Retrospective Study of Obesity in Children with Down Syndrome
Retrospective Study of Obesity in Children with Down Syndrome
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DOI：
10.1016/j.jpeds.2016.02.046
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发表时间：
2016-06-01
影响因子：
5.1
通讯作者：
Saal, Howard M.
中科院分区：
文献类型：
--
作者：
Basil, Janet S.;Santoro, Stephanie L.;Saal, Howard M.
为了评估美国唐氏综合症儿童肥胖风险是否增加，我们确定了一组唐氏综合症儿童的肥胖患病率，并分析了整个儿童时期的肥胖发展情况。此外，我们分析了与唐氏综合征和肥胖相关的合并症，阻塞性睡眠呼吸暂停综合征（OSAS）。研究设计本研究是一项回顾性图表回顾，评估了303名2至18岁的唐氏综合症儿童。所有儿童都是辛辛那提儿童医院医疗中心的病人，有多种身高和体重测量。为了确定肥胖负担，使用列联表将肥胖率与当地对照队列进行比较。肥胖率随时间的变化是用混合模型确定的。通过列联表确定肥胖与OSAS的关系。结果我们评估了303人，其中47.8%为肥胖（体重指数>=年龄和性别的第95百分位）。这明显高于普通儿科人群12.1%的肥胖率（P < 0.0001）。身体质量指数z分数随时间没有显著变化（P = 0.40）。大多数患有唐氏综合症的儿童也患有阻塞性睡眠呼吸暂停症（177名接受多导睡眠图研究的儿童中有74.0%）。然而，肥胖儿童的OSAS风险升高（风险比= 2.4,P = 0.0015）。结论：我们的研究结果表明，患有唐氏综合征的儿童存在肥胖和阻塞性睡眠呼吸暂停的巨大风险。这些发现支持在儿童早期和整个生命周期进行更积极的体重管理的必要性。
Objectives To assess whether children with Down syndrome in the US are at an increased risk for obesity, we determined the obesity prevalence and analyzed obesity development throughout childhood in a cohort of children with Down syndrome. In addition, we analyzed a comorbidity that is associated with Down syndrome and obesity, obstructive sleep apnea syndrome (OSAS).Study design This study was a retrospective chart review that evaluated 303 children ages 2 through 18 years with a diagnosis of Down syndrome. All children were patients at Cincinnati Children's Hospital Medical Center with multiple height and weight measurements. To determine obesity burden, the rate of obesity was compared with a local control cohort using contingency tables. Change in obesity rate through time was determined with mixed models. Association of obesity with OSAS was determined with contingency tables.Results We evaluated 303 individuals, 47.8% of whom were obese (body mass index >= 95th percentile for age and sex). This was significantly higher than the general pediatric population, which had a 12.1% obesity rate (P < .0001). Body mass index z-scores did not change markedly over time (P = .40). The majority of children with Down syndrome also had OSAS (74.0% of the 177 children who had polysomnography studies). However, OSAS risk was elevated in obese children (risk ratio = 2.4, P = .0015).Conclusions Our results indicate that children with Down syndrome are at a substantial risk for obesity and OSAS. These findings support the need for more aggressive weight management in early childhood and throughout the lifespan.