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兒童發炎性腸道疾病患者超重與肥胖的盛行率與趨勢解析

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12 月

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研究顯示，23.6%的炎症性腸病（IBD）兒童屬於過重或肥胖，潰瘍性結腸炎患者（30.1%）比例更接近一般兒童群體。非裔背景、接受過手術及使用公共醫療保險的兒童更易出現肥胖情況，提示疾病嚴重性與肥胖可能相關，需更深入的臨床關注與管理。

Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease

兒童發炎性腸道疾病患者超重與肥胖的盛行率與流行病學

Long MD, Crandall WV, Leibowitz IH, et al. Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17(10):2162-2168. doi:10.1002/ibd.21585

https://pubmed.ncbi.nlm.nih.gov/21910178/

Abstract

Background

Obesity is a significant public health threat to children in the United States. The aims were to: 1) Determine the prevalence of obesity in a multicenter cohort of children with inflammatory bowel disease (IBD); 2) Evaluate whether overweight and obese status is associated with patient demographics or disease characteristics.

Methods

We used data from the ImproveCareNow Collaborative for pediatric IBD, a multicenter registry of children with IBD, collected between April 2007 and December 2009. Children ages 2-18 years were classified into body mass index (BMI) percentiles. Bivariate analyses and multivariate logistic regression were used to compare demographic and disease characteristics by overweight (BMI >85%) and obese (BMI >95%) status.

Results

The population consisted of 1598 children with IBD. The prevalence of overweight/obese status in pediatric IBD is 23.6%, (20.0% for Crohn’s disease [CD] and 30.1% for ulcerative colitis [UC] and indeterminate colitis [IC]). African American race (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.10-2.48) and Medicaid insurance (OR 1.67, 95% CI 1.19-2.34) were positively associated with overweight/obese status. Prior IBD-related surgery (OR 1.73, 95% CI 1.07-2.82) was also associated with overweight and obese status in children with CD. Other disease characteristics were not associated with overweight and obesity in children with IBD.

Conclusions

Approximately one in five children with CD and one in three with UC are overweight or obese. Rates of obesity in UC are comparable to the general population. Obese IBD patients may have a more severe disease course, as indicated by increased need for surgery. Sociodemographic risk factors for obesity in the IBD population are similar to those in the general population.

摘要

背景

肥胖是美國兒童的重要公共衛生威脅。本研究旨在：1）確定一組多中心兒童發炎性腸道疾病（IBD）患者中肥胖的盛行率；2）評估超重和肥胖狀態是否與患者的人口學特徵或疾病特性相關。

方法

我們使用來自 ImproveCareNow Collaborative 的兒童IBD數據，該數據庫為兒童IBD的多中心登錄系統，數據收集時間為2007年4月至2009年12月。年齡介於2至18歲的兒童依據身體質量指數（BMI）百分位數進行分類。使用雙變量分析與多變量邏輯回歸比較超重（BMI >85%）和肥胖（BMI >95%）狀態下的人口學及疾病特徵。

結果

本研究納入1,598名IBD兒童。兒童IBD患者的超重/肥胖盛行率為23.6%（克隆氏症 [CD] 患者為20.0%，潰瘍性結腸炎 [UC] 及未定型結腸炎 [IC] 患者為30.1%）。非裔美國人（優勢比 [OR] 1.64，95%信賴區間 [CI] 1.10–2.48）及使用醫療補助保險（OR 1.67，95% CI 1.19–2.34）與超重/肥胖狀態呈正相關。曾接受IBD相關手術的CD患者（OR 1.73，95% CI 1.07–2.82）也更容易出現超重或肥胖狀態。其他疾病特徵與兒童IBD患者的超重或肥胖無顯著相關性。

結論

約五分之一的CD兒童患者及三分之一的UC兒童患者為超重或肥胖。UC患者的肥胖率與一般兒童人群相當。肥胖的IBD患者可能有更嚴重的疾病進程，這可從其手術需求增加中看出。IBD族群中肥胖的社會人口學危險因素與一般人群相似。

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