A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.
A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.
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DOI：
10.1371/journal.pone.0173033
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Holm JC
中科院分区：
文献类型：
--
作者：
Mollerup PM;Gamborg M;Trier C;Bøjsøe C;Nielsen TR;Baker JL;Holm JC
由于儿童和青少年超重和肥胖的流行，需要改善超重和肥胖治疗的可得性和可及性。在这项前瞻性研究中，我们调查了体重指数（BMI）标准差评分（SDS）和腰围（WC）是否会在基于有效的医院超重和肥胖治疗方案-儿童肥胖诊所治疗方案-的1.5年社区超重和肥胖治疗期间发生减少。所有咨询均测量身高、体重和腰围。在每个儿童重复测量的基础上，使用线性混合模型分析BMI SDS和WC的变化。从2012年6月到2015年1月，1001名儿童（455名男孩）连续参加了社区治疗项目。入组时，中位年龄为11岁（范围：3 - 18），男孩的中位BMI SDS为2.85（范围：1.26 - 8.96），女孩的中位BMI SDS为2.48（范围：1.08 - 4.41）。治疗1.5年后，74%的儿童BMI SDS下降。治疗1.5年后，男孩BMI SDS平均降低0.38(95%可信区间（CI）： 0.30 - 0.45, p<0.0001)，女孩BMI SDS平均降低0.18 (95% CI: 0.12 - 0.25, p<0.0001)，与基线年龄、BMI SDS和Tanner分期（均p< 0.08）无关。男孩WC平均减少3.8 cm (95% CI: 2.7 ~ 4.9, p>0.0001)，女孩WC平均减少5.1 cm （95% CI: 4.0 ~ 6.2, p>0.0001）。1年半后，辍学率为31%。每名儿童每年的平均咨询时间为4.5小时。治疗1.5年后，BMI SDS和WC下降。因此，这种以社区为基础的超重和肥胖治疗方案可能有助于满足改善治疗可得性和可及性的需求。
Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.