儿童肥胖症的相关影响因素与控制对策分析及其对糖尿病发病情况的影响

目的 分析儿童肥胖症的相关影响因素与控制对策分析及其对糖尿病发病情况的影响,为制定针对儿童肥胖症的防控措施提供理论依据。方法 将2012年5月-2018年1月期间于沈阳市第五人民医院儿科进行体检的836名儿童作为研究对象,统计本组研究对象中肥胖症发生率,并调查所有研究对象性别、年龄、学校性质、生活习惯等因素与肥胖症发生率的相关性。将出现肥胖症的患儿作为观察组,将正常儿童作为对照组,对比两组对象空腹血糖、餐后2 h血糖(2 hPBG),空腹血糖受损(IFG)、葡萄糖耐量异常(IGT)以及糖尿病发生率的差异。结果 836名儿童中,89名存在肥胖症,231名儿童体重超重,516名儿童BMI正常,肥胖症发生率为10.65%;多因素Logistic回归分析结果显示,男性(OR＝6.415,95%CI:2.714~12.684,P=0.027)、年龄>10岁(OR＝9.328,95%CI:2.413~10.152,P=0.003)、居住地在城市(OR＝6.413,95%CI:2.748~8.503,P=0.015)、早餐地点在家里(OR＝6.349,95%CI:2.692~8.419,P=0.009)、周末活动时间<1 h(OR＝14.928,95%CI:4.210~15.384,P<0.001)均是儿童肥胖症的危险因素;观察组FPG及2 hPBG表达水平均显著高于对照组(P<0.05);观察组IFG、IGT及糖尿病发生率均显著高于对照组(P<0.05)。结论 儿童肥胖症的发生与外界及自身多项因素有密切联系,还可能诱发糖尿病等并发症,临床中应针对诱导儿童肥胖症产生的具体因素制定相应控制对策,改善肥胖患儿生活质量,使其健康成长。     

The Impact of a Healthy Weight Intervention Embedded in a Home-Visiting Program on Children's Weight and Mothers’ Feeding Practices

Objective

To examine whether a healthy weight intervention embedded in the Parents as Teachers (PAT) home visiting program, which was previously found to improve mothers’ body mass index (BMI) and obesity-related behaviors, changed the BMI of preschool children or maternal feeding practices.

Endoscopic gastroplasty to treat medically uncontrolled obesity needs more quality data: A systematic review

Endoscopic gastroplasty (EG) has been used in clinical practice to treat obesity. This systematic review has the objective of assessing if there is an acceptable level of scientific evidence on the safety and effectiveness of EG. A thorough search strategy was used up to October 2018, including the 2 most common techniques: endoscopic suturing and the primary obesity surgery endolumenal procedure. The quality of the studies was evaluated through the Joanna Briggs Institute Critical Appraisal tools for use in Systematic Reviews—“Checklist for Case Series”—and summarized using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Only 1 randomized controlled trial (moderate GRADE evidence) was found, and the remaining were case reports or small case series (very low GRADE evidence). The literature has low scientific quality. All studies, with 1 exception, are small case series with short follow-up. One of the randomized controlled trials did not meet the primary endpoint for weight loss in both groups (EG × sham) after 1-year follow-up. The case series reported from 16% to 19% total weight loss, but few had more than 6 months of follow-up. Serious adverse events ranged from 2% to 10%. Based on current literature, there is not enough quality scientific evidence regarding long-term weight loss and the procedure’s safety to recommend the use of EG in current clinical practice.     

健康干预在肥胖中学生中所起的效果评价

目的：探讨健康干预应用于肥胖中学生的效果。方法：抽取张掖市第一中学肥胖中学生180例，随机分为观察组与对照组，观察组实施健康干预，对照组仅予以常规健康教育，比较两组肥胖改善情况。结果：观察组干预效果显著优于对照组（P＜0．05）；干预后观察组的 BMI、腰围、胸围及皮脂厚度均较对照组显著降低（P＜0．05）。结论：在肥胖中学生中实施健康干预有利于促进学生身体形态生长水平的改善，控制和降低学生 BMI和肥胖增长速度。