Pediatric Obesity最新文献_第3页

Effectiveness of behavioural and psychological interventions for managing obesity in children and adolescents: A systematic review and meta-analysis framed using minimal important difference estimates based on GRADE guidance to inform a clinical practice guideline 管理儿童和青少年肥胖的行为和心理干预的有效性：基于GRADE指南的最小重要差异估计框架的系统回顾和荟萃分析，为临床实践指南提供信息。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-01-16 DOI: 10.1111/ijpo.13193

M. Henderson, S. A. Moore, S. Harnois-Leblanc, B. C. Johnston, D. Fitzpatrick-Lewis, A. M. Usman, D. Sherifali, R. Merdad, A. M. Rigsby, Z. Esmaeilinezhad, K. M. Morrison, J. Hamilton, G. D. C. Ball, C. S. Birken, the Steering Committee for Updating Canada's Clinical Practice Guideline for Managing Pediatric Obesity

Objective

Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) of behavioural and psychological interventions for managing paediatric obesity.

Methods

Eligible studies, published between 1985 and 2022, included 0 to 18 year olds with outcomes reported ≥3 months post-baseline, including patient-reported outcome measures (PROMs), cardiometabolic and anthropometric outcomes, and adverse events (AEs). We pooled data using a random effects model and assessed certainty of evidence (CoE) related to minimally important difference estimates for outcomes using GRADE.

Results

We included 73 unique RCTs (n = 6305 participants, 53% female). Intervention types included physical activity (n = 1437), nutrition (n = 447), psychological (n = 1336), technology-based (n = 901) or multicomponent (≥2 intervention types, n = 2184). Physical activity had a small effect on health-related quality of life (HRQoL), varying effects ranging from moderate to very large on blood pressure, lipids and insulin resistance, and a small effect on BMIz. Nutrition had a small effect on lipids, insulin resistance and BMIz. Psychological interventions showed a small effect on HRQoL and triglycerides and moderate benefits on depressive symptoms, while technology interventions showed small benefits on blood pressure and BMIz. Multicomponent interventions had a large benefit on anxiety, small benefit on depressive symptoms, with large to very large benefits on lipids, and small benefits for diastolic blood pressure, insulin resistance and BMIz. AEs were reported infrequently, and when reported, were described as mild.

Conclusion

Physical activity and multicomponent interventions showed improvements in PROMs, cardiometabolic and anthropometric outcomes. Future trials should consistently measure PROMs, evaluate outcomes beyond the intervention period, and study children <6 years of age.

目的：对行为和心理干预治疗儿童肥胖的随机对照试验（rct）进行系统回顾和荟萃分析。方法：1985年至2022年间发表的符合条件的研究，纳入0至18岁的患者，基线后报告≥3个月的结果，包括患者报告的结果测量（PROMs）、心脏代谢和人体测量结果以及不良事件（ae）。我们使用随机效应模型汇总数据，并使用GRADE评估与结果的最小重要差异估计相关的证据确定性（CoE）。结果：我们纳入了73项独特的随机对照试验（n = 6305名参与者，53%为女性）。干预类型包括身体活动（n = 1437）、营养（n = 447）、心理（n = 1336）、技术（n = 901）或多成分（≥2种干预类型，n = 2184）。体育活动对健康相关生活质量（HRQoL）的影响很小，对血压、血脂和胰岛素抵抗的影响从中等到非常大不等，对bmi的影响很小。营养对血脂、胰岛素抵抗和bmi的影响很小。心理干预对HRQoL和甘油三酯的影响较小，对抑郁症状的影响中等，而技术干预对血压和体重指数的影响较小。多组分干预对焦虑有很大的好处，对抑郁症状有很小的好处，对血脂有很大到很大的好处，对舒张压，胰岛素抵抗和BMIz有很小的好处。ae很少被报道，即使被报道，也被描述为轻微的。结论：体力活动和多组分干预可改善PROMs、心脏代谢和人体测量结果。未来的试验应持续测量PROMs，评估干预期后的结果，并对儿童进行研究

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引用次数: 0

Association between body mass index at birth and neonatal health outcomes in preterm infants: A retrospective analysis 早产儿出生时体重指数与新生儿健康结局的关系：一项回顾性分析

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-01-14 DOI: 10.1111/ijpo.13203

Chuntian Liu, Yijia Chen, Mengqing Pan, Xiaoyu Lu, Jianhong Xu, Xiaochun Chen

Background

Studies on how birth body mass index (BMI) affects health outcomes in preterm infants are relatively limited.

Aim

To analyze the association between BMI at birth and neonatal health outcomes in extremely low and very low birth weight preterm infants in China.

Methods

Used data from the Chinese Premature Infant Informatization Platform (2022–2023). Preterm infants were categorized based on their birth BMI z-scores into three groups: low BMI group (< −2), normal BMI group (−2 to 2) and high BMI group (>2). The relationship between BMI and neonatal health outcomes was then analyzed.

Results

The final analysis included 1662 extremely low and very low birth weight preterm infants. The results indicated that low BMI was significantly associated with an increased risk of respiratory distress syndrome (RDS) (AOR 1.61, 95% CI 1.31–2.30), bronchopulmonary dysplasia (BPD) (AOR 1.34, 95% CI 1.00–1.80) and necrotizing enterocolitis (NEC) (AOR 1.57, 95% CI 1.01–2.42). High BMI was significantly associated with an increased risk of RDS (AOR 1.60, 95% CI 1.05–2.45).

Conclusions

BMI at birth is significantly associated with the risks of RDS, BPD and NEC in ELBW and VLBW, highlighting the importance of monitoring BMI as an additional risk predictor in a population of neonates already at high risk for adverse outcomes.

背景：关于出生体重指数（BMI）如何影响早产儿健康结局的研究相对有限。目的：分析中国极低和极低出生体重早产儿出生时体重指数与新生儿健康结局的关系。方法：使用中国早产儿信息化平台（2022-2023）数据。根据早产儿出生时BMI z-score分为3组：低BMI组（< -2）、正常BMI组（-2 ~ 2）和高BMI组（bb0 2）。然后分析BMI与新生儿健康结局之间的关系。结果：最终分析了1662例极低和极低出生体重早产儿。结果显示，低BMI与呼吸窘迫综合征（RDS）（AOR 1.61, 95% CI 1.31-2.30）、支气管肺发育不良（BPD）（AOR 1.34, 95% CI 1.00-1.80）和坏死性小肠结肠炎（NEC）（AOR 1.57, 95% CI 1.01-2.42）的风险增加显著相关。高BMI与RDS风险增加显著相关（AOR 1.60, 95% CI 1.05-2.45）。结论：出生时的BMI与ELBW和VLBW中RDS、BPD和NEC的风险显著相关，强调了在已经处于不良结局高风险的新生儿群体中监测BMI作为额外风险预测因子的重要性。

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引用次数: 0

Prenatal exposure to particulates and anthropometry through 9 years of age in a birth cohort 出生队列中9岁前的产前颗粒物暴露和人体测量。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-01-09 DOI: 10.1111/ijpo.13202

Ian R. Trees, Abhisek Saha, Diane L. Putnick, Priscilla K. Clayton, Pauline Mendola, Rajeshwari Sundaram, Edwina H. Yeung

Background

Previous research observed links between prenatal air pollution and risk of childhood obesity but the timing of the exposure is understudied. Aim: We examined prenatal particulate matter (PM₁₀, PM_2.5) exposure and child anthropometry.

Materials & Methods

Children's body mass index z-scores (zBMI) at 0–3 (N = 4370) and 7–9 (n = 1191) years were derived from reported anthropometry at paediatric visits. We ran linear mixed models for six windows, adjusting for maternal, child, and neighbourhood factors.

Results

PM₁₀ exposure across pregnancy and at multiple windows was associated with higher zBMI in both early and middle childhood. For instance, one interquartile range increase in PM₁₀ exposure during the first 2 weeks of pregnancy was associated with higher zBMI at 0–3 (0.05, 95% CI: 0.01, 0.10) and 7–9 (0.14, 95% CI: 0.02, 0.23). PM_2.5 exposure during the final 2 weeks of gestation was associated with higher zBMI at 7–9 years (B: 0.12, 95% CI: 0.04, 0.22).

Conclusion

Even at low levels of air pollution, prenatal PM₁₀ exposure was associated with higher zBMI in childhood.

背景：先前的研究发现了产前空气污染与儿童肥胖风险之间的联系，但暴露的时间尚未得到充分研究。目的：我们检查了产前颗粒物（PM10, PM2.5）暴露和儿童人体测量。材料与方法：0-3岁（N = 4370）和7-9岁（N = 1191）儿童身体质量指数z-分数（zBMI）来源于儿科就诊时报告的人体测量数据。我们运行了六个窗口的线性混合模型，调整了母亲、儿童和邻里因素。结果：PM10在怀孕期间和多个窗口暴露与儿童早期和中期较高的zBMI有关。例如，怀孕前两周PM10暴露增加一个四分位数范围与0-3 （0.05,95% CI: 0.01, 0.10）和7-9 （0.14,95% CI: 0.02, 0.23）较高的zBMI相关。妊娠最后2周暴露于PM2.5与7-9岁时较高的zBMI相关（B: 0.12, 95% CI: 0.04, 0.22）。结论：即使在低水平的空气污染下，产前PM10暴露与儿童时期较高的zBMI有关。

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引用次数: 0

Associations between parent and adolescent weight outcomes within two parent approaches to family-based adolescent obesity treatment: Secondary analyses from the TEENS+ pilot trial 基于家庭的青少年肥胖治疗的两种父母方法中父母和青少年体重结果之间的关联：来自TEENS+试点试验的二次分析。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-01-07 DOI: 10.1111/ijpo.13198

Kristina L. Tatum, Katlyn Garr, Elizabeth L. Adams, Laura J. Caccavale, Edmond P. Wickham III, Jessica Gokee LaRose, Suzanne E. Mazzeo, Hollie A. Raynor, Melanie K. Bean

Objective

To examine associations between parent and adolescent weight change within two parent approaches to adolescent obesity treatment.

Methods

Adolescent (M_age = 13.7 ± 1.2 years; M_BMI = 34.9 ± 7.0 kg/m²) and parent (M_BMI = 36.4 ± 7.3 kg/m²) dyads (N = 82) were randomized to TEENS+Parents as Coaches (PAC) or TEENS+parent weight loss (PWL). Anthropometrics were assessed at baseline (0-month), 4 months (post) and 7 months (after 3-month maintenance period). Regression analyses examined associations between parent and adolescent ΔBMI_0-4m and ΔBMI_4-7m, with parent group as a moderator.

Results

Post-treatment, parent and adolescent ∆BMI_0-4m were positively related (β = 0.68, p < 0.001), with no group interaction. Parent and adolescent ΔBMI_4-7m were related (β = 0.48, p = 0.012) during maintenance, moderated by parent group (β = −0.49, p = 0.010): positive relationships persisted in PAC (β = 0.39, p = 0.011), but not PWL (β = −0.19, p = 0.211).

Discussion

Parent and adolescent weight changes were positively related during treatment in both parent groups. During maintenance, weight change associations persisted only in PAC. These patterns prompt further exploration of parent factors driving weight change relationships.

目的：探讨两种父母治疗青少年肥胖的方法中父母与青少年体重变化之间的关系。方法：青少年(年龄= 13.7±1.2岁；MBMI = 34.9±7.0 kg/m2)和父母（MBMI = 36.4±7.3 kg/m2）二组（N = 82）随机分为青少年+父母作为教练组（PAC）和青少年+父母减肥组（PWL）。在基线（0个月）、4个月（术后）和7个月（3个月维持期后）对人体测量进行评估。回归分析检验了父母与青少年ΔBMI0-4m和ΔBMI4-7m之间的关系，父母组是一个调节因素。结果：治疗后维持期间，父母与青少年的∆BMI0-4m呈正相关（β = 0.68, p = 0.48, p = 0.012），受父母组的调节（β = -0.49, p = 0.010）； PAC持续呈正相关（β = 0.39, p = 0.011）， PWL无显著正相关（β = -0.19, p = 0.211）。讨论：在治疗期间，父母和青少年体重变化呈正相关。在维持期间，体重变化关联仅在PAC中持续存在。这些模式促使进一步探索驱动体重变化关系的母体因素。

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引用次数: 0

The long-term effects of a school-based intervention on preventing childhood overweight: Propensity score matching analysis within the Generation R Study cohort

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-01-06 DOI: 10.1111/ijpo.13200

Famke J. M. Mölenberg, Michel S. Smit, Daan Nieboer, Trudy Voortman, Wilma Jansen

Background

This study investigated the long-term impact of the primary school-based multicomponent lifestyle intervention “Lekker Fit!” (LF) on obesity-related outcomes, and studied whether the impact differed between population subgroups.

Methods

Children from the Generation R Study (Rotterdam, the Netherlands) were categorized into the LF group (6 years exposure, between the ages 6/7 to 12/13 years) or regular school group (no exposure). BMI and DXA-derived fat mass were assessed after 4 years of intervention (age 10 years), and 1.5 years post-intervention (age 14 years). A propensity score matching model was fitted to examine the intervention effect on BMI-z-score and percent fat mass, and we tested for differences by sex, pre-intervention weight status, ethnic background, and income.

Results

We found no effect on BMI-z-score [0.06 (95% confidence interval [CI]: −0.04 to 0.17)] and percent fat mass (0.4%-point [95% CI: −0.2 to 1.1]) after 4 years of intervention. 1.5 years post-intervention and after 6 years of exposure, BMI-z-score (0.11 [95% CI: 0.00–0.22]) and percent fat mass (1.1%-point [95% CI: 0.2–1.9]) were significantly higher for children in the LF group. No subgroup differences were found.

Conclusion

Findings suggest the need for obesity prevention programs that extend beyond primary education.

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引用次数: 0

Acute simulated weight gain might not increase the energy cost of walking in adolescents with obesity. 急性模拟体重增加可能不会增加肥胖青少年步行的能量消耗。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-12-30 DOI: 10.1111/ijpo.13197

D Thivel, G Ennequin, J Siroux, A Couret, D Beraud, B Pereira, M Duclos, S Lazzer, Y Boirie, L Isacco

Introduction: This work aims at evaluating the adaptations of the energy cost of walking (Cw) to simulated weight gain at different walking speeds in adolescents with obesity.

Methods: Substrate use and Cw were evaluated during a graded walking exercise (4 × 5min at 0.75, 1, 1.25, 1.5 m.s^-1) performed under three randomized body weight conditions (BW-conditions): (i) at the adolescents' body weight (BW + 0%) or with a simulated weight gain of (ii) 5%(BW + 5%) and (iii) 10%(BW + 10%), in 18 adolescents with obesity (14.2 ± 1.4 years, BMI:33.86 ± 2.55 kg.m-²). Body composition was assessed by absorptiometry and perceived exertion rated after every walking speed stage.

Results: EE in absolute or relative to BW and FFM was different between BW-conditions (p = 0.017, 0.006 and 0.007, respectively) being lower on BW + 5% than BW + 10%. Gross Cw (absolute, relative to BW and fat-free mass) showed overall speed (p < 0.001) and BW-conditions effects, being lower on BW + 5% compared with BW + 10% (p < 0.001). Net Cw (absolute, relative to BW and fat-free mass) showed a significant speed effect (<0.001) but no BW-conditions nor interaction effect.

Conclusion: While EE and Cw have been shown to decrease in response to weight loss, potentially as a way to save stored energy and limit further weight loss, inverse adaptations do not seem to occur with increased acute simulated weight gain in weight stable adolescents with obesity.

摘要：本研究旨在评估肥胖青少年在不同步行速度下步行能量消耗（Cw）对模拟体重增加的适应性。方法：对18名肥胖青少年（14.2±1.4岁，BMI:33.86±2.55 kg.m-2）在三种随机体重条件（BW条件）下(i)体重（体重+ 0%）或模拟体重增加（ii） 5%（体重+ 5%）和（iii） 10%（体重+ 10%）进行分级步行运动（4 × 5min, 0.75、1、1.25、1.5 m- s-1）时进行底物使用和Cw进行评估。在每个步行速度阶段后，通过吸收测定法评估身体成分和感知运动强度。结果：不同BW条件下，EE的绝对或相对于BW和FFM有差异（p分别为0.017,0.006和0.007），BW + 5%比BW + 10%低。总代谢速率（绝对，相对于体重和无脂质量）显示出总体速度(p)。结论：虽然EE和代谢速率在体重减轻后会下降，这可能是一种节省储存能量和限制进一步体重减轻的方式，但在体重稳定的肥胖青少年中，急性模拟体重增加似乎不会发生反向适应。

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引用次数: 0

Adolescent experiences of weight-related communication: Sociodemographic differences and the role of parents 青少年体重相关沟通的经验：社会人口统计学差异和父母的角色。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-12-19 DOI: 10.1111/ijpo.13196

Leah M. Lessard, Rui Wu, Rebecca M. Puhl, Gary D. Foster, Michelle I. Cardel

Background

Weight-related conversations are common between adolescents and parents. However, there is limited understanding of how these conversations vary across sociodemographic groups, such as sex, sexual orientation, race/ethnicity, or parents' level of education. This study assessed the prevalence of weight-related communication among adolescents and parents across sociodemographic characteristics, and identified adolescents' preferred sources for these discussions.

Methods

Quantitative data were collected through online surveys from two independent U.S. samples: adolescents aged 10–17 years of age (N = 2032), and parents of children aged 10–17 years of age (N = 1936). Frequency and sources of weight-related communication were assessed. Sociodemographic factors were analysed for their associations with these communication patterns.

Results

While few differences emerged based on race/ethnicity or grade level, significant variation was observed for sex, sexual orientation, and parental education. Girls, sexual minority youth, high school students, and those with college-educated parents were more likely to communicate about their own weight, whereas boys were more likely to comment on others' weight. Most adolescents preferred healthcare professionals (71%) and parents (69%) for these conversations, although sexual minority youth preferred mental health professionals considerably more than parents. Among parents, 77% discussed their child's weight, with fathers and Latinx parents engaging more frequently in these conversations, and Black parents engaging least frequently.

Conclusion

Weight-related communication is prevalent among adolescents and parents, with variation across sociodemographic characteristics. As healthcare professionals and parents were identified as the preferred sources for weight-related communication by adolescents across sociodemographic groups, it is important that paediatricians and parents are equipped to engage in these conversations without imparting stigma.

背景：与体重相关的对话在青少年和父母之间很常见。然而，对于这些对话在不同的社会人口统计学群体（如性别、性取向、种族/民族或父母的教育水平）之间的差异，人们的理解有限。本研究评估了青少年和父母之间体重相关交流的流行程度，并确定了青少年对这些讨论的首选来源。方法：通过在线调查收集两个独立的美国样本的定量数据：10-17岁青少年（N = 2032）和10-17岁儿童的父母（N = 1936）。评估了与体重相关的通信频率和来源。分析了社会人口因素与这些通信模式的关系。结果：虽然种族/民族或年级水平的差异很小，但性别、性取向和父母教育程度的差异很大。女孩、性少数青年、高中生和父母受过大学教育的人更有可能谈论自己的体重，而男孩更有可能评论别人的体重。大多数青少年更喜欢医疗保健专业人员（71%）和父母（69%）进行这些谈话，尽管性少数青年更喜欢心理健康专业人员而不是父母。在父母中，77%的人讨论过孩子的体重，父亲和拉丁裔父母更频繁地参与这些对话，黑人父母参与的频率最低。结论：体重相关的沟通在青少年和父母中普遍存在，但在不同的社会人口统计学特征中存在差异。由于医疗保健专业人员和家长被确定为跨社会人口统计群体青少年体重相关交流的首选来源，儿科医生和家长有能力参与这些对话而不被污名化是很重要的。

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引用次数: 0

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-12-18 DOI: 10.1111/ijpo.13195

Claudia Strugnell, Cadeyrn J. Gaskin, Denise Becker, Liliana Orellana, Michelle Jackson, Monique Hillenaar, Jillian Whelan, Andrew D. Brown, Vicki Brown, Colin Bell, Josh Hayward, Lena D. Stephens, Hayley Jensen, Izzy Gribben, Lee Coller, Diana Tatlock, Elizabeth Lehman, Steven Allender

Background

During the coronavirus disease 2019 (COVID-19) pandemic, the Australian state of Victoria (in particular, its capital, Melbourne) experienced some of the longest lockdowns in the world.

Objective

This repeated cross-sectional study examined changes between March to June 2019 (pre-pandemic) and April to August 2022 (6 to 11 months following pandemic-related lockdowns) in overweight and obesity prevalence, physical activity, sedentary behaviour, sleep, diet quality, and health-related quality of life (HRQoL) among primary school children in north-east Victoria, Australia.

Methods

Height and weight were measured for Grade 2, 4, and 6 students in 2019 (3889 children) and 2022 (1816 children). Grade 4 and 6 students self-reported on their movement behaviours, diet quality, and HRQoL.

Results

Participation declined among schools (2019:56%, 2022:34%) and students (2019:87%, 2022:75%). Compared to children in 2019, children in 2022 had a higher prevalence of overweight and obesity; were less likely to have met guidelines for moderate-to-vigorous physical activity, recreational screen time, and vegetable consumption; had higher intakes of takeaway food, energy-dense nutrient-poor snacks, and sugar-sweetened beverages; and had lower HRQoL.

Conclusion

Children's health-related behaviours and outcomes seemed not to have returned to pre-pandemic levels 6 to 11 months after the final lockdowns lifted for their communities. Continued monitoring and interventions targeting the drivers of childhood obesity are urgently needed.

背景：在2019年冠状病毒病（COVID-19）大流行期间，澳大利亚维多利亚州（特别是其首府墨尔本）经历了世界上最长的一次封锁。目的：这项重复横断面研究调查了2019年3月至6月（大流行前）和2022年4月至8月（大流行相关封锁后6至11个月）澳大利亚维多利亚州东北部小学生在超重和肥胖患病率、身体活动、久坐行为、睡眠、饮食质量和健康相关生活质量（HRQoL）方面的变化。方法：分别于2019年（3889名）和2022年（1816名）测量二年级、四年级和六年级学生的身高和体重。四年级和六年级学生自我报告运动行为、饮食质量和HRQoL。结果：学校（2019:56%,2022:34%）和学生（2019:87%,2022:75%）的参与率下降。与2019年的儿童相比，2022年的儿童超重和肥胖患病率更高；不太可能达到中度到剧烈体育活动、娱乐屏幕时间和蔬菜消费的指导方针；摄入更多的外卖食品、高能量、低营养的零食和含糖饮料；HRQoL较低。结论：在最终解除对社区的封锁后6至11个月，儿童的健康相关行为和结果似乎没有恢复到大流行前的水平。迫切需要针对儿童肥胖的驱动因素继续进行监测和干预。

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引用次数: 0

Impact of prenatal exposure to delta 9-tetrahydrocannabinol and cannabidiol on birth size and postnatal growth trajectories 产前暴露于δ 9-四氢大麻酚和大麻二酚对出生尺寸和出生后生长轨迹的影响。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-12-16 DOI: 10.1111/ijpo.13187

Brianna F. Moore, Noel T. Mueller, Wei Perng, Katherine A. Sauder, Emily T. Hébert, Adrienne T. Hoyt, Erica M. Wymore, Kristen E. Boyle, Emily J Su, Allison L. B. Shapiro, Gregory Kinney, Cristina Sempio, Jost Klawitter, Uwe Christians, Dana Dabelea

Background

Prenatal exposure to cannabis (or more specifically, delta 9-tetrahydrocannabinol [Δ9-THC]) has been consistently linked to low birthweight. Animal models further show that Δ9-THC is associated with rapid postnatal growth. Whether this association is modified by breastfeeding is unknown.

Methods

In this exploratory study, we followed 128 mother–child pairs through 3 years. Urinary Δ9-THC and cannabidiol (CBD) were measured mid-gestation. Generalized linear models estimated the associations between Δ9-THC and neonatal body composition. A mixed-effects model estimated the association between Δ9-THC and body mass index (BMI) z-score trajectories. Interaction was assessed by a three-way product term (Δ9-THC × breastmilk months × age).

Results

Fifteen children (12%) had Δ9-THC exposure; three had concomitant CBD exposure. Prenatal exposure to Δ9-THC alone was associated with lower fat mass (−95 g, 95% confidence interval [CI]: −174, −14) and neonatal adiposity (−2.1%; 95% CI: −4.2, −0.4) followed by rapid postnatal growth (0.42 increase in BMI z-score per square root year; 95% CI: 0.12, 0.72). Breastfeeding modified this association (p = 0.04), such that growth was similar for those breastfed for 5 months whereas a shorter duration of breastfeeding was associated with 1.1 higher BMI z-score at 3 years (95% CI: 0.21, 2.05).

Conclusions

Our study suggests that prenatal exposure to Δ9-THC may alter early-life growth. Breastfeeding may stabilize rapid postnatal growth, but the impact of lactational exposure requires further investigation.

背景：产前接触大麻（或更具体地说，δ 9-四氢大麻酚[Δ9-THC]）一直与低出生体重有关。动物模型进一步表明Δ9-THC与产后快速生长有关。这种关联是否会因母乳喂养而改变尚不清楚。方法：采用探索性研究方法，对128对母子进行为期3年的随访。妊娠中期测量尿Δ9-THC和大麻二酚（CBD）。广义线性模型估计Δ9-THC和新生儿身体组成之间的关系。混合效应模型估计了Δ9-THC和身体质量指数（BMI） z得分轨迹之间的关联。相互作用的评估采用三方产品项（Δ9-THC ×母乳月龄×年龄）。结果：15名儿童（12%）有Δ9-THC暴露；其中三人同时接触了CBD。产前单独暴露于Δ9-THC与较低的脂肪量（-95 g， 95%可信区间[CI]: -174， -14）和新生儿肥胖(-2.1%；95% CI: -4.2, -0.4)，随后是产后快速生长(BMI z-score每平方根年增加0.42；95% ci: 0.12, 0.72)。母乳喂养改变了这一关联（p = 0.04），因此母乳喂养5个月的婴儿的生长情况相似，而母乳喂养时间较短的婴儿在3岁时的BMI z评分高1.1 （95% CI: 0.21, 2.05）。结论：我们的研究表明，产前暴露于Δ9-THC可能会改变生命早期的生长。母乳喂养可以稳定产后快速生长，但哺乳期暴露的影响需要进一步调查。

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引用次数: 0

Oxidized high-density lipoprotein and low-density lipoprotein in adolescents with obesity and metabolic dysfunction-associated steatotic liver disease 氧化高密度脂蛋白和低密度脂蛋白与青少年肥胖和代谢功能障碍相关的脂肪变性肝病

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-12-16 DOI: 10.1111/ijpo.13194

Alyssa M. Bartlett, Ali M. Boone, Jordan A. Bays, Youngsil Kim, Sirish K. Palle, Kevin R. Short

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common in the pediatric population and may increase risk for developing cardiovascular disease (CVD) in people with MASLD. Oxidized high-density lipoprotein (oxHDL) and oxidized low-density lipoprotein (oxLDL) are modified, pro-atherosclerotic lipoproteins that are increased in adults with MASLD and CVD but have not been reported in adolescents with MASLD.

Purpose

To determine if oxLDL and oxHDL are increased in adolescents with MASLD.

Methods

Fasting oxHDL and oxLDL were measured in adolescents (11–20 years) with obesity and biopsy-confirmed MASLD (n = 47), and peers without MASLD but with obesity (Ob; n = 28), or normal weight (NW; n = 29).

Results

oxHDL was 27% higher (p < 0.05) in the MASLD group (mean ± SD: 11.9 ± 4.7 ng/mL) compared to the Ob group (9.3 ± 3.7 ng/mL, p < 0.05) but only 7% higher than the NW group (11.1 ± 3.8 ng/mL, p > 0.05). However, HDL-C was 19% and 32% lower in the MASLD group than in the Ob and NW groups, respectively. Thus, oxHDL/HDL-C ratio was 55% and 66% higher in MASLD compared to the Ob group (p < 0.004) and the NW group (p < 0.001), respectively. oxLDL (52.4 ± 16.0, 46.7 ± 10.1 and 47.1 ± 15.2 U/L for MASLD, Ob and NW, respectively), LDL-C and the oxLDL/LDL-C ratio did not differ among groups.

Conclusions

The elevated oxHDL and oxHDL/HDL-C in adolescents with MASLD compared to peers with Ob or NW suggests that there is some oxidative stress in MASLD independent of obesity and potential for increased CVD risk in the future.

背景：代谢功能障碍相关的脂肪变性肝病（MASLD）在儿科人群中越来越常见，并可能增加MASLD患者发生心血管疾病（CVD）的风险。氧化高密度脂蛋白（oxHDL）和氧化低密度脂蛋白（oxLDL）是经过修饰的促动脉粥样硬化脂蛋白，在成人MASLD和CVD患者中升高，但在青少年MASLD患者中未见报道。目的：确定青少年MASLD患者oxLDL和oxHDL是否升高。方法：对肥胖和活检证实的MASLD青少年（n = 47）和无MASLD但肥胖的同龄人（n = 47）进行空腹oxHDL和oxLDL测定。n = 28)或正常体重(NW；n = 29)。结果：oxHDL升高27% （p < 0.05）。然而，MASLD组的HDL-C分别比Ob组和NW组低19%和32%。因此，与Ob组相比，MASLD的oxHDL/HDL-C比值分别高出55%和66% (p结论：与Ob或NW组相比，MASLD青少年的oxHDL和oxHDL/HDL-C升高表明MASLD中存在一些独立于肥胖的氧化应激，并可能增加未来心血管疾病的风险。

{"title":"Oxidized high-density lipoprotein and low-density lipoprotein in adolescents with obesity and metabolic dysfunction-associated steatotic liver disease","authors":"Alyssa M. Bartlett, Ali M. Boone, Jordan A. Bays, Youngsil Kim, Sirish K. Palle, Kevin R. Short","doi":"10.1111/ijpo.13194","DOIUrl":"10.1111/ijpo.13194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common in the pediatric population and may increase risk for developing cardiovascular disease (CVD) in people with MASLD. Oxidized high-density lipoprotein (oxHDL) and oxidized low-density lipoprotein (oxLDL) are modified, pro-atherosclerotic lipoproteins that are increased in adults with MASLD and CVD but have not been reported in adolescents with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine if oxLDL and oxHDL are increased in adolescents with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fasting oxHDL and oxLDL were measured in adolescents (11–20 years) with obesity and biopsy-confirmed MASLD (<i>n</i> = 47), and peers without MASLD but with obesity (Ob; <i>n</i> = 28), or normal weight (NW; <i>n</i> = 29).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>oxHDL was 27% higher (<i>p</i> < 0.05) in the MASLD group (mean ± SD: 11.9 ± 4.7 ng/mL) compared to the Ob group (9.3 ± 3.7 ng/mL, <i>p</i> < 0.05) but only 7% higher than the NW group (11.1 ± 3.8 ng/mL, <i>p</i> > 0.05). However, HDL-C was 19% and 32% lower in the MASLD group than in the Ob and NW groups, respectively. Thus, oxHDL/HDL-C ratio was 55% and 66% higher in MASLD compared to the Ob group (<i>p</i> < 0.004) and the NW group (<i>p</i> < 0.001), respectively. oxLDL (52.4 ± 16.0, 46.7 ± 10.1 and 47.1 ± 15.2 U/L for MASLD, Ob and NW, respectively), LDL-C and the oxLDL/LDL-C ratio did not differ among groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The elevated oxHDL and oxHDL/HDL-C in adolescents with MASLD compared to peers with Ob or NW suggests that there is some oxidative stress in MASLD independent of obesity and potential for increased CVD risk in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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