survey of Youth-Child Cohort (1988-2006) of 3 nationally representative cohorts of children. Children were aged 2 through 8 years at the beginning of each study period, and cohorts were followed up for 6 years, from 1988 to 1994 ( cohort 1, n=2337), 1994 to 2000 ( cohort 2, n=1759), and 2000 to 2006 (n=905).Main Outcome Measures Parent report of a child having a health condition that limited activities or schooling or required medicine, special equipment, or specialized health services and that lasted at least 12 months. Obesity was defined as a body mass index at or above the 95th percentile for age. Chronic conditions were grouped into 4 categories: obesity, asthma, other physical conditions, and behavior/learning problems.Results The end-study prevalence of any chronic health condition was 12.8% (95% confidence interval [CI], 11.2%-14.5%) for cohort 1 in 1994, 25.1% ( 95% CI, 22.7%-27.6%) for cohort 2 in 2000, and 26.6% ( 95% CI, 23.5%-29.9%) for cohort 3 in 2006. There was substantial turnover in chronic conditions: 7.4% ( 95% CI, 6.5%-8.3%) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end, 9.3% ( 95% CI, 8.3%-10.3%) reported conditions at the beginning that resolved within 6 years, and 13.4% ( 95% CI, 12.3%-14.6%) had new conditions that arose during the 6-year study period. The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 (51.5%; 95% CI, 47.3%-55.0%), and there were higher rates among male ( adjusted odds ratio [AOR], 1.24; 95% CI, 1.07-1.42), Hispanic ( AOR, 1.36; 95% CI, 1.11-1.67), and black ( AOR, 1.60; 95% CI, 1.35-1.90) youth.Conclusions Prevalence of chronic conditions among children and youth increased from 1988 to 2006. However, presence of these conditions was dynamic over each 6-year cohort. JAMA. 2010; 303(7):623-630 www.jama.com