Pediatric Obesity最新文献_第2页

Central Adiposity, Rather Than in Utero Exposure to Maternal Obesity or Gestational Diabetes, Predicts Metabolic Syndrome Risk in Children Aged 4–10 Years 中枢性肥胖，而不是子宫内暴露于母体肥胖或妊娠期糖尿病，预测4-10岁儿童代谢综合征风险

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-12-10 DOI: 10.1111/ijpo.70066

Daniel O. Mensah, Alysha B. Everett, Amelia E. Fouts, Gretchen L. Hoelscher, Samantha L. Martin, Jessica S. Bahorski, Priscilla H. Mensah, Makenzie L. Callahan, W. Timothy Garvey, Paula C. Chandler-Laney

Background

Children born to mothers with obesity or gestational diabetes mellitus (GDM) face elevated risks of central adiposity and adverse cardiometabolic outcomes, including metabolic syndrome (MetS) and systemic inflammation. However, it remains unclear whether these risks are primarily driven by current adiposity or by in utero exposure. This study investigated associations between waist circumference (WC), waist-to-height ratio (WHtR), and continuous MetS (cMetS) scores in children, and evaluated whether in utero exposure to maternal obesity or GDM moderated these relationships. Associations between cMetS and cardiometabolic biomarkers were also examined.

Methods

Children were grouped by maternal early-pregnancy weight status and GDM diagnosis: (1) normal weight without GDM, (2) overweight/obesity without GDM, and (3) overweight/obesity with GDM. WC was classified as < 85th or ≥ 85th percentile; WHtR as < 0.5 or ≥ 0.5. cMetS scores were computed with and without the WC component. Group differences and associations were assessed using ANCOVA and correlation analyses.

Results

WC and WHtR were strong predictors of cMetS, independent of in utero exposure group. Children with WC ≥ 85th percentile or WHtR ≥ 0.5 had significantly higher cMetS scores (p < 0.0001), even when WC was excluded from the cMetS calculation. cMetS was inversely correlated with adiponectin and positively correlated with leptin, the leptin-to-adiponectin ratio, HOMA-IR, CRP, and IL-6 (all p < 0.01).

Conclusions

Central adiposity—indexed by WC or WHtR—rather than in utero exposure, is the primary driver of cardiometabolic risk. Associations between cMetS and cardiometabolic biomarkers underscore insulin resistance and adipose tissue dysfunction as key mechanisms underlying MetS in children.

背景：肥胖或妊娠期糖尿病（GDM）母亲所生的孩子面临中枢性肥胖和不良心脏代谢结局（包括代谢综合征（MetS）和全身性炎症）的风险升高。然而，目前尚不清楚这些风险主要是由目前的肥胖还是由子宫内暴露引起的。本研究调查了儿童腰围（WC）、腰高比（WHtR）和连续代谢当量（cMetS）评分之间的关系，并评估子宫内暴露于母亲肥胖或GDM是否会调节这些关系。cmet与心脏代谢生物标志物之间的关联也被检查。方法：根据产妇妊娠早期体重状况和GDM诊断对儿童进行分组：(1)体重正常，无GDM；(2)超重/肥胖，无GDM；(3)超重/肥胖，伴GDM。结果：WC和WHtR是cMetS的强预测因子，独立于子宫暴露组。WC≥85百分位或WHtR≥0.5的儿童cMetS评分显著较高(p)。结论：以WC或WHtR为指标的中心性肥胖是心脏代谢风险的主要驱动因素，而不是子宫暴露。cMetS与心脏代谢生物标志物之间的关联强调了胰岛素抵抗和脂肪组织功能障碍是儿童MetS的关键机制。

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引用次数: 0

MRI Analysis of Cardiac Fat, Abdominal Adiposity and Cardiac Function After Vertical Sleeve Gastrectomy in Youth With Type 2 Diabetes 2型糖尿病青年胃垂直套管切除术后心脏脂肪、腹部脂肪和心功能的MRI分析。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-11-17 DOI: 10.1111/ijpo.70068

Tyler J. Dobbs, Linnea Gutierrez, Houchun Harry Hu, Kendall S. Hunter, Brian Fonseca, Lorna Browne, David Winter, Melanie G. Cree, Laura Pyle, Jonathan L. Hills-Dunlap, Jane E. B. Reusch, Megan M. Kelsey, Thomas H. Inge, Petter Bjornstad, Kristen J. Nadeau

Background

Adolescents with youth-onset type 2 diabetes (YO-T2D) have an increased risk for cardiometabolic complications. The impact of vertical sleeve gastrectomy (VSG) on fat distribution and cardiac morphology/function in YO-T2D is unknown.

Objectives

To evaluate changes in body composition, abdominal and cardiac fat depots, and cardiometabolic health in adolescents with YO-T2D undergoing VSG.

Methods

Anthropometrics, labs and imaging were used to assess participants pre-surgery and 3–12 months post-surgery. MRI quantified pericardial (PAT), epicardial (EAT), subcutaneous (SAT) and visceral adipose tissue (VAT), hepatic fat fraction (HFF) and cardiac morphology/function. Mixed-effects models assessed longitudinal changes.

Results

By 12 months, weight decreased from 134.3 ± 5.1 to 103.3 ± 5.2 kg, VAT 1943 ± 148 to 1248 ± 150 cm³, HFF 23.2% ± 2.3% to 5.3% ± 2.3% and PAT and EAT by 27% and 33% (all p < 0.01). Homeostatic model assessment of insulin resistance (HOMA-IR) improved (7.8 ± 1.2 to 1.7 ± 1.2 [p < 0.01]). BMI, SAT, resting heart rate (RHR), left ventricular (LV) mass and cardiac output (CO) also decreased (all p < 0.05). VAT decreases correlated with decreases in HFF (r = 0.70, p = 0.01), HOMA-IR (r = 0.60, p = 0.04) and CO (r = 0.70, p = 0.03). HFF decreases correlated with decreases in BMI (r = 0.70, p = 0.03), HOMA-IR (r = 0.90, p < 0.001), RHR (r = 0.90, p = 0.002), CO (r = 0.80, p = 0.007) and LV mass (r = 0.70, p = 0.02).

Conclusions

VSG reduces ectopic and regional fat and improves associated insulin sensitivity and cardiac health in adolescents with YO-T2D.

背景：青少年2型糖尿病（YO-T2D）发生心脏代谢并发症的风险增加。垂直袖胃切除术（VSG）对YO-T2D患者脂肪分布和心脏形态/功能的影响尚不清楚。目的：评价青少年YO-T2D患者行VSG后身体组成、腹部和心脏脂肪库以及心脏代谢健康的变化。方法：术前和术后3-12个月采用人体测量学、实验室和影像学方法对参与者进行评估。MRI量化心包（PAT）、心外膜（EAT）、皮下（SAT）和内脏脂肪组织（VAT）、肝脏脂肪分数（HFF）和心脏形态/功能。混合效应模型评估了纵向变化。结果：12个月后，青少年YO-T2D患者体重从134.3±5.1降至103.3±5.2 kg， VAT从1943±148降至1248±150 cm3， HFF从23.2%±2.3%降至5.3%±2.3%，PAT和EAT分别下降27%和33%（均为p）。结论：VSG减少异位和局部脂肪，改善相关胰岛素敏感性和心脏健康。

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引用次数: 0

Risk Factors for Development of Type 2 and Prediabetes in Children During the COVID-19 Pandemic COVID-19大流行期间儿童2型糖尿病和前驱糖尿病发展的危险因素

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-11-14 DOI: 10.1111/ijpo.70070

Jeralyn B. Jacobs, Haihong Hu, Seohyun Kim, Yi-shin Sheu, R. Clayton Bishop, Karen Chesbrough, Nancy S. Weinfield

Background

During the COVID-19 pandemic, there was a rise in the incidence of type 2 diabetes (T2D) and prediabetes in children and teenagers. We investigated whether new risk factors for diabetes in children emerged during the pandemic period.

Methods

Using health records of a large, integrated health system, we evaluated the incidence of new-onset T2D and prediabetes in patients aged 0–19 years from 2020 to 2023. We utilised descriptive statistics, chi-square and multivariable logistic regressions to predict the risk of T2D and prediabetes.

Results

Compared to children with normal weight, children with obesity (p < 0.0001) and those overweight (p < 0.0001) were more likely to develop prediabetes, and children with obesity were more likely to develop T2D (p < 0.0001). Children aged 12–19 were more likely to develop prediabetes (p < 0.0001) and T2D (p < 0.0001) compared to younger children. Publicly insured children were more likely to develop T2D (p = 0.003). Black and Asian children were at higher risk than White individuals of developing both prediabetes (p < 0.0001) and T2D (p = 0.019 and p = 0.02, respectively). COVID-19 infection was not a meaningful risk factor for prediabetes or T2D.

Conclusion

Risk factors for prediabetes and T2D in children remained the same during the pandemic as prior: adolescents, overweight/obese patients, publicly insured individuals and non-White individuals.

背景：在2019冠状病毒病大流行期间，儿童和青少年中2型糖尿病（T2D）和前驱糖尿病的发病率有所上升。我们调查了在大流行期间是否出现了儿童糖尿病的新危险因素。方法：利用大型综合卫生系统的健康记录，评估2020 - 2023年0-19岁患者新发T2D和前驱糖尿病的发病率。我们使用描述性统计、卡方和多变量logistic回归来预测T2D和前驱糖尿病的风险。结论：大流行期间儿童糖尿病前期和T2D的危险因素与之前相同：青少年、超重/肥胖患者、公共保险个体和非白人个体。

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引用次数: 0

Childhood Obesity and Age-Related Diseases: A Systematic Review and Meta-Analysis of Mendelian Randomization Evidence 儿童肥胖和年龄相关疾病：孟德尔随机化证据的系统回顾和荟萃分析。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-11-14 DOI: 10.1111/ijpo.70071

Haoxue Zhu, Xinghao Yi, Mengyu He, Siyi Wu, Ming Li, Shan Gao

Background

Childhood obesity poses a global health threat, with emerging evidence suggesting distinct adipocyte senescence patterns compared to adult-onset obesity. We systematically explored whether childhood obesity may be causally associated with age-related diseases through a meta-analysis of Mendelian randomization (MR) evidence.

Methods

We screened six databases (MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Library and CNKI) and identified 45 MR articles examining paediatric adiposity and major age-related diseases. For each disease, we performed a meta-analysis using results from published MR studies and conducted de novo analyses based on genetic data from UK Biobank (n = 453 169), FinnGen (n > 200 000) and other large consortiums.

Results

The meta-analysis examined 44 diseases across 9 systems, revealing suggestive associations between genetically determined childhood obesity and increased risk of 16 age-related diseases, including hypertension, atrial fibrillation, coronary artery disease, stroke and myocardial infarction; colorectal, endometrial and pancreatic cancers; nonalcoholic fatty liver disease, type 2 diabetes, diabetic nephropathy; multiple sclerosis and gout; Alzheimer's disease; depression and asthma. Three of these associations were marginal (p = 0.03–0.05). Paradoxical inverse associations emerged for breast cancer and ulcerative colitis.

Conclusion

The findings from this meta-analysis underscore associations between childhood adiposity and multisystem age-related pathologies, underscoring the imperative for early obesity prevention.

背景：儿童肥胖是一个全球性的健康威胁，新出现的证据表明，与成人发病的肥胖相比，儿童肥胖的脂肪细胞衰老模式不同。通过对孟德尔随机化（MR）证据的荟萃分析，我们系统地探讨了儿童肥胖是否与年龄相关疾病有因果关系。方法：我们筛选了6个数据库（MEDLINE、PubMed、EMBASE、Web of Science、Cochrane Library和CNKI），筛选了45篇探讨儿童肥胖和主要年龄相关疾病的MR文章。对于每种疾病，我们使用已发表的MR研究结果进行了荟萃分析，并基于来自UK Biobank （n = 453169）、FinnGen （n = 20000）和其他大型财团的遗传数据进行了从头分析。结果：荟萃分析检查了9个系统的44种疾病，揭示了遗传决定的儿童肥胖与16种年龄相关疾病风险增加之间的暗示关联，包括高血压、心房颤动、冠状动脉疾病、中风和心肌梗死；结直肠癌、子宫内膜癌和胰腺癌；非酒精性脂肪肝、2型糖尿病、糖尿病肾病；多发性硬化症和痛风；阿尔茨海默病;抑郁症和哮喘。其中三个相关性为边缘相关性（p = 0.03-0.05）。在乳腺癌和溃疡性结肠炎中出现了矛盾的负相关。结论：这项荟萃分析的发现强调了儿童肥胖与多系统年龄相关病理之间的联系，强调了早期预防肥胖的必要性。

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引用次数: 0

The Association Between Schoolwork Pressure and Overweight/Obesity in Swedish Schoolchildren Across Different Socioeconomic Groups 瑞典不同社会经济群体学童学业压力与超重/肥胖的关系

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-11-12 DOI: 10.1111/ijpo.70067

Cassandra Comey, Kenisha Russell Jonsson, Maria Corell

Background

In Sweden, schoolwork pressure and adolescent overweight/obesity prevalence have increased in recent decades. This study investigates the relationship between schoolwork pressure and weight status, considering the moderating role of socioeconomic background.

Methods

We analysed pooled cross-sectional data from 12 154 adolescents in the nationally representative Swedish Health Behaviour in School-aged Children surveys (2013/14, 2017/18, 2021/22). Logistic regression models examined the association between schoolwork pressure and self-reported overweight/obesity status (standardised by IOTF cut-offs) across socioeconomic backgrounds assessed by the Family Affluence Scale (FAS) and perceived family wealth (PFW). We calculated population attributable fractions to quantify schoolwork pressure's contribution to overweight/obesity.

Results

37% of students reported high schoolwork pressure, and 14% had overweight or obesity. High schoolwork pressure was associated with increased odds of overweight/obesity (OR 1.17, 95% CI 1.03–1.32). Adolescents experiencing high pressure from low socioeconomic backgrounds FAS (OR 2.10, 95% CI 1.60–2.76) or PFW (OR 1.82, 95% CI 1.22–2.71) had the highest odds of overweight/obesity. Approximately 5% of overweight/obesity cases were attributable to high schoolwork pressure.

Conclusions

High schoolwork pressure increases the likelihood of adolescent overweight/obesity, particularly for disadvantaged socioeconomic groups. Implementing policies to reduce academic stress and providing targeted support are essential for promoting healthier outcomes.

背景：在瑞典，近几十年来，学业压力和青少年超重/肥胖患病率有所增加。本研究探讨学业压力与体重状况的关系，并考虑社会经济背景的调节作用。方法：我们分析了全国代表性瑞典学龄儿童健康行为调查（2013/14、2017/18、2021/22）中12154名青少年的汇总横截面数据。逻辑回归模型检验了家庭富裕量表（FAS）和感知家庭财富（PFW）评估的社会经济背景下，学业压力与自我报告的超重/肥胖状况（由IOTF截止值标准化）之间的关系。我们计算了人口归因分数来量化学业压力对超重/肥胖的贡献。结果：37%的学生报告了高中学业压力，14%的学生超重或肥胖。高中学业压力与超重/肥胖的几率增加相关（OR 1.17, 95% CI 1.03-1.32）。来自低社会经济背景（FAS）（OR 2.10, 95% CI 1.60-2.76）或PFW （OR 1.82, 95% CI 1.22-2.71）的高压力青少年超重/肥胖的几率最高。大约5%的超重/肥胖病例可归因于高中学业压力。结论：高中学业压力增加了青少年超重/肥胖的可能性，特别是对社会经济弱势群体。实施减轻学业压力的政策和提供有针对性的支持对于促进更健康的结果至关重要。

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引用次数: 0

Prenatal Exposure to Gestational Diabetes Mellitus Is Associated With Greater Pre-Pubertal BMI Growth and Faster Post-Pubertal Cortical Thinning During Peri-Adolescence 产前暴露于妊娠期糖尿病与青春期前较大的BMI增长和青春期后更快的皮质变薄有关

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-11-12 DOI: 10.1111/ijpo.70069

Eustace Hsu, Trevor A. Pickering, Shan Luo

Background

The longitudinal trajectory of body mass index (BMI) and brain structure development during peri-adolescence is not clearly defined in offspring prenatally exposed to gestational diabetes mellitus (GDM) versus unexposed offspring.

Methods

Participants between age 9 and 10 years (N = 9583) were included from the Adolescent Brain and Cognitive Development (ABCD) Study and followed yearly through 4-year follow-up. GDM and puberty status were self-reported. BMI was calculated yearly, and MRI assessed brain structure biennially. Mixed-effects models analysed trajectories of BMI and brain structural measures between groups controlling for sociodemographic covariates, and linear spline was defined with a knot at the onset of puberty.

Results

There was an interaction of exposure by age in change in BMI [β (95% CI) = 0.032 (0.008, 0.056), p = 0.009] and mean cortical thickness [β (95% CI) = −0.038 (−0.071, −0.004), p = 0.027]. The former was driven by greater pre-pubertal increases in BMI [β (95% CI) = 0.051 (0.002, 0.100), p = 0.043], whereas the latter was driven by faster post-pubertal declines in cortical thickness among GDM-exposed offspring [β (95% CI) = −0.051 (−0.095, −0.007), p = 0.046].

Conclusion

Prenatal GDM exposure is associated with greater pre-pubertal increases in BMI and faster post-pubertal cortical thinning in youth aged between 9 and 15.

背景：产前暴露于妊娠期糖尿病（GDM）的后代与未暴露于妊娠期糖尿病（GDM）的后代在青春期前后身体质量指数（BMI）和大脑结构发育的纵向轨迹尚不清楚。方法：从青少年大脑和认知发展（ABCD）研究中纳入年龄在9至10岁之间的参与者（N = 9583），每年随访4年。GDM和青春期状态均为自我报告。BMI每年计算一次，MRI每两年评估一次脑结构。混合效应模型分析了控制社会人口协变量的组间BMI和脑结构测量的轨迹，线性样条被定义为青春期开始时的一个结。结果：暴露与年龄之间存在交互作用，影响BMI [β (95% CI) = 0.032 (0.008, 0.056), p = 0.009]和平均皮质厚度[β (95% CI) = -0.038 (-0.071, -0.004), p = 0.027]。前者是由青春期前较大的BMI增加引起的[β (95% CI) = 0.051 (0.002, 0.100), p = 0.043]，而后者是由gdm暴露后代青春期后皮质厚度下降更快引起的[β (95% CI) = -0.051 (-0.095, -0.007), p = 0.046]。结论：在9 - 15岁的青少年中，产前GDM暴露与青春期前BMI增加和青春期后皮质变薄有关。

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引用次数: 0

Associations of Acculturation With Added Sugars Intake and Weight Status Among Mexican American Adolescents in the United States, NHANES, 2009–2018 美国墨西哥裔美国青少年中添加糖摄入与体重状况的文化适应关系，NHANES, 2009-2018。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-10-28 DOI: 10.1111/ijpo.70063

Euisun Pyo, Regine Haardörfer, Liliana Aguayo, Miriam Vos, Mary Beth Weber, Jean A. Welsh

U.S. acculturation is associated with poor diet quality and obesity. This study examined the association of acculturation with added sugars among Mexican American adolescents, and whether added sugars mediate the association between acculturation and overweight/obesity. Data from NHANES 2009–2018 included 1317 Mexican American adolescents aged 12–19 years. Acculturation was measured by language spoken at home (English vs. Spanish) and birthplace of child and caregiver (United States vs. Mexico). Added sugars intake was assessed by 24-h dietary recall and categorised as ‘high’ (≥ 10% total energy intake) versus ‘low’ (< 10%). Multivariable logistic regressions tested associations between acculturation and added sugars, and path analysis evaluated the mediation of added sugars between acculturation and overweight/obesity (≥ 85th BMI percentile). Greater acculturation, indicated by primarily speaking English at home (OR: 1.6; 95% CI: 1.0, 2.5), caregiver being U.S.-born (2.2; 1.1, 4.2), both child and caregiver U.S.-born (2.8; 1.2, 6.5), or both U.S.-born + English at home (2.9; 1.1, 7.5), was associated with higher odds of high added sugars intake. Added sugars did not mediate the effect of acculturation on obesity/overweight status. These findings suggest that while higher acculturation is associated with excess added sugars intake, future research is needed to clarify how acculturation influences obesity risk.

美国文化的适应与饮食质量差和肥胖有关。本研究考察了墨西哥裔美国青少年的文化适应与添加糖之间的关系，以及添加糖是否介导了文化适应与超重/肥胖之间的关系。NHANES 2009-2018年的数据包括1317名12-19岁的墨西哥裔美国青少年。文化适应是通过家庭使用的语言（英语vs.西班牙语）和孩子和照顾者的出生地（美国vs.墨西哥）来衡量的。通过24小时饮食回忆评估添加糖摄入量，并将其分为“高”（≥10%的总能量摄入）和“低”(

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引用次数: 0

Memory Performance and Hippocampal Volumes in Healthy Weight Children at High- and Low-Familial Risk for Obesity 高、低家族性肥胖风险健康体重儿童的记忆表现和海马体体积

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-10-26 DOI: 10.1111/ijpo.70061

Melanie A. Dratva, Zoe L. Lanman, Amanda Bischoff-Grethe, Dawn M. Eichen, David R. Strong, Christina E. Wierenga, Kerri N. Boutelle

<div> <section> <h3> Background</h3> <p>Children with overweight or obesity (OW/OB), relative to healthy weight (HW), have lower cognitive performance and hippocampal volumes. Whether this extends to children with HW at familial risk for future OW/OB is unknown.</p> </section> <section> <h3> Objectives</h3> <p>To compare memory performance and hippocampal subfield volumes between HW children at high risk (HR) and low risk (LR) for OW/OB.</p> </section> <section> <h3> Methods</h3> <p>HW children (<i>n</i> = 95, aged 8–11), classified as HR (<i>n</i> = 43, both parents with OW/OB) or LR (<i>n</i> = 52, both parents with HW), underwent structural magnetic resonance imaging and memory testing (Verbal List Learning Test-Food-Child Version (VLLT-Food-C) and Child Memory Scale subtests: word pairs, dot locations). Linear models tested group differences in memory scores, hippocampal and subfield (CA1, CA3, dentate gyrus (DG), subiculum) volumes.</p> </section> <section> <h3> Results</h3> <p>Groups did not differ on demographics except body mass index (HR > LR, <i>p</i> = 0.003), despite all children being HW. LR children performed better on VLLT-Food-C short- (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.34, <i>p</i> < 0.01) and long-delay cued recall (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.21, <i>p</i> = 0.04) and word pairs delayed recall (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.21, <i>p</i> = 0.04). Children with HR had smaller bilateral whole hippocampus, CA1, DG and right CA3 volumes (<i>p</i>s < 0.05); only the right DG remained significant (<span></span><math> <semantics> <mrow> <mi>β</mi> </mrow> <annotation>$$ beta $$</annotation> </semantics></math> = 0.15, <i>p</i> = 0.04) after intracranial volume adjustment.</p> </section> <section> <h3> Conclusions</h3> <p>Memory and hippocampal volume differences may reflect underlying familial

背景：与健康体重（HW）相比，超重或肥胖儿童（OW/OB）的认知能力和海马体积较低。这是否适用于有家族性OW/OB风险的HW患儿尚不清楚。目的：比较OW/OB高风险（HR）和低风险（LR） HW儿童的记忆表现和海马亚区体积。方法：HW儿童（n = 95，年龄8-11岁），分为HR组（n = 43，父母双方均患有OW/OB）和LR组（n = 52，父母双方均患有HW），采用结构磁共振成像和记忆测试（言语表学习测试-食物-儿童版（VLLT-Food-C）和儿童记忆量表子测试：单词对、点位置）。线性模型测试各组在记忆评分、海马和子区（CA1、CA3、齿状回（DG）、丘下）体积方面的差异。结果：各组在人口统计学上没有差异，除了身体质量指数（HR > LR, p = 0.003），尽管所有儿童都是高体重。LR儿童在VLLT-Food-C短记忆（β $$ beta $$ = 0.34, p β $$ beta $$ = 0.21, p = 0.04）和单词对延迟回忆（β $$ beta $$ = 0.21, p = 0.04）上表现较好。颅内容积调整后，HR患儿双侧海马全区、CA1、DG、右侧CA3体积减小（ps β $$ beta $$ = 0.15, p = 0.04）。结论：记忆和海马体积的差异可能反映了HW儿童OW/OB的潜在家族风险。

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引用次数: 0

Parent Perspectives on the 2023 Clinical Practice Guideline for Pediatric Obesity: A Mixed-Methods Study of Acceptance and Concerns 家长对2023年儿童肥胖临床实践指南的看法：一项接受和关注的混合方法研究

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-10-26 DOI: 10.1111/ijpo.70065

Brooke E. Wagner, Annika B. Kruse, Sarah C. Armstrong, Asheley C. Skinner, Karen A. Scherr

Background

The 2023 Clinical Practice Guideline for pediatric obesity recommends immediate, intensive treatment, including behavioral therapy, medications, and surgery when indicated. Understanding parental agreement with the guideline is critical for successful implementation.

Objective

To evaluate parental awareness of and agreement with the guideline.

Methods

Parents (n = 150; 62.9% female; 75.5% White; M_age = 37.6 ± 7.4 years) completed an online survey assessing guideline awareness and agreement. K-means cluster analysis identified parent subgroups based on agreement patterns. Linear regression examined predictors of agreement (e.g., parent age, BMI). Inductive content analysis explored underlying perspectives.

Results

Few parents (5.3%) were aware of the guideline before the survey. Cluster analysis identified three subgroups: Guideline Skeptics (34%; broadly disagreed), Selective Supporters (28%; mostly agreed but opposed medications and surgery), and Guideline Supporters (38%; broadly agreed). Higher parental BMI predicted lower agreement (β = −0.20, p = 0.018). Qualitative findings added nuance to parents' preference for lifestyle changes, highlighted concerns about mental health and eating disorders, and emphasized parental responsibility in the development and treatment of obesity.

Conclusions

Parental agreement with the guideline varies widely. While most support behavioral treatment, many express concerns about medications and surgery, and a subset of “Guideline Skeptics” reject core principles such as the use of BMI. Tailored implementation strategies are needed to address these diverse views.

背景：2023儿科肥胖临床实践指南建议立即进行强化治疗，包括行为治疗、药物治疗和必要时的手术治疗。理解家长同意指导方针是成功实施的关键。目的：评价家长对该指南的认知度和认同程度。方法：150名家长（女性62.9%，白人75.5%，年龄37.6±7.4岁）完成在线问卷调查，评估家长对指南的认知和认同。K-means聚类分析根据一致性模式确定父子组。线性回归检验了一致性的预测因子（如父母年龄、体重指数）。归纳性内容分析探究了潜在的观点。结果：调查前很少有家长知晓该指南（5.3%）。聚类分析确定了三个亚组：指南怀疑论者（34%；广泛不同意），选择性支持者（28%；大部分同意但反对药物和手术）和指南支持者（38%；广泛同意）。父母BMI越高，一致性越低（β = -0.20, p = 0.018）。定性研究发现，父母对改变生活方式的偏好有细微差别，强调了对心理健康和饮食失调的关注，并强调了父母在肥胖发展和治疗中的责任。结论：家长对指南的认同差异很大。虽然大多数人支持行为治疗，但许多人表达了对药物和手术的担忧，还有一部分“指南怀疑论者”拒绝使用BMI等核心原则。需要量身定制的实施战略来处理这些不同的观点。

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引用次数: 0

Parental Communication in the Prevention and Treatment of Child and Adolescent Obesity: A Position Statement of the European Childhood Obesity Group 父母沟通在预防和治疗儿童和青少年肥胖：欧洲儿童肥胖小组的立场声明。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-10-22 DOI: 10.1111/ijpo.70052

Rebecca Puhl, Sandra Hassink, Julia Lischka, Gabriel Torbahn, Susanne Ring-Dimitriou, Caroline Braet, Elpis Vlachopapadopoulou, Teodora Handjieva-Darlenska, Andrea Vania, Edyta Łuszczki, Dénes Attila Molnár, David Thivel, Daniel Weghuber, Paulina Nowicka

Parental communication plays a critical role in weight-related health of children and adolescents and requires a balanced, thoughtful and supportive approach. The European Childhood Obesity Group (ECOG) convened a panel of experts to discuss the topic of parental communication in the prevention and treatment of child and adolescent obesity, as summarised in this statement. Parental concern about weight is evident, but the lack of parental knowledge about obesity, the impact of weight bias and stigma on their children and adolescents' health behaviours, and the influences of culture, media, and advertising all make communication challenging and problematic for many families. Parents need support and skill building in order to provide a communication environment that is healthy and accepting. Healthcare professionals can model healthy communication styles by focusing on health, building family strengths and supports, asking youth about what words they prefer using to discuss their weight, and acknowledging the multifactorial causes of obesity that reside in the socioecological environment. While parental communication offers a powerful platform for promoting healthy behaviours in youth, it must be handled with care to avoid the harms of stigmatisation and oversimplification of obesity as a reflection of individual lifestyle choices. With appropriate tools, knowledge, skills, and support, parents can be better equipped to engage in supportive dialogue that empowers their children and promotes their health and wellbeing.

父母的沟通在儿童和青少年的体重相关健康中起着至关重要的作用，需要一种平衡、周到和支持的方法。欧洲儿童肥胖小组（ECOG）召集了一个专家小组，讨论父母沟通在预防和治疗儿童和青少年肥胖方面的主题，总结在本声明中。父母对体重的关注是显而易见的，但父母对肥胖缺乏了解，体重偏见和污名对儿童和青少年健康行为的影响，以及文化、媒体和广告的影响，都使许多家庭的沟通充满挑战和问题。父母需要支持和技能培养，以提供一个健康和包容的交流环境。医疗保健专业人员可以通过关注健康，建立家庭力量和支持，询问年轻人他们更喜欢用什么词来讨论他们的体重，并承认存在于社会生态环境中的肥胖的多因素原因来塑造健康的沟通方式。虽然父母的沟通为促进青少年的健康行为提供了一个强有力的平台，但必须谨慎处理，以避免将肥胖污名化和过度简化为个人生活方式选择的反映。有了适当的工具、知识、技能和支持，父母就能更好地参与支持性对话，增强孩子的权能，促进他们的健康和福祉。

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引用次数: 0