Prevalence of obesity in ambulatory children with cerebral palsy
Prevalence of obesity in ambulatory children with cerebral palsy
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DOI：
10.2106/jbjs.f.01080
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发表时间：
2007-11-01
影响因子：
5.3
通讯作者：
Blackhurst, Dawn W.
中科院分区：
文献类型：
--
作者：
Rogozinski, Benjamin M.;Davids, Jon R.;Blackhurst, Dawn W.
背景：根据最新数据，估计美国有17.1%的儿童肥胖。我们没有发现任何已发表的研究记录了患有脑瘫的非卧床儿童的肥胖患病率。本研究的目的是记录脑瘫儿童的肥胖患病率，并研究过去十年中肥胖的趋势。方法：采用回顾性分析方法，对脑瘫患儿的年龄、性别、身高、体重、体格分类、根据粗大运动功能分类系统（GMFCS）确定的功能水平1994年1月至2004年12月期间在我们机构的运动分析实验室进行步态分析的所有脑瘫儿童。这些信息被用来确定肥胖症的患病率（身体质量指数在或高于性别-特定身体质量随年龄增长图表的第95百分位数）及其与年龄、性别、脑瘫的身体分类和GMFCS水平的关系。当数据被分为三个时间段（1994年至1997年，1998年至2002年和2003年至2004年）时，注意到肥胖症随时间的推移显着增加（p = 0.017）。在相应的时间段内，患病率从7.7%增加到14%和16.5%。随着时间的推移，患病率在男性和女性，偏瘫和双瘫，以及根据GMFCS功能I级和II级的患者中均增加。肥胖和时间之间的关联在女性（p = 0.015）、偏瘫（p = 0.049）、小于8岁（p = 0.020）和GMFCS II级（p = 0.003）组中是显著的。我们发现，当我们控制年龄、脑瘫类型和GMFCS水平时，该时间段与肥胖独立相关（p = 0.014）。参与程度较低（GMFCS II级）的儿童肥胖的几率是参与程度较高（GMFCS III级）的儿童肥胖的几率的两倍。结论：在过去的十年中，脑瘫儿童的肥胖患病率从7.7%上升到16.5%，这一增长与美国一般儿科人群的肥胖率相似。这一发现可能会对这些儿童成年后的一般健康和功能能力产生重大影响。
Background: According to the most recent data, an estimated 17.1% of children in the United States are obese. We found no published studies documenting the prevalence of obesity in ambulatory children with cerebral palsy. The purpose of this study was to document the prevalence of obesity in ambulatory children with cerebral palsy and examine the trend in this measure over the last decade.Methods: A retrospective review was performed to analyze the age, gender, height, weight, physical classification of the cerebral palsy, and functional level as determined with the Gross Motor Function Classification System (GMFCS) of all children with cerebral palsy who had a gait analysis performed in the Motion Analysis Laboratory of our institution between January 1994 and December 2004. This information was used to determine the prevalence of obesity (a body mass index in or above the 95th percentile of the sex-specific body mass inclex-for-age growth chart) in this population and its relationship to age, gender, the physical classification of the cerebral palsy, and the GMFCS level.Results: When the data were grouped into three time periods (1994 to 1997, 1998 to 2002, and 2003 to 2004), a significant increase in obesity over time was noted (p = 0.017). The prevalences increased from 7.7% to 14% to 16.5% in the respective time periods. The prevalence increased over time in both males and females, those with hemiplegia and those with diplegia, and those with level-I function and those with level-II function according to the GMFCS. The association between obesity and time was significant in the female (p = 0.015), hemiplegic (p = 0.049), less than eight-year-old (p = 0.020), and GMFCS level-II (p = 0.003) groups. We found that the time period was independently associated with obesity when we controlled for age, type of cerebral palsy, and GMFCS level (p = 0.014). Children with a lesser degree of involvement (GMFCS level II) had twice the odds of becoming obese than did children with greater involvement (GMFCS level III).Conclusions: The prevalence of obesity in ambulatory children with cerebral palsy has risen over the last decade from 7.7% to 16.5%, an increase that is similar to that seen in the general pediatric population in the United States. This finding may have a major impact on the general health and functional abilities of these children as they reach adult life.