Pediatric Obesity最新文献_第5页

Racial Disparities in Paediatric Metabolic and Bariatric Surgery: An MBSAQIP Analysis 儿科代谢和减肥手术的种族差异：MBSAQIP分析。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-21 DOI: 10.1111/ijpo.70045

Zachary Ballinger, Jonathan Green, Muriel Cleary, Kaitlyn Wong, Nicole Cherng, Jeremy Aidlen

Objective

To evaluate disparities in paediatric metabolic and bariatric surgery (MBS) and examine the effects of recent policy changes on access and outcomes.

Study Design

Adolescents aged 10–18 who underwent MBS between 2017 and 2023 were identified using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use Files. Trends by race and ethnicity and clinical outcomes were assessed using univariate comparisons and multivariable logistic regression.

Results

A total of 4940 paediatric patients underwent MBS from 2017 to 2023. The cohort was 71% female, 60% white, and had a mean age of 17.1 years. Female representation declined by approximately 1.1% annually. Hispanic patients comprised 32% of cases, with an average yearly increase of 1.1%. Black patient representation increased from 14% in 2017 to 24% in 2023. Asian, American Indian, and Pacific Islander patients accounted for only 1.5% of cases. Black patients were younger, had higher preoperative BMIs, and more frequently presented with comorbidities including diabetes and sleep apnoea. Hispanic patients had higher rates of hypertension, hyperlipidemia, and sleep apnoea than non-Hispanics. Robotic procedures were more common among Black patients, while Roux-en-Y gastric bypass was more frequent among white patients. Surgical outcomes were similar across racial groups. However, multivariable analysis showed that female patients had increased odds of postoperative complications and emergency department (ED) visits (aOR 1.54 and 2.74, respectively), and Hispanic patients had higher odds of ED visits (aOR 1.32).

Conclusions

While MBS use is diversifying, disparities persist. Black and Hispanic youth face higher comorbidity burdens, indicating possible delayed access to surgery.

目的：评估儿科代谢和减肥手术（MBS）的差异，并检查近期政策变化对获取和结果的影响。研究设计：使用代谢和减肥手术认证和质量改进计划（MBSAQIP）参与者使用文件确定2017年至2023年间接受MBS的10-18岁青少年。使用单变量比较和多变量逻辑回归评估种族和民族的趋势和临床结果。结果：2017年至2023年，共有4940名儿科患者接受了MBS。该队列71%为女性，60%为白人，平均年龄为17.1岁。女性代表每年下降约1.1%。西班牙裔患者占32%，年均增长1.1%。黑人患者的比例从2017年的14%上升到2023年的24%。亚裔、美洲印第安人和太平洋岛民患者仅占病例的1.5%。黑人患者更年轻，术前bmi更高，并且更经常出现合并症，包括糖尿病和睡眠呼吸暂停。西班牙裔患者的高血压、高脂血症和睡眠呼吸暂停的发病率高于非西班牙裔患者。机器人手术在黑人患者中更常见，而Roux-en-Y胃旁路手术在白人患者中更常见。不同种族的手术结果相似。然而，多变量分析显示，女性患者术后并发症和急诊科（ED）就诊的几率增加（aOR分别为1.54和2.74），西班牙裔患者ED就诊的几率更高（aOR为1.32）。结论：虽然MBS的使用是多样化的，但差异仍然存在。黑人和西班牙裔青年面临更高的合并症负担，表明可能延迟获得手术。

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引用次数: 0

Association Between Caffeine and Nicotine Use and Optimal Obesity Measures for Adolescents: A Refugee Adolescent Study 青少年使用咖啡因和尼古丁与最佳肥胖措施之间的关系：一项难民青少年研究。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-17 DOI: 10.1111/ijpo.70042

Basma Damiri, Hamza Abdul-Hafez, Motaz Saifi

Background

The weight impact of caffeine and nicotine use by adolescents, unlike adults, has not been conclusively determined. The prevalence of obesity among adolescents, especially in vulnerable populations such as refugee adolescents, is a crucial public health concern. The study aimed to investigate the prevalence of central obesity and its associated risk factors among refugee adolescents.

Methods

This cross-sectional study was conducted in 2022 on refugee teenagers aged 11–15 in four refugee camps in West Bank. Data was collected through surveys and anthropometric measurements to assess waist circumference, waist-to-hip ratio and body mass index. Statistical analyses evaluated the relationship between caffeine and nicotine use and central obesity measures while accounting for potential confounders.

Results

A total of 454 participants (51.3% boys, 48.7% girls) were included in the study. The median age was 14.49 years, with a median BMI of 21.7. The prevalence of overweight and obesity was 24% and 21.1%, respectively. 14.1% had high waist circumferences. The study found significant associations between central obesity and cigarette smoking (p = 0.03), waterpipe smoking (p = 0.008) and energy drink (p = 0.016) and coffee (p = 0.027) consumption. Adjusted multiple logistic regression revealed an association between overweight status and energy drink consumption (AOR = 3.035, p = 0.009) and the interaction between energy drink and coffee consumption (AOR = 3.924, p = 0.010). Obese status showed a significant association with waterpipe smoking (AOR = 2.975, p = 0.021).

Conclusion

Obesity is a significant health concern among Palestinian refugee adolescents, with various factors contributing to its prevalence. Central obesity, in particular, is associated with increased health risks, emphasising the importance of identifying its determinants, including caffeine and nicotine use among adolescents.

背景：与成年人不同，青少年使用咖啡因和尼古丁对体重的影响尚未得到最终确定。青少年，特别是难民青少年等弱势群体中肥胖的流行是一个重要的公共卫生问题。本研究旨在调查难民青少年中中心性肥胖的患病率及其相关危险因素。方法：本横断面研究于2022年对西岸四个难民营中11-15岁的难民青少年进行。数据收集通过调查和人体测量来评估腰围，腰臀比和身体质量指数。统计分析评估了咖啡因和尼古丁使用与中枢性肥胖测量之间的关系，同时考虑了潜在的混杂因素。结果：共纳入454名参与者（51.3%的男孩，48.7%的女孩）。中位年龄为14.49岁，中位BMI为21.7。超重和肥胖的患病率分别为24%和21.1%。14.1%的人腰围高。研究发现，中心性肥胖与吸烟（p = 0.03）、吸烟（p = 0.008）、饮用能量饮料（p = 0.016）和咖啡（p = 0.027）之间存在显著关联。调整后的多元logistic回归显示，超重状态与能量饮料消费之间存在相关性（AOR = 3.035, p = 0.009），能量饮料与咖啡消费之间存在交互作用（AOR = 3.924, p = 0.010）。肥胖状况与水烟吸烟有显著相关性（AOR = 2.975, p = 0.021）。结论：肥胖是巴勒斯坦难民青少年的一个重大健康问题，其流行有多种因素。特别是中心性肥胖与健康风险增加有关，强调了确定其决定因素的重要性，包括青少年对咖啡因和尼古丁的使用。

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引用次数: 0

The Association of Eating Behaviours, and Self-Concept, With Weight Status of Indian Adolescents 印度青少年饮食行为和自我概念与体重状况的关系。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-17 DOI: 10.1111/ijpo.70044

Shivangi Choudhary, Anmol Bhandari, Suninder Tung, Gurcharan Kaur

Background

The epidemiological and sociocultural context of Indian adolescents is rapidly changing, thus affecting their eating behaviours and increasing overweight and obesity prevalence.

Objectives

The current study was aimed at exploring associations of problematic eating behaviours and self-concept with overweight/obesity in adolescents.

Methods

This cross-sectional study was conducted in six schools in Punjab, India, and enrolled 538 randomly selected adolescents aged 10–16 years. The cut-off of > 23rd adult equivalent BMI for overweight/obesity and < 23rd adult equivalent for healthy weight (IAP, 2015) was used. The Three-Factor Eating Questionnaire Revised 18-item version and Piers-Harris Self-Concept Scale were used. Pearson's correlation coefficient was used to quantify linear relationships among eating behaviours, self-concept and BMI-based weight status. An independent t-test was applied to determine eating behaviour and self-concept variations.

Results

Eating behaviour such as cognitive restraint showed a statistically significant positive correlation with BMI in adolescents (p ≤ 0.001). Higher cognitive restraint significantly increased the probability of being overweight/obese (odds ratio [OR] = 1.153; 95% confidence interval [CI] 1.097–1.211). Physical appearance (PHY) and happiness and satisfaction (HAP) domains of adolescents' self-concept showed a significant negative correlation with BMI. In girls, the domain of social acceptance (SOC) showed a significant negative correlation with BMI.

Conclusion

The study highlights the relationship of overweight/obesity with certain aspects of problematic eating behaviours as well as self-concept in adolescents. These findings warrant further longitudinal studies to establish causality, which may provide a comprehensive understanding of the epidemic of adolescent overweight/obesity in India.

背景：印度青少年的流行病学和社会文化背景正在迅速变化，从而影响了他们的饮食行为，增加了超重和肥胖的患病率。目的：本研究旨在探讨青少年问题饮食行为和自我概念与超重/肥胖的关系。方法：本横断面研究在印度旁遮普省的6所学校进行，随机抽取538名10-16岁的青少年。结果：青少年的饮食行为如认知约束与BMI呈统计学显著正相关（p≤0.001）。较高的认知约束显著增加超重/肥胖的概率(优势比[OR] = 1.153；95%置信区间[CI] 1.097-1.211)。青少年自我概念的外形（Physical appearance， PHY）和快乐与满意（happiness and satisfaction， HAP）域与BMI呈显著负相关。在女孩中，社会接受域（SOC）与BMI呈显著负相关。结论：该研究强调了超重/肥胖与青少年问题饮食行为的某些方面以及自我概念的关系。这些发现支持进一步的纵向研究，以确定因果关系，这可能提供对印度青少年超重/肥胖流行的全面了解。

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引用次数: 0

Mediating Effect of Infant Rapid Weight Gain on the Association Between Exclusive Breastfeeding and the Risk of Obesity Later in Life 婴儿体重快速增加在纯母乳喂养与后期肥胖风险之间的中介作用。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-14 DOI: 10.1111/ijpo.70039

Carlos Nagore González, Iris Iglesia Altaba, Cristina Guillén Sebastián, Maria Luisa Alvarez Sauras, Sheila García Enguita, Luis A. Moreno, Gerardo Rodríguez

Introduction

Obesity is a global health problem, with an impact on future health. Early factors such as infant feeding and rapid weight gain (RWG) may play a role in its development. However, their contribution is not fully understood.

Objective

To analyse associations and potential interactions between the type of infant feeding during the first 4 months of age, RWG and later development of obesity in children at 6 years of age.

Materials and Methods

This observational longitudinal study examines growth in 834 children born at term with adequate weight for their gestational age. Data were collected from birth to 6 years, focusing on weight, height and body mass index (BMI) z-scores. The relationships between infant feeding, RWG, and BMI at 6 years were explored using mediation models.

Results

Formula-fed infants showed higher BMI z-scores and obesity prevalence at 6 years compared to exclusively breastfed infants (p = 0.012 and p = 0.003 respectively). RWG also was associated with higher BMI z-scores and obesity (p < 0.001 in both cases), with formula-fed infants more likely to experience RWG (39.7% vs. 32.2%; p = 0.036). Mediation analysis revealed that the association between feeding type and BMI at 6 years is partly positively mediated by infant RWG up to 6 months.

Conclusions

Infant feeding practices, particularly exclusive breastfeeding in the first 4 months, are associated with weight and BMI trajectories up to 6 years. Rapid weight gain mediates this relationship in the first 6 months, but from 6 to 12 months.

导读：肥胖是一个全球性的健康问题，影响着未来的健康。早期因素，如婴儿喂养和快速体重增加（RWG）可能在其发展中发挥作用。然而，他们的贡献并没有被完全理解。目的：分析婴儿出生后4个月的喂养方式、RWG与6岁儿童肥胖的后期发展之间的关联和潜在的相互作用。材料和方法：本观察性纵向研究调查了834名足月出生的体重与胎龄相符的儿童的生长情况。从出生到6岁收集数据，重点关注体重、身高和身体质量指数（BMI） z分数。采用中介模型探讨6岁时婴儿喂养、RWG和BMI之间的关系。结果：与纯母乳喂养的婴儿相比，配方奶喂养的婴儿在6岁时的BMI z得分和肥胖患病率更高（p = 0.012和p = 0.003）。RWG还与较高的BMI z分数和肥胖相关(p)。结论：婴儿喂养方式，特别是前4个月的纯母乳喂养，与体重和BMI长达6年的轨迹相关。体重快速增加在前6个月起到中介作用，但从6个月到12个月。

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引用次数: 0

Non-Nutritive Sweeteners Intake and Its Association With Sugars Intake Among Chilean Toddlers 非营养性甜味剂的摄入量及其与智利幼儿糖摄入量的关系。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-13 DOI: 10.1111/ijpo.70036

Paola Arévalo, Natalia Rebolledo, Marcela Reyes

Non-nutritive sweeteners (NNS) are used as sugar alternatives in foods and beverages. However, their intake and dietary sources in toddlers and their association with total sugars intake have been scarcely explored. We aimed to characterise NNS intake (sucralose, acesulfame-K, aspartame, steviol glycosides, saccharin and cyclamate) and their individual association with dietary total sugars in a sample of Chilean toddlers. Participants of the Chilean Infant Nutrition Randomised Controlled Trial (N = 450, 50% girls) were assessed at 3 years of age with sociodemographic information from their families, anthropometry of the participants and their mothers and dietary intake (via a single 24-h recall). For reported packaged foods, we obtained the energy, nutrients and NNS information from nutrition facts panels (NFP). We estimated the dietary intake (total energy, macronutrients, total sugars and NNS intake) and NNS dietary sources for each participant. We used linear regression models to study crude and adjusted associations. Mean total energy intake was 1006 ± 351 kcal/day, with 27% of those calories coming from total sugars. Seventy-six percent of the toddlers consumed at least one NNS: 63% sucralose, 35% acesulfame-K, 32% aspartame, 27% steviol, < 1% saccharin and < 1% cyclamate. Beverages were the top contributors to NNS intake. NNS intake was not significantly associated with total sugars intake. In conclusion, we found a high prevalence of NNS intake among 3-year-old children, with sucralose being the most frequently consumed. NNS intake was not associated with lower sugars consumption. These results support new recommendations discouraging NNS intake among healthy populations, which can be even more relevant in young children.

非营养性甜味剂（NNS）被用作食品和饮料中的糖替代品。然而，它们在幼儿中的摄入量和饮食来源以及它们与总糖摄入量的关系很少被探索。我们的目的是表征NNS摄入量（三氯蔗糖、乙酰磺胺- k、阿斯巴甜、甜菊糖苷、糖精和甜蜜素）及其与智利幼儿膳食总糖的个体关系。智利婴儿营养随机对照试验（N = 450，其中50%为女孩）的参与者在3岁时接受了来自其家庭的社会人口统计信息、参与者及其母亲的人体测量数据和饮食摄入量（通过单次24小时回忆）的评估。对于已报告的包装食品，我们从营养成分面板（NFP）获得了能量、营养成分和NNS信息。我们估计了每个参与者的膳食摄入量（总能量、宏量营养素、总糖和NNS摄入量）和NNS饮食来源。我们使用线性回归模型来研究粗关联和调整关联。平均总能量摄入为1006±351千卡/天，其中27%的卡路里来自总糖。76%的幼儿食用至少一种NNS: 63%的三氯蔗糖，35%的安赛蜜- k， 32%的阿斯巴甜，27%的甜菊糖，

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引用次数: 0

Identifying Children With Obesity at High Risk for Metabolic Syndrome: Sensitivity and Specificity of the Monocyte/HDL Index 识别代谢综合征高危肥胖儿童：单核细胞/高密度脂蛋白指数的敏感性和特异性

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-08 DOI: 10.1111/ijpo.70040

Juan Pablo Rojas, Tamara Robles, Delma Salinas, Francisco Moraga, Verónica Mericq

Background

Visceral fat accumulation causes a low-grade chronic inflammatory state in individuals with Metabolic Syndrome (MetS). MetS detection, with simple and non-invasive tests, is crucial.

Objective

To establish the sensitivity and specificity of the monocyte/HDL (MHR), neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR) and lymphocytes/monocytes (LMR) ratios to identify clinical characteristics of MetS in prepubertal children.

Methods

Prospective cross-sectional study comparing 79 children fulfilling MetS IDF criteria and 75 control children. A clinical history and physical examination were performed. Blood glucose levels, lipid profile, ESR, usCRP, and complete blood count were determined, and the different ratios were calculated manually. The sensitivity and specificity of each ratio were determined using ROC curves.

Results

MHR was the most sensitive and specific haematological index to determine clinical characteristics of MetS with a cut-off point of 8.62, allowing for the identification of low HDL, hypertriglyceridemia, large waist circumference, high blood pressure, sedentary lifestyle, and a family history of obesity as the main factors related to MetS in childhood.

Conclusion

MHR is the best proxy of MetS and reveals the early elevation of proinflammatory factors in childhood, suggesting that it serves as a diagnostic tool in patients under 10 years of age, where the identification of MetS is controversial.

背景：在代谢综合征（MetS）患者中，内脏脂肪积累引起低度慢性炎症状态。通过简单和非侵入性的测试来检测MetS至关重要。目的：建立单核细胞/高密度脂蛋白（MHR）、中性粒细胞/淋巴细胞（NLR）、血小板/淋巴细胞（PLR）和淋巴细胞/单核细胞（LMR）比值用于鉴别青春期前儿童met临床特征的敏感性和特异性。方法：前瞻性横断面研究，比较79名符合MetS IDF标准的儿童和75名对照儿童。进行了临床病史和体格检查。测定血糖水平、血脂、ESR、usCRP和全血细胞计数，并人工计算不同比值。采用ROC曲线确定各比值的敏感性和特异性。结果：MHR是确定MetS临床特征的最敏感和特异性的血液学指标，截断点为8.62，可以确定低HDL、高甘油三酯血症、大腰围、高血压、久坐生活方式和肥胖家族史是儿童期MetS的主要相关因素。结论：MHR是诊断MetS的最佳指标，可显示儿童早期促炎因子的升高，提示MHR可作为10岁以下患者的诊断工具，而10岁以下的患者对MetS的识别存在争议。

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引用次数: 0

Metabolic Dysfunction-Associated Steatotic Liver Disease in an Urban Paediatric Cohort With High Socioeconomic Deprivation 高社会经济剥夺的城市儿童队列中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 : 2025-07-05 DOI: 10.1111/ijpo.70037

Christine Brichta, Ariel Porto, Mark Fishbein, Saeed Mohammad, Catherine A. Chapin

Background

Whether higher socioeconomic deprivation indices are associated with more severe paediatric metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), remains unknown.

Objective

We aimed to evaluate differences in MASLD characteristics and social deprivation in a cohort of urban children.

Methods

Retrospective study of 277 paediatric patients ≤ 18 years old evaluated between January 2009 and December 2019 with a suspected diagnosis of MASLD who underwent liver biopsy. Patients were classified as having metabolic dysfunction-associated steatohepatitis (MASH) based on their NAFLD Activity Score (NAS). Fibrosis was determined based on biopsy presence. Social deprivation index (SDI) scores were calculated using patient address.

Results

Patients were predominantly Hispanic males with obesity and a median age of 12 years. Median SDI score was 85 (65–93). Median ALT was significantly higher in patients with MASH compared with MASLD (136 vs. 92 IU/L, p < 0.001) or with fibrosis compared with no fibrosis (120 vs. 68 IU/L, p < 0.001). High SDI group patients had a significantly higher median AST (60 vs. 47 IU/L, p = 0.022), NAS score (4 vs. 3, p = 0.026) and rates of bridging fibrosis (24% vs. 10%, p = 0.023) compared with the lower SDI group.

Conclusion

Within a cohort of predominantly Hispanic children with MASLD and high socioeconomic disadvantage, there are significant laboratory and histologic differences in patients with higher SDI scores, suggesting increased MASLD severity.

背景：较高的社会经济剥夺指数是否与更严重的儿童代谢功能障碍相关的脂肪变性肝病（MASLD），即以前的非酒精性脂肪性肝病（NAFLD）相关，尚不清楚。目的：我们旨在评估城市儿童MASLD特征和社会剥夺的差异。方法：回顾性研究2009年1月至2019年12月期间277例≤18岁的疑似MASLD的儿科患者，这些患者接受了肝活检。根据患者的NAFLD活动评分（NAS），将患者分类为代谢功能障碍相关脂肪性肝炎（MASH）。纤维化是根据活检的存在来确定的。社会剥夺指数（SDI）评分采用患者地址计算。结果：患者主要为西班牙裔男性，肥胖，中位年龄12岁。SDI评分中位数为85（65-93）。与MASLD相比，MASH患者的中位ALT显著高于MASLD （136 vs 92 IU/L, p）。结论：在以西班牙裔为主的MASLD和高社会经济劣势儿童队列中，SDI评分较高的患者存在显著的实验室和组织学差异，表明MASLD严重程度增加。

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引用次数: 0

Anthropometry and Body Composition in Childhood: Follow-Up of a Randomised, Double-Blinded Controlled Trial With a Modified, Low-Protein Infant Formula During Infancy 儿童时期的人体测量和身体组成：一项随机、双盲对照试验的随访，在婴儿期使用改良的低蛋白婴儿配方奶粉。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-04 DOI: 10.1111/ijpo.70038

Jacqueline Muts, Stefanie M. P. Kouwenhoven, Nadja Antl, Marieke Abrahamse-Berkeveld, Britt J. van Keulen, Jos W. R. Twisk, Dewi van Harskamp, Chris H. P. van den Akker, Berthold Koletzko, Johannes B. van Goudoever

Introduction

Formula feeding is associated with an increased obesity risk compared to breastfeeding, possibly due to its higher protein content. We aimed to investigate the influence of feeding a modified, low-protein infant formula during the first 6 months of life on growth and body composition at 6 years.

Methods

Healthy term-born infants were randomised to receive a low-protein (mLP) infant formula with modified amino acid composition (n = 90; 1.7 g protein/100 kcal) or a control infant formula (CTRL) (n = 88; 2.1 g protein/100 kcal) up to 6 months. A breastfed (BF, n = 67) group served as a reference. At 6 years, anthropometry and body composition (air-displacement plethysmography) were measured.

Results

A total of 106 infants were measured at 6y follow-up, (n = 39 mLP; n = 33 CTRL; n = 34 BF). No significant differences were observed in mean weight, length, BMI, or fat mass percentage. However, the mean fat-free mass was lower in the mLP compared to the CTRL group (−1240 g; 95% CI: −1889 to −591, p < 0.001). Moreover, both formula groups had a higher absolute fat mass when compared to the breastfed group (p = 0.01).

Conclusions

Feeding a mLP formula during early life did not have beneficial effects on body composition in a subset of infants studied at age 6 year.

与母乳喂养相比，配方奶喂养与肥胖风险增加有关，可能是由于其更高的蛋白质含量。我们的目的是研究在出生后前6个月喂养改良的低蛋白婴儿配方奶粉对6岁时生长和身体成分的影响。方法：健康足月婴儿随机接受改良氨基酸组成的低蛋白（mLP）婴儿配方奶粉(n = 90；1.7 g蛋白质/100千卡)或对照婴儿配方奶粉（CTRL） (n = 88；2.1克蛋白质/100千卡)，可达6个月。以母乳喂养组（BF, n = 67）为参照。6岁时，测量人体测量和身体组成（空气置换体积脉搏图）。结果：随访6年时共测量106例婴儿，(n = 39 mLP；n = 33 CTRL；n = 34 BF)。在平均体重、身高、BMI或脂肪质量百分比方面没有观察到显著差异。然而，与CTRL组相比，mLP组的平均无脂质量较低(-1240 g；95% CI: -1889至-591，p结论：在6岁时的研究中，早期喂养mLP配方奶粉对婴儿的身体成分没有有益的影响。

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引用次数: 0

The effect of continuous glucose monitoring feedback on glycaemic variability in youth with obesity: A within-participant feasibility study 连续血糖监测反馈对青少年肥胖患者血糖变异性的影响：一项参与者内可行性研究。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-07-01 DOI: 10.1111/ijpo.70035

Sri Nikhita Chimatapu, Steven D. Mittelman, Alexandra Klomhaus, My H. Vu, Manal Habib, Lauren E. Wisk, David S. Black, Alaina P. Vidmar

Background

Continuous glucose monitors (CGM) offer real-time biofeedback that might support behavioural changes to reduce obesity in youth. However, the feasibility and acceptability of CGM in this population remain underexplored.

Methods

A 6-week crossover trial was conducted with youth aged 10–18 years with a body mass index above the 95th percentile. Participants experienced two phases in random order: (1) masked CGM (without data access) and (2) unmasked CGM (with real-time data access). The primary objective was to assess feasibility through recruitment, retention and adherence rates. Secondary measures included CGM-derived glucose metrics, sleep patterns, dietary intake, physical activity, eating behaviours and weight change. Descriptive analyses and mixed-effects regression models were used to examine between-condition differences on an intention-to-treat basis.

Results

Of 30 eligible participants, 27 were enrolled (90% recruitment rate; age: 14.5 ± 2.2 years, HbA1c: 5.5 ± 0.24%, 15/27 [55%] Hispanic, 16/27 [59%] female). Of the enrolled participants, 24 completed the protocol. Adherence averaged 35.1 days over 42 days (87% of days). The CGM was well tolerated, with no adverse effects reported. There was no significant difference in glycaemic variability metrics between masked and unmasked conditions over the 6-week period.

Conclusions

This trial supports the feasibility and acceptability of CGM use in youth with obesity. Given the exploratory nature of this study, longer-term research is needed to evaluate its effectiveness in modifying health behaviours and metabolic outcomes in this population.

背景：连续血糖监测仪（CGM）提供实时生物反馈，可能支持行为改变以减少青少年肥胖。然而，CGM在这一人群中的可行性和可接受性仍未得到充分探讨。方法：对体重指数高于95百分位的10-18岁青少年进行为期6周的交叉试验。参与者按随机顺序经历了两个阶段：(1)屏蔽CGM（没有数据访问）和(2)非屏蔽CGM（有实时数据访问）。主要目标是通过招募、保留和坚持率来评估可行性。次要测量包括cgm衍生的葡萄糖指标、睡眠模式、饮食摄入、身体活动、饮食行为和体重变化。描述性分析和混合效应回归模型用于在意向治疗基础上检验条件间差异。结果：在30名符合条件的参与者中，有27人入选(招募率90%；年龄:14.5±2.2年,糖化血红蛋白:5.5±0.24%,15/27(55%)拉美裔,16/27(59%)女性)。在登记的参与者中，有24人完成了协议。42天内平均坚持35.1天（87%的天数）。CGM耐受性良好，无不良反应报道。在6周的时间里，蒙面组和未蒙面组的血糖变异性指标没有显著差异。结论：本试验支持青少年肥胖患者使用CGM的可行性和可接受性。鉴于这项研究的探索性，需要长期研究来评估其在改变这一人群的健康行为和代谢结果方面的有效性。

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引用次数: 0

The impact of community-based childhood obesity prevention interventions in Australia by socio-economic position: An individual participant data meta-analysis 社会经济地位对澳大利亚社区儿童肥胖预防干预的影响：个体参与者数据荟萃分析

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2025-06-19 DOI: 10.1111/ijpo.70031

Jane Jacobs, Kathryn Backholer, Steven Allender, Vicki Brown, Liliana Orellana, Rachel Novotny, Luke Wolfenden, Marj Moodie, Melanie Nichols

Introduction

Community-based interventions (CBIs) to prevent childhood obesity show promise in reducing body mass index z-scores (zBMI). Assessing whether this approach produces equitable outcomes across socio-economic sub-groups is typically limited by inadequate sample size. This study aimed to assess the effectiveness of CBIs on zBMI and weight-related behaviours by socio-economic position (SEP).

Methods

Individual participant data meta-analysis using seven Australian childhood obesity prevention CBIs conducted between 2003 and 2022. Trials used consistent intervention approaches, objectively measured height and weight, and self- or parent-reported behaviours, and lasted 2–4 years. Area-level SEP was estimated using Australian Index of Relative Socio-economic Advantage and Disadvantage tertiles based on home or school postcodes. Multi-level linear and logistic models estimated the intervention effect on zBMI and behaviours across SEP levels.

Results

While zBMI scores increased across all groups, the increase was significantly greater in control compared to intervention students (difference: −0.036 [95%CI −0.065, −0.007]), among the 25 346 observations analysed. The effect of CBIs was greater in low compared to high SEP students (intervention effect difference = −0.10 [95%CI −0.18, −0.02]).

Discussion

Obesity prevention CBIs may have greater impacts among children from low SEP areas, potentially contributing to reducing health inequities. Further research is needed to understand barriers to improving weight-related behaviours across socio-economic groups.

前言：以社区为基础的干预措施（CBIs）预防儿童肥胖显示出降低体重指数z分数（zBMI）的希望。由于样本量不足，评估这种方法是否能在社会经济子群体中产生公平的结果通常受到限制。本研究旨在通过社会经济地位（SEP）评估CBIs对zBMI和体重相关行为的影响。方法：使用2003年至2022年期间进行的七个澳大利亚儿童肥胖预防CBIs进行个体参与者数据荟萃分析。试验采用一致的干预方法，客观测量身高和体重，以及自我或父母报告的行为，持续2-4年。根据家庭或学校的邮政编码，使用澳大利亚相对社会经济优势和劣势指数来估计区域水平的SEP。多层次线性和逻辑模型估计了干预对zBMI和跨SEP水平行为的影响。结果：在分析的25346个观察结果中，虽然所有组的zBMI得分都有所增加，但对照组的增加幅度明显大于干预学生（差异：-0.036 [95%CI -0.065, -0.007]）。与高SEP学生相比，低SEP学生的CBIs效果更大（干预效果差异= -0.10 [95%CI -0.18, -0.02]）。讨论：肥胖预防CBIs可能对来自低SEP地区的儿童有更大的影响，可能有助于减少健康不平等。需要进一步的研究来了解社会经济群体中改善体重相关行为的障碍。

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引用次数: 0