跨理论模型在肥胖儿童体质量管理中的应用

随着社会经济的迅猛发展、居民生活水平的提高和生活饮食习惯的改变,儿童肥胖的发生率呈快速上升趋势。儿童肥胖对儿童乃至成人后的健康构成了严重的威胁。跨理论模型在健康领域的研究较为成功,近年来国外跨理论模型用于肥胖儿童体质量管理取得一定成效,对跨理论模型在肥胖儿童体质量管理中的应用进行总结,可借鉴国外有关研究,将跨理论模型融入中国国情,管理肥胖儿童体质量,进而促进其健康成长。     

儿童瘦素水平与性别和体质量指数的关系

目的研究儿童血清瘦素水平与性别和体质量指数的关系。方法在小学生7—9岁体检人群中随机抽取160人;使用放射免疫法检测他们的瘦素水平;根据性别分为男女两组,根据体质量指数（BMI）分为正常和肥胖组;分别评价儿童血清瘦素水平与性别和体质量指数的关系。结果（1）女孩瘦素水平明显高于男孩（P〈0．01）,正常和肥胖组比有显著性差异（P〈0．01）。结论（1）儿童血清瘦素水平男女之间有显著差异（2）正常儿童和肥胖儿童血清瘦素水平也有显著差异,所以儿童瘦素水平与性别密切相关,肥胖儿童将成为血清瘦素观察和治疗对象。     

儿童情绪障碍过氧化脂质及谷胱甘肽过氧化物酶的研究

目的：了解儿童障碍过氧化脂质（LPO）及谷胱甘肽过氧化物酶（GPX）水平，探讨其病因，方法：测定30例儿童情绪障碍LPO及GPX水平与正常儿童（30例）比较研究。结果：儿童情绪障碍LPO明显高于对照组（P＜0．05），结论：LPO的改变可能是儿童情绪障碍的生物学原因之一。     

儿童情绪障碍过氧化脂质及谷胱甘肽过氧化物酶的研究

目的了解儿童情绪障碍过氧化脂质(LPO)及谷胱甘肽过氧化物酶(GPX)水平,探讨其病因。方法测定30例儿童情绪障碍LPO及GPX水平与正常儿童(30例)比较研究。结果儿童情绪障碍LPO明显高于对照组(P<0.05)。结论LPO的改变可能是儿童情绪障碍的生物学原因之一。     

血清胰岛素水平及高敏C反应蛋白与小儿单纯性肥胖的关系

随着物质生活水平的提高,生活方式及饮食结构的改变,单纯性肥胖儿童发病率越来越高。而单纯性肥胖儿童成年后罹患代谢综合征的概率明显增加,成为严重的社会问题及健康隐患。小儿单纯性肥胖的发生、发展机制较为复杂,近期临床研究发现,血清胰岛素（INS）水平及高敏C反应蛋白（CRP）均参与了单纯性肥胖的形成及发展过程。     

儿童肥胖干预对策的现状与分析

儿童肥胖是一个日趋严重、全球关注的公共卫生问题.儿童肥胖与许多成年期慢性病如高血压、高脂血症、糖尿病、动脉粥样硬化性心脑血管疾病等有非常密切关系，肥胖导致这些疾病的患病率和死亡率急剧上升，使人群健康水平下降.国外学者前瞻性研究表明，35％的超重儿童会在成年期发胖，其心血管疾病的患病率和死亡率明显高于成年期发胖的患     

肥胖儿童血浆内皮素检测的意义

由于生活水平的提高和饮食结构的改变,儿童肥胖症患病率呈逐年增多趋势,肥胖儿童也可能存在心脏结构和功能的改变、血管内皮细胞功能紊乱和动脉粥样硬化。研究如何有效干预儿童肥胖症迫在眉睫。儿童肥胖可导致血管内皮细     

儿童鼾症的临床分析与护理

儿童睡觉打鼾并不一定是睡得好，很可能是睡眠障碍的警告。抽样调查表明，3岁～14岁儿童中有20％患有睡眠障碍；鼾症等睡眠呼吸障碍占1％～3％。儿童睡眠呼吸障碍常见于多种原因引起的呼吸调节障碍性疾病，反复的呼吸道感染、哮喘、扁桃体炎、腺样体肥大、肥胖和遗传等因素都是致病的原因。由于它可以导致心、肺、脑等多器官损害，会带来多种并发症；尤其是影响儿童的智力发育等。现将我院收治的儿童鼾症患儿的临床分析与护理介绍如下。     

儿童膳食结构调查结果的启示

为研究儿童饮食与身高、体重关系，调查了７－１４岁肥胖儿童５３名，身材矮小儿童５３名共１０６名儿童饮食情况。调查结果表明肥胖儿童热量摄入过多，热量摄入越多肥胖虎重。身体矮小儿童热量、蛋白质摄入过少、热量、蛋白质摄入越少身高落后越多。肥胖儿童、身份和童饮食问题中突出问题是儿童及家长不清楚每天应该吃什么，应该吃多少，制订文科滨饮食方案对于儿童肥胖、身材矮小的防治、对于提高儿童健康水平，极为必要。     

儿童学习障碍原因及早期表现

目的：儿童学习障碍是基本学习技能获得障碍，常常表现为学习困难和情绪行为异常，未经及时干预矫治者，易出现品行障碍、抑郁，甚至人格障碍、反社会行为：为此，回顾了儿童学习障碍原因及早期表现，阐明引起儿童学习障碍的常见原因．主要表现，进而寻求有效的方法进行早期诊断、早期干预：资料来源：应用计算机检索PubMed数据库1985—01／2003—12期间的相关文章，检索词“Learning disabilities，Children，Survey documents”，限定文章语言种类为英文，同时计算机检索中国期刊全文数据库、万方数据库1990—01／2003—12期间的相关文章，检索词“学习障碍，儿童，综述文献”，限定文章种类为中文。资料选择：对资料进行初审．纳入标准：包括儿童学习障碍原因．学习障碍早期表现的随机对照实验以及关于学习障碍儿童的预后及矫治方法的文献。资料提炼：共收集到25篇关于儿童学习障碍原因及早期表现的文献．其中16篇符合标准，其余9篇系重复实验。资料综合：16篇包括3132例学习障碍儿童均符合诊断标准。其中10篇文章调查了2081例儿童学习障碍，发现其原因有遗传因素、脑功能失调、脑结构异常、脑损伤、外部环境影响；6篇文章分析1051例学习障碍儿童的主要表现为阅读障碍、拼写和描写障碍、计算技能障碍、情绪和行为问题，提出学习障碍儿童的预后及矫治方法。结论：儿童学习障碍迄今为止原因不明确，可能是内因和外因多种因素共同作用的结果，具体分为阅读障碍、拼写和书写障碍、计算技能障碍、情绪和行为问题，矫治关键在于早期诊断、早期治疗。     

陕西省27200名0～18岁健康儿童体质指数参考曲线

目的用于儿童青少年超重和肥胖评价的方法很多,各种方法各有优缺点,尚未形成一种统一的评价方法,由此造成不同地区儿童青少年肥胖及超重发病率缺乏可比性。近年来,WHO肥胖工作组的专家建议在儿童肥胖的常规评价中应采用体质指数(BMI)的年龄别百分位数。但是到目前为止,中国还没有BMI的年龄别百分位数报道。本文提供了陕西省0-18岁儿童的BMI的年龄别百分位数曲线。方法采用LMS法拟合曲线;所有分析均采用由TJCole教授提供的LMS法的特殊软件,分性别和地区进行分析。结果BMI中位数曲线由生命早期的12.70kg/m2迅速增加,8个月达高峰,为17.02kg/m2,然后下降,达6岁左右的14.61kg/m2最低点后平稳变化。城市儿童脂肪重聚比乡村儿童早2年,男生比女生早1年,脂肪重聚后,女生的BMI增加比男生快,城市儿童的增加比乡村儿童的快,随着青春期的开始,女生BMI逐渐大于男生,乡村男女生之间的差别大于城市的。陕西省儿童青少年超重百分位数所在曲线男女生分别为P95.3和P94.5,肥胖所在百分位数曲线男女生分别为P99.5和P99.8,明显低于欧美等发达国家的标准。结论通过LMS法,建立了陕西省儿童青少年BMI的年龄别百分位数曲线,百分位数曲线、超重与肥胖的界值可用于陕西省0-18岁儿童青少年营养状况的评价,不同性别、地区间的差别可帮     

体质量指数、血糖水平与急性胰腺炎相关性分析

目的探讨体质量指数、血糖水平与急性胰腺炎病情程度的关系。方法 398例急性胰腺炎患者依据病情分为重症急性胰腺炎组38例和轻症急性胰腺炎组360例,分析2组患者体质量指数、血糖水平与Ranson评分、Balthazar CT分级等的相关性。再依据体质量指数将398例患者分为肥胖组88例,超体质量组140例,体质量正常组170例,比较3组重症急性胰腺炎发病率。结果重症急性胰腺炎组入院时血糖水平、体质量指数高于轻症急性胰腺炎组（P〈0.05）;肥胖组重症急性胰腺炎发病率高于体质量正常组与超体质量组（P〈0.05）;Ranson评分≥3分、BalthazarCT分级为D或E级者体质量指数、血糖水平均高于Ranson评分〈3分者、Balthazar CT分级为A,B或C级者（P〈0.05）;血糖水平、体质量指数与Ranson评分、Balthazar CT均呈正相关（P〈0.05）。结论体质量指数、血糖水平可作为评估急性胰腺炎病情严重程度的参考指标之一。     

Body composition and adipose tissue cellularity before and after jejuno-ileostomy in severely obese subjects

In severe obesity with adipose tissue hyperplasia it is difficult to achieve and sustain weight decrease by conventional therapy. Fifteen severely obese patients (mean body weight 135 kg) with hyperplastic obesity had a jejuno-ileostomy according to Payne to induce weight reduction by controlled malabsorption. Body composition, adipose tissue cellularity, and glucose tolerance were studied before and after the operation when the patients had reached a new stable weight (WS) a mean 21 months after surgery. Preoperative fat cell number was unchanged at follow-up in contrast to all other variables of body composition. Reductions in fat cell size were evenly distributed in different major subcutaneous regions. Body potassium was determined immediately after operation and at 6 months intervals until WS. The postoperative decrease stopped at 6 months, thus differing from the decrease in body weight. Significant positive correlations between the postoperative decrease in body weight or body fat, and preoperative body weight, body fat and body cell mass were analysed by multiple stepwise regression. Preoperative body weight and body fat were shown to predict postoperative weight loss at a leve of P less than 0.005. A positive correlation between body fat decrease and fat cell number could be explained hypothetically by an increased caloric demand in hyperplastic obesity.     

某市成人居民体质量指数和腰围分布特点的调查

目的：研究分析重庆市成人居民的体质量指数（BMI）情况及腰围分布情况,为相关研究提供有效的数据支撑。方法对2012年对重庆市成人居民进行调查的情况作回顾性分析,调查随机纳入40000人进行研究,对入选人群按照性别、年龄、居住情况进行分组,并针对其BM I、身高和腰围进行调查和测量。结果与非主城区人群相比,主城区中居住人群的腰围和BMI均有明显下降,两组之间差异有统计学意义（P＜0．05）;对男性居民和女性居民进行比较发现,男性的腰围和超重比例明显高于女性人群,差异有统计学意义（P＜0．05）;比较不同年龄段人群的腰围和超重情况,显示不同年龄段人群的腰围、BMI和肥胖情况差异均有统计学意义（P＜0．05）。结论不同年龄、性别、居住地点是影响重庆市人群的BM I和腰围的重要因素。其中,非主城区域的中年男性的腰围和体质量均有明显上升的趋势。     

Obesity in School Children with Intellectual Disabilities in France

Background The aims of this study were to assess the prevalence of obesity in school children with intellectual disabilities and to determine the most appropriate indicators of obesity measurement. Materials and Methods The weight, height, body mass index (BMI), waist circumference, waist‐to‐height ratio and body fat percentage as measured by bio‐impedance were evaluated in 192 children with intellectual disabilities. Results According to the BMI, 26% of the children were overweight or obese. An excess of body fat was measured in 44.9% of the boys and 47% of the girls. Excess visceral adipose tissue (a high waist‐to‐height ratio) was identified in 26.4% of the boys and 36.5% of the girls. Conclusions The results indicate the high prevalence of obesity in these children and the heightened risk of developing comorbidities due to visceral adipose tissue. Professional staff should be warned of these potential health problems: early identification and management of excess body fat is the best strategy for preventing obesity and comorbidities in adulthood.     

The novel association between red complex of oral microbe and body mass index in healthy Japanese: a population based cross-sectional study

Microbiota has been thought to be one of important environmental factors for obesity or Type 2 diabetes mellitus. Among oral microbe, Porphyromonas gingivalis, Treponema denticola and Tannellera forsythia are known as risk factors, so called red complex, for periodontitis. Red complex could also be a risk factor for obesity. However, recent study indicated that obesity was not improved by periodontal therapy. Thus, we performed a cross sectional study to reveal the association of oral microbe with body mass index in a healthy population. Healthy individuals were randomly recruited. The infections of oral microbe were identified by Taqman polymerase chain reaction. The relationships between number of red complex and body mass index or waist circumference were analyzed. Two hundred and twenty-two apparently healthy Japanese were enrolled. BMI and waist circumference as well as age, periodontitis, number of brushing teeth were significantly associated with the number of red complex after adjusting covariance. The effect size of body mass index or waist circumference was 0.023 (p = 0.028) or 0.024 (p = 0.024), respectively. Body mass index and waist circumference were independently associated with the number of red complex among apparently healthy Japanese. The current observation implies the possibility that oral microbe was associated with obesity in healthy population.     

Headache prevention outcome and body mass index

A population-based longitudinal study suggests that obesity is a strong risk factor for the development of headaches on 15 or more days per month. Little is know about the influence of weight on the response to headache preventive treatment. Herein we prospectively assessed the influence of the baseline body mass index (BMI) on the response to headache preventive treatment. We included adults with episodic or chronic migraine (ICHD-2), or transformed migraine (Silberstein and Lipton criteria) that sought care in a headache clinic. BMI was assessed in the first visit. Baseline information included headache frequency, number of days with severe headache (prospectively obtained over 1 month), and headache-related disability (HIT-6). The same information was obtained after 3 months of preventive treatment. Subjects were categorized based on BMI in: normal weight (/=30). We contrasted the headache end-points using anova with post-test and Kruskal-Wallis with post-test. We used logistic regression to model BMI and headache parameters adjusting for covariates. Our sample consisted of 176 subjects (79.5% women, mean of 44.4 years). At baseline 40.9% had normal weight, 29.5% were overweight and 27.3% were obese. No significant differences were observed in the number of headache days at baseline. After treatment, frequency declined in the entire population, but no significant differences were found by BMI group. Regarding the number of days with severe pain per month, there were also no significant differences at baseline (normal = 6.1, overweight = 6.5, obese = 6.7), and improvement overall (P = 0.01). However, changes were greater in the obese (reduction in 2.7 days with treatment) and overweight (3.9) vs. normal (1.5, P < 0.01). Finally, HIT scores at baseline did not differ by BMI group (normal weight = 63.8, overweight = 64.1, obese = 63.6). However, compared with the normal weighted group, change in HIT scores (follow-up baseline) were greater in the obese (6.4 vs. 3.5, P < 0.05) and overweight groups (6.8 vs. 3.5, P < 0.05). In the logistic regression model, BMI did not account for changes in disability, headache frequency, or in the number of days with severe headache per month, after adjusting for covariates. Contrary to what we hypothesized, obesity at baseline does not seem to be related to follow-up refractoriness to preventive treatment.     

Effect of a Low-Cost Intervention on Recording Body Mass Index in Patients'' Records

PURPOSE: Evaluate the effectiveness of body mass index (BMI) tables placed in exam rooms as an intervention to encourage providers to calculate and record BMI scores in patients' medical records. DESIGN: In a prospective cohort design, medical record data for 276 adult patients at a federally funded community health center in New England were examined from August 2000 to August 2002 following the intervention. METHODS: Prominent, multicolored, laminated BMI tables were posted in the exam rooms of one of the study site's three primary health care teams. Medical record data collected included documentation of BMI calculation in medical records, documentation of an obesity diagnosis, and inclusion of heights and current weights. Frequency distributions were calculated; chi-square tests were used to identify associations. FINDINGS: In contrast to the comparison teams, patients on the intervention team were more likely to have BMI recorded in the medical record. A statistically significant increase in the diagnosis of obesity was observed throughout the health center after the intervention. CONCLUSIONS: Posting BMI tables in exam rooms contributed to increased BMI documentation in patients' medical records.