Pediatrics最新文献_第4页

Mindfulness Intervention for Parent Stress and Childhood Obesity Risk: A Randomized Trial. 父母压力和儿童肥胖风险的正念干预：一项随机试验。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-06 DOI: 10.1542/peds.2025-072230

Nia Fogelman,Heather Bernstein,Tara Bautista,Mary Savoye,Tara M Chaplin,Wendy K Silverman,Ania M Jastreboff,Rajita Sinha

OBJECTIVETo assess whether a novel parent stress with nutrition vs nutrition alone intervention decreases early childhood obesity risk.METHODSA prospective, parallel, 12-week randomized controlled trial with parents who were overweight (114 dyads body mass index [BMI]: 34.7 ± 6.6) and their young children (aged 2-5 years) was conducted between November 2018 and July 2022. Parenting Mindfully for Health (PMH+N) was compared with the control (CTL+N) weekly group intervention, each with nutrition and physical activity (N) psychoeducation. Changes in child BMI and parent stress were coprimary outcomes, whereas observed parenting in an established laboratory-based parent-child Toy-Wait Task (TWT) and child food intake were secondary outcomes.RESULTSChild BMI z score significantly increased by 0.41 ([0.13, 0.69], P < .005) in the CTL+N, but PMH+N remained unchanged (0.20 [-0.49, 0.09], P > .17) over the 3-month follow-up, and parent stress decreased (3.17 [-5.19, -1.15] points, P < .003) only in the PMH+N arm. Significant time main effects indicated increased TWT positive parenting (2.82 [1.24, 4.4], P < .001) and reduced unhealthy child food intake (-1.78 [-3.02, -0.54]), driven by the PMH+N arm (P values <.02). Parent stress interacted with PMH+N vs CTL+N intervention to predict lower TWT positive parenting and child healthy food intake in the CTL+N arm (-1.74 [-3.26, -0.22] and -3.41 [-7.25, 0.42], respectively).CONCLUSIONSTargeting parent stress with healthy nutrition is effective in preventing short-term early childhood obesity risk and in improving positive parenting and child healthy food intake. Further assessment of long-term effects of the PMH+N intervention on early childhood risk is warranted. (Clinical Trials Registration: NCT03950453).

目的评估一种新的父母压力与营养干预是否能降低儿童早期肥胖风险。方法于2018年11月至2022年7月对体重超重（114对体重指数[BMI]: 34.7±6.6）的父母及其幼儿（2-5岁）进行前瞻性、平行、为期12周的随机对照试验。采用PMH+N与对照（CTL+N）每周组干预，分别进行营养和身体活动(N)心理教育。儿童体重指数和父母压力的变化是主要结果，而观察到的父母在一个建立在实验室基础上的亲子玩具等待任务（TWT）和儿童食物摄入量是次要结果。结果儿童BMI z评分显著升高0.41 ([0.13,0.69]，P。（17）随访3个月，父母压力降低(3.17[-5.19,-1.15]分，P <。003)仅在PMH+N组。显着的时间主效应表明TWT阳性父母教养增加(2.82 [1.24,4.4]P <。在PMH+N组的驱动下（P值< 0.02），儿童不健康食物摄入量减少（-1.78[-3.02,-0.54]）。父母压力与PMH+N与CTL+N干预相互作用，预测CTL+N组TWT阳性父母和儿童健康食物摄入量降低（分别为-1.74[-3.26,-0.22]和-3.41[-7.25,0.42]）。结论以健康营养为目标的父母应激可有效预防短期儿童早期肥胖风险，提高父母的积极教养和儿童健康食物摄入。有必要进一步评估PMH+N干预对儿童早期风险的长期影响。（临床试验注册：NCT03950453）。

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引用次数: 0

Michigan's Crusade for Clean Hands: The Modern Health Crusade Revisited. 密歇根清洁双手运动：现代健康运动重访。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-05 DOI: 10.1542/peds.2025-071429

Dillon Prus

引用次数: 0

Power Training Combined With Interval Treadmill Training in Cerebral Palsy: An RCT. 力量训练结合间歇跑步机训练治疗脑瘫：一项随机对照试验。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-05 DOI: 10.1542/peds.2025-074493

Noelle G Moreau,Kristie F Bjornson,Phil Hurvitz,Donald E Mercante

OBJECTIVESDetermine the effect of lower-extremity power training combined with interval treadmill training (PT3) on walking capacity and performance in children with cerebral palsy (CP).METHODSIn this multisite, single-blinded randomized clinical trial, children with spastic, bilateral CP between ages 10 and 17 years were randomized to receive 24 sessions of either PT3 or traditional strength training combined with steady-state treadmill training (STT). Primary outcomes were normalized self-selected and fast gait speed and muscle power. Participants were assessed at baseline, immediate postintervention, 2-month post, and 6-month post.RESULTSOf 43 recruited participants (20 female participants; mean age 13.1 SD 2.2 years for PT3 group; mean age 13.8 SD 2.6 years for STT group), 38 were included in the final analyses. No differences between groups were observed for self-selected speed. PT3 had significantly greater change in fast speed from baseline to 2-month post compared with STT (adjusted mean difference [MD], 0.030; 95% CI, 0.002-0.059; P = .04). Change in muscle power from baseline to immediate post was significantly greater in the PT3 group (MD, 52.01; 95% CI, 5.63-98.39; P = .03). Stride rate intensity increased immediate post after PT3 (MD, 7.95; 95% CI, 0.45-15.95; P = .04).CONCLUSIONSPower training combined with high-intensity interval treadmill training was superior to an equivalent dosage of traditional strength training combined with steady-state treadmill training for improving muscle power immediate post-training and fast gait speed 2-month post-training. Increases in stride rate intensity after PT3 were not maintained at follow-up time points.

目的探讨下肢力量训练联合间歇跑步机训练（PT3）对脑瘫（CP）患儿行走能力和运动表现的影响。方法在这项多中心、单盲随机临床试验中，年龄在10 - 17岁之间的痉挛性双侧CP儿童随机接受24次PT3或传统力量训练结合稳态跑步机训练（STT）。主要结果是标准化的自我选择和快速的步态速度和肌肉力量。在基线、干预后立即、干预后2个月和干预后6个月对参与者进行评估。结果招募的43名参与者（20名女性参与者，PT3组平均年龄13.1 SD 2.2岁，STT组平均年龄13.8 SD 2.6岁）中有38人被纳入最终分析。自选速度组间无差异。与STT相比，PT3从基线到2个月后的快速变化明显更大（调整后的平均差[MD]， 0.030; 95% CI, 0.002-0.059; P = 0.04）。PT3组肌肉力量从基线到术后即刻的变化明显更大（MD, 52.01; 95% CI, 5.63-98.39; P = .03）。PT3后步频强度立即增加（MD, 7.95; 95% CI, 0.45-15.95; P = 0.04）。结论力量训练联合高强度间歇跑步机训练在提高训练后即刻肌肉力量和训练后2个月快速步态速度方面优于同等剂量的传统力量训练联合稳态跑步机训练。PT3后步幅强度的增加在随访时间点未保持。

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引用次数: 0

Generative Artificial Intelligence: Implications for Families and Pediatricians. 生成式人工智能：对家庭和儿科医生的影响。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-04 DOI: 10.1542/peds.2025-074912

Robert W Grundmeier,Alexander G Fiks,Brian P Jenssen,Stephon N Proctor,Daria F Ferro,Kevin B Johnson,

Generative artificial intelligence (AI) technologies, capable of producing original text, images, audio, and video, are increasingly embedded in children's learning, play, and daily life. Pediatric clinicians and parents face the challenge of guiding children toward safe and constructive engagement with these rapidly evolving tools. This state-of-the-art review synthesizes current knowledge regarding opportunities, risks, and best practices related to children's interactions with generative AI. Developmental considerations are emphasized because the impact of AI varies across early childhood, middle childhood, and adolescence. We highlight potential benefits, including personalized learning, creative expression, and enhanced communication, while also discussing risks such as misinformation, privacy threats, and false perceptions of AI as a friend or caregiver. Evidence-based strategies are proposed to promote AI literacy, critical thinking, and safe integration of AI into pediatric care and education.

生成式人工智能（AI）技术能够生成原创的文本、图像、音频和视频，越来越多地嵌入到儿童的学习、游戏和日常生活中。儿科临床医生和家长面临着引导儿童安全、建设性地使用这些快速发展的工具的挑战。这篇最新的综述综合了有关儿童与生成式人工智能互动的机会、风险和最佳实践的当前知识。发展方面的考虑被强调，因为人工智能的影响在儿童早期、儿童中期和青少年时期是不同的。我们强调了潜在的好处，包括个性化学习、创造性表达和加强沟通，同时也讨论了错误信息、隐私威胁以及将人工智能视为朋友或照顾者的错误看法等风险。提出了基于证据的战略，以促进人工智能素养、批判性思维和将人工智能安全地融入儿科护理和教育。

引用次数: 0

Tuberculosis Disease and Infection in US-Bound International Adoptees: 2016 to 2023. 2016年至2023年赴美国际被收养者的结核病和感染

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-04 DOI: 10.1542/peds.2025-073442

Yecai Liu,Christina R Phares,Pamela Logan,Michelle S Weinberg,Sean Toney,Drew L Posey,Elizabeth Soda

OBJECTIVEThe objective of this study was to evaluate required culture-based overseas tuberculosis (TB) screening in US-bound international adoptees.METHODSWe conducted a cross-sectional analysis of 22 053 international adoptees who underwent TB screening overseas and arrived in the United States during 2016 to 2023.RESULTSOf 22 053 international adoptees (aged younger than 18 years) screened for TB overseas, 12 (54 cases/100 000 persons) were diagnosed with TB disease, and 169 (766 cases/100 000 persons) had suspected TB disease (defined for this analysis as a chest radiograph or clinical signs/symptoms suggestive of TB or known HIV infection but negative sputum culture results overseas). Of 15 386 persons who underwent a tuberculin skin test (TST) or interferon-γ release assay (IGRA) overseas, 390 (2.5%) were diagnosed with latent TB infection (LTBI). Among 12 persons who initiated treatment of TB disease overseas, 10 (83.3%) completed post-arrival evaluation in the United States; of these, none were diagnosed with TB disease after arrival. Among 169 persons diagnosed overseas with suspected TB disease, 108 (63.9%) completed post-arrival evaluation; of these, 2 (1.9%) were diagnosed with TB disease. Among 390 persons diagnosed overseas with LTBI, 220 (56.4%) completed post-arrival evaluation; of these, none were diagnosed with TB disease. Of 150 persons diagnosed with LTBI at post-arrival evaluation, 137 (91.3%) were recommended for treatment; of these, 104 (75.9%) initiated and 79 (57.7%) completed treatment.CONCLUSIONSUS-bound international adoptees have a similarly high prevalence of TB disease compared with US-bound immigrant and refugee children, highlighting the importance of TB screening before immigration and ensuring timely recommended post-arrival evaluation.

目的：本研究的目的是评估赴美国际被收养者需要的基于文化的海外结核病（TB）筛查。方法：我们对2016年至2023年期间在海外接受结核病筛查并抵达美国的22 053名国际被收养者进行了横断面分析。结果22 053名在海外接受结核病筛查的国际被收养者（年龄小于18岁）中，12人（54例/10万人）被诊断为结核病，169人（766例/10万人）疑似结核病（在本分析中定义为胸片或临床体征/症状提示结核病或已知HIV感染，但在海外痰培养结果阴性）。在海外接受结核菌素皮肤试验（TST）或干扰素γ释放试验（IGRA）的15386人中，390人（2.5%）被诊断为潜伏性结核感染（LTBI）。在海外开始治疗结核病的12人中，10人（83.3%）在美国完成了抵达后评估；其中没有人在抵达后被诊断患有结核病。在海外确诊的169名疑似结核病患者中，108人（63.9%）完成了抵达后评估；其中2人（1.9%）被诊断患有结核病。在海外诊断为LTBI的390人中，220人（56.4%）完成了抵达后评估；在这些人中，没有人被诊断患有结核病。在抵达后评估中诊断为LTBI的150人中，有137人（91.3%）被推荐治疗；其中，104例（75.9%）开始治疗，79例（57.7%）完成治疗。结论入境美国的国际被收养儿童与入境美国的移民和难民儿童相比，结核病患病率相似，突出了移民前结核病筛查和确保及时推荐的抵达后评估的重要性。

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引用次数: 0

Epidemiology of Herpes Simplex Virus in Infants Aged 0-42 Days: 2008-2024. 0-42天婴幼儿单纯疱疹病毒流行病学：2008-2024。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-03 DOI: 10.1542/peds.2025-073629

Tara L Greenhow,Zahra Samiezade-Yazd,Lea Bornstein,Beverly R Young,Tran H P Nguyen

BACKGROUNDInfant herpes simplex virus (HSV) incidence ranges from 1.7 to 13.4 per 100 000 live births, varies by region, and prior to 2019, has been increasing. HSV-1 has surpassed HSV-2 as the predominant subtype. We aimed to report trends in infant HSV disease.METHODSThis was a retrospective study of infants aged 0-42 days born between October 1, 2008 to September 30, 2024 with HSV disease. Demographics, clinical symptoms, type of HSV disease, and subtype of HSV were captured. Trends of HSV disease and subtype were reported.RESULTSIn our 16-year cohort of 632 979 infants, we identified 62 cases of HSV disease, with a cumulative incidence of 9.8 (95% CI 7.6-12.5) per 100 000 births. The cumulative incidence of skin, eye, and/or mouth (SEM), disseminated (DIS), and central nervous system (CNS) disease were 5.4 (95% CI 3.7-7.5), 2.8 (95% CI 1.7-4.5), and 1.6 (95% CI 0.8-2.9) per 100 000 births, respectively. SEM and CNS disease incidence remained stable during the study period. However, there was a statistically significant change in the incidence of DIS disease between 2008-2021 and 2021-2024 with a rise in DIS disease of 4.5 per 100 000 births per year from 2021 to 2024. HSV-1 disease occurred in 61% and HSV subtype distribution was stable over time.CONCLUSIONSEM disease and HSV-1 were predominant throughout the study period. Incidence of DIS disease increased significantly after the COVID-19 pandemic, likely reflecting changing sexual practices during the pandemic and a population vulnerable to primary HSV-1 genital lesions.

背景：婴儿单纯疱疹病毒（HSV）的发病率为每10万活产1.7至13.4例，因地区而异，在2019年之前一直在增加。1型单纯疱疹病毒已超过2型单纯疱疹病毒成为主要亚型。我们的目的是报告婴儿HSV疾病的趋势。方法对2008年10月1日至2024年9月30日出生的0-42天HSV患儿进行回顾性研究。捕获人口统计学、临床症状、HSV疾病类型和HSV亚型。报告了HSV疾病和亚型的趋势。结果在我们16年的63279名婴儿队列中，我们确定了62例HSV疾病，累积发病率为每10万例出生9.8例（95% CI 7.6-12.5）。皮肤、眼睛和/或口腔（SEM）、弥散性（DIS）和中枢神经系统（CNS）疾病的累积发病率分别为每10万新生儿5.4例（95% CI 3.7-7.5）、2.8例（95% CI 1.7-4.5）和1.6例（95% CI 0.8-2.9）。扫描电镜和中枢神经系统疾病的发病率在研究期间保持稳定。然而，在2008-2021年和2021-2024年之间，DIS发病率有统计学上的显著变化，从2021年到2024年，每年每10万新生儿中有4.5例DIS发病率上升。HSV-1发病发生率为61%，HSV亚型分布长期稳定。结论研究期间以sem和HSV-1为主。在2019冠状病毒病大流行之后，DIS的发病率显著增加，这可能反映了大流行期间性行为的改变以及易受1型单纯疱疹病毒生殖器病变影响的人群。

{"title":"Epidemiology of Herpes Simplex Virus in Infants Aged 0-42 Days: 2008-2024.","authors":"Tara L Greenhow,Zahra Samiezade-Yazd,Lea Bornstein,Beverly R Young,Tran H P Nguyen","doi":"10.1542/peds.2025-073629","DOIUrl":"https://doi.org/10.1542/peds.2025-073629","url":null,"abstract":"BACKGROUNDInfant herpes simplex virus (HSV) incidence ranges from 1.7 to 13.4 per 100 000 live births, varies by region, and prior to 2019, has been increasing. HSV-1 has surpassed HSV-2 as the predominant subtype. We aimed to report trends in infant HSV disease.METHODSThis was a retrospective study of infants aged 0-42 days born between October 1, 2008 to September 30, 2024 with HSV disease. Demographics, clinical symptoms, type of HSV disease, and subtype of HSV were captured. Trends of HSV disease and subtype were reported.RESULTSIn our 16-year cohort of 632 979 infants, we identified 62 cases of HSV disease, with a cumulative incidence of 9.8 (95% CI 7.6-12.5) per 100 000 births. The cumulative incidence of skin, eye, and/or mouth (SEM), disseminated (DIS), and central nervous system (CNS) disease were 5.4 (95% CI 3.7-7.5), 2.8 (95% CI 1.7-4.5), and 1.6 (95% CI 0.8-2.9) per 100 000 births, respectively. SEM and CNS disease incidence remained stable during the study period. However, there was a statistically significant change in the incidence of DIS disease between 2008-2021 and 2021-2024 with a rise in DIS disease of 4.5 per 100 000 births per year from 2021 to 2024. HSV-1 disease occurred in 61% and HSV subtype distribution was stable over time.CONCLUSIONSEM disease and HSV-1 were predominant throughout the study period. Incidence of DIS disease increased significantly after the COVID-19 pandemic, likely reflecting changing sexual practices during the pandemic and a population vulnerable to primary HSV-1 genital lesions.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"45 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Capture of Race and Ethnicity Data in a Regional Neonatal Intensive Care Unit. 改进地区新生儿重症监护病房的种族和民族数据采集。

IF 8 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-03 DOI: 10.1542/peds.2025-072493

Jeffrey M Meyers,Diane Prinzing,Rebecca L Kanaley,Paula Emrich,Mallory Prideaux,Angelica Trybulska,Anne Fallon,

BACKGROUND/OBJECTIVEAddressing disparities and improving outcomes for patients in a neonatal intensive care unit (NICU) requires accurate and reliable reporting of race and ethnicity. We sought to increase the percentage of infants with caregiver-reported race and ethnicity at NICU discharge to greater than 90% using quality improvement (QI) methods.METHODSWe first identified drivers including standardization, increasing reliability, and addressing gaps in education and health literacy. Tests of change included revising forms to enhance clarity and support equity, addressing barriers to the reliable processing of paper forms, real-time auditing and clinical decision support in the electronic health record, and development of a patient portal prebirth electronic form. Statistical process control charts were used to track the outcome measure, the percentage of patients in a NICU who had caregiver-reported race and ethnicity documented at discharge, and the process measure of the percentage of infants whose forms were received within 7 days of admission.RESULTSThe average percentage of patients with caregiver-reported race and ethnicity documented at NICU discharge increased from 38% to 94%. The percentage of forms received within 7 days of admission increased from 81% to 96%. Improvements have been sustained for more than 18 months.CONCLUSIONWe improved the documentation of caregiver-reported race and ethnicity among patients discharged from our NICU through rigorous QI methods. Accurate and reliable capture of race and ethnicity data should help identify and address disparities and improve care for all infants.

背景/目的解决新生儿重症监护病房（NICU）患者的差异和改善预后需要准确可靠的种族和民族报告。我们试图使用质量改进（QI）方法将新生儿重症监护病房出院时照顾者报告的种族和民族的婴儿比例提高到90%以上。方法我们首先确定了驱动因素，包括标准化、提高可靠性以及解决教育和卫生素养方面的差距。变革测试包括修订表格以提高清晰度和支持公平性，解决纸质表格可靠处理方面的障碍，电子健康记录中的实时审计和临床决策支持，以及开发患者门户网站产前电子表格。统计过程控制图用于跟踪结果测量，新生儿重症监护室中出院时记录有护理人员报告的种族和民族的患者百分比，以及入院后7天内收到表格的婴儿百分比的过程测量。结果在新生儿重症监护病房出院时记录的具有护理人员报告的种族和民族的患者的平均百分比从38%增加到94%。入院后7天内收到表格的比例从81%增加到96%。改善已经持续了18个多月。结论：通过严格的QI方法，我们改进了NICU出院患者中护理人员报告的种族和民族的记录。准确可靠地获取种族和族裔数据应有助于确定和解决差异，并改善对所有婴儿的护理。

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引用次数: 0

Characteristics of Youth Treated With GLP-1RAs at an Integrated Weight Management Clinic. 综合体重管理诊所青少年GLP-1RAs治疗的特点

IF 6.4 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-02 DOI: 10.1542/peds.2025-074094

Emily F Gregory, Rachana D Shah, Jeremy J Michel, Zia H Huballah, Nia A Frederick, Deepthi Gunturi, Emma K Edmondson

Objectives: Youth use of GLP-1RAs is increasing. This study described GLP-1RA prescription patterns and barriers to treatment at a pediatric integrated weight management clinic.

Methods: This retrospective cohort included youth 12 to 17 years with BMI at least 95th% for age and sex, with at least 1 visit at an integrated weight management program from January 2023 to August 2025. We identified youth with at least 1 GLP-1RA prescription in the electronic health record. We assessed demographic factors (age, sex, race, ethnicity, insurance payer, preferred language) and health factors (BMI, Type 2 diabetes, results of ALT, cholesterol, and hemoglobin A1c testing). Logistic regression assessed for an association between GLP-1RA prescription and demographic and health factors. Manual medical record review of a subsample of 102 youth with GLP-1RA prescriptions described reasons for interruptions in use.

Results: Of 1647 youth, 325 (20%) had at least 1 GLP-1RA prescription. Odds of prescription increased with increasing age, increasing BMI, abnormal laboratory testing results, and non-Hispanic white or Hispanic race and ethnicity (compared with non-Hispanic Black). Odds of a prescription decreased with a preferred language other than English. In medical record review, 65 youth (64%) experienced GLP-1RA treatment interruptions, most commonly related to cost and insurance coverage.

Conclusions: At one institution's integrated weight management program, 20% of potentially eligible youth were prescribed GLP-1RAs. Prescriptions were more likely for older patients and those with comorbid conditions, and less likely for Black or non-English speaking patients, reflecting known pediatric health disparities. Barriers to treatment were common after the prescription.

目的：青少年GLP-1RAs的使用正在增加。本研究描述了GLP-1RA在儿科综合体重管理诊所的处方模式和治疗障碍。方法：该回顾性队列包括年龄和性别BMI至少为95%的12至17岁青年，在2023年1月至2025年8月期间至少进行过一次综合体重管理计划。我们在电子健康记录中确定了至少有1个GLP-1RA处方的青少年。我们评估了人口统计学因素（年龄、性别、种族、民族、保险付款人、首选语言）和健康因素（BMI、2型糖尿病、ALT、胆固醇和血红蛋白A1c检测结果）。Logistic回归评估GLP-1RA处方与人口统计学和健康因素之间的关联。使用GLP-1RA处方的102名青年的子样本的手工医疗记录审查描述了中断使用的原因。结果：在1647名青少年中，325名（20%）至少有1份GLP-1RA处方。处方的几率随着年龄增加、BMI增加、实验室检测结果异常、非西班牙裔白人或西班牙裔种族和民族（与非西班牙裔黑人相比）的增加而增加。使用英语以外的首选语言，处方的几率会降低。在医疗记录回顾中，65名年轻人（64%）经历了GLP-1RA治疗中断，最常见的是与费用和保险范围有关。结论：在一个机构的综合体重管理项目中，20%的潜在合格青年服用了GLP-1RAs。老年患者和有合并症的患者更有可能得到处方，黑人或非英语患者的可能性较小，这反映了已知的儿科健康差异。处方后治疗障碍很常见。

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引用次数: 0

Disparities in Medication Treatment of Type 2 Diabetes and Obesity. 2型糖尿病和肥胖症药物治疗的差异。

IF 6.4 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-02 DOI: 10.1542/peds.2025-074840

Rachel Whooten, Leora Allen, Fatima C Stanford

引用次数: 0

GLP-1RA Dispensing in Youth With Type 2 Diabetes: 2020 to 2023. GLP-1RA在青少年2型糖尿病患者中的应用：2020年至2023年

IF 6.4 2区医学 Q1 PEDIATRICS

Pediatrics

Pub Date : 2026-03-02 DOI: 10.1542/peds.2025-071971

Patricia Y Chu, Andrea Kelly, Sean Hennessy, Mary Ellen Vajravelu, Jing Huang, Sandra Amaral

Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel pharmacotherapeutic option for pediatric type 2 diabetes (T2D); however, little is known about their current use. This study evaluated trends in GLP-1RA dispensing in youth with T2D between 2020 and 2023 and compared use by insurance type (ie, Medicaid vs commercial).

Methods: We conducted a multiyear cross-sectional study of youth aged 10 to 17 years with T2D using Merative™ MarketScan® Multi-State Medicaid and Commercial Database claims and encounters data (2020-2023). Annual prevalence of GLP-1RA dispensing was calculated for each year. Temporal trends in dispensing were examined using the Cochran-Armitage test. Poisson regression with robust variance estimated adjusted prevalence ratios (aPRs) were used to evaluate associations between insurance type (ie, Medicaid vs commercial) and GLP-1RA dispensing in 2023.

Results: Annual prevalence of GLP-1RA dispensing in youth with T2D increased from 10.9% in 2020 to 35.6% in 2023 (P value for trend < .001) but remained less frequent than long- (49.5%) and short-acting insulin (43.4%). In 2023, overall GLP-1RA dispensing was similar for Medicaid-insured and commercially insured youth; however, the types of GLP-1RA differed by insurance. Medicaid-insured youth were less likely than commercially insured youth to be dispensed semaglutide (aPR 0.3, 95% CI: 0.2-0.4) and more likely to be dispensed dulaglutide (aPR 1.5, 95% CI: 1.2-2.0), exenatide (aPR 2.3, 95% CI: 1.2-4.2), or liraglutide (aPR 1.6, 95% CI: 1.2-2.1).

Conclusions: GLP-1RA dispensing increased in youth with T2D, but the type of GLP-1RA differed by insurance type. Comparative effectiveness studies and research identifying barriers to GLP-1RA use are needed to ensure optimal treatment of youth with T2D.

目的：胰高血糖素样肽-1受体激动剂（GLP-1RAs）是儿童2型糖尿病（T2D）的一种新的药物治疗选择；然而，人们对它们目前的用途知之甚少。本研究评估了2020年至2023年间青少年T2D患者GLP-1RA配药的趋势，并比较了保险类型（即医疗补助与商业保险）的使用情况。方法：我们使用Merative™MarketScan®多州医疗补助和商业数据库索赔和就诊数据（2020-2023）对10至17岁T2D青少年进行了一项多年横断面研究。计算每年GLP-1RA配药的年患病率。使用Cochran-Armitage检验分配的时间趋势。使用泊松回归与稳健方差估计调整患病率（aPRs）来评估2023年保险类型（即医疗补助与商业）与GLP-1RA分配之间的关联。结果：青少年T2D患者GLP-1RA的年配药率从2020年的10.9%上升到2023年的35.6% （P值为趋势值）。结论：青少年T2D患者GLP-1RA配药率上升，但不同保险类型GLP-1RA的类型不同。需要进行比较有效性研究和确定GLP-1RA使用障碍的研究，以确保青年T2D患者的最佳治疗。

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引用次数: 0