目的 分析学龄期注意缺陷多动障碍(ADHD)儿童的人体成分情况,为ADHD儿童的临床干预提供指导。方法 招募2022年1—12月于苏州大学附属儿童医院儿童保健科就诊,初诊确诊为ADHD的376名儿童作为ADHD组,并选取94名同期常规健康体检儿童作为对照组。对所有儿童采用生物电阻抗法测量人体成分指标。结果 ADHD组儿童体重、体脂肪量(BF)、体质量指数(BMI)、脂肪质量指数(FMI)、体脂百分比(PBF)、腰臀比(WHR)高于对照组,差异有统计学意义(t=2.400、3.618、3.358、3.901、3.458、2.935,P＜0.05)。注意缺陷为主型组、多动/冲动型组与混合型组ADHD患儿BF、FMI、PBF比较,差异有统计学意义(F=3.295、3.362、4.337,P＜0.05)。结论 ADHD患儿的人体成分与正常儿童存在差异,ADHD患儿有更高的肥胖风险,尤其是注意缺陷为主型ADHD患儿共患肥胖的风险更高。
Abstract
Objective To analyze the body composition of school-age children with attention-deficit/hyperactivity disorder (ADHD),in order to provide guidance for clinical intervention in children with ADHD. Methods A total of 376 children were recruited as ADHD group from January to December 2022 in the Department of Child Health Care in Children's Hospital of Soochow University.Meanwhile,94 children who took physical examination in this hospital were selected as the control group.The body composition of all children was assessed by bioelectrical impedance analysis. Results The weight,body fat(BF),body mass index(BMI),fat mass index(FMI),percentage of body fat (PBF) and waist hip ratio(WHR) of children in ADHD group were higher than those of children in control group (t=2.400,3.618,3.358,3.901,3.458,2.935,P＜0.05).Furthermore,significant differences were observed in BF,FMI,PBF among children with predominantly inattentive ADHD,predominantly hyperactive/impulsive ADHD and combined ADHD (F=3.295,3.362,4.337,P＜0.05). Conclusions The body composition of ADHD children is different from that of typicallt developed children.Children with ADHD are at a higher risk of obesity,especially in those with predominantly inattentive ADHD.
关键词
注意缺陷多动障碍 /
肥胖 /
体成分 /
体脂
Key words
attention-deficit/hyperactivity disorder /
obesity /
body composition /
body fat
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中华医学会儿科学分会发育行为学组.注意缺陷多动障碍早期识别、规范诊断和治疗的儿科专家共识[J].中华儿科杂志,2020,58(3): 188-193.
The Subspecialty Group of Developmental and Behavioral Pediatric, the Society of Pediatrics,Chinese Medical Association.Consensus on pediatric clinical practice of early identification,standardized diagnosis and treatment of attention deficit hyperactivity disorder[J].Chin J Pediatr,2020,58(3): 188-193.(in Chinese)
[2] Wolraich ML,Hagan JF,Allan C,et al.Clinical practice guideline for the diagnosis,evaluation,and treatment of attention-deficit/hyperactivity disorder in children and adolescents[J].Pediatrics,2019,144(4).
[3] Wang TT,Liu KH,Li ZZ,et al.Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: A systematic review and meta-analysis[J].BMC Psychiatry,2017,17.
[4] Mccoy KT,Pancione K,Hammonds LS,et al.Management of attention-deficit/hyperactivity disorder in primary care[J].Nurs Clin North Am,2019,54(4): 517-.
[5] Martins-Silva T,Vaz JD,Hutz MH,et al.Assessing causality in the association between attention-deficit/hyperactivity disorder and obesity: A mendelian randomization study[J].Int J Obes,2019,43(12): 2500-2508.
[6] Egbert AH,Wilfley DE,Eddy KT,et al.Attention-deficit/hyperactivity disorder symptoms are associated with overeating with and without loss of control in youth with overweight/obesity[J].Childhood Obesity,2018,14(1):50-57.
[7] San Mauro Martín I,Blumenfeld Olivares JA,Garicano Vilar E,et al.Nutritional and environmental factors in attention-deficit hyperactivity disorder (ADHD): A cross-sectional study[J].Nutr Neurosci,2018,21(9): 641-647.
[8] Trkoglu S,Etin FH.The relationship between chronotype and obesity in children and adolescent with attention deficit hyperactivity disorder[J].Chronobiol Int,2019,36(8): 1138-1147.
[9] Racicka E,Hanc T,Giertuga K,et al.Prevalence of overweight and obesity in children and adolescents with ADHD:The significance of comorbidities and pharmacotherapy[J].J Atten Disord,2018,22(12): 1095-1108.
[10] Wolraich ML,Hagan JF,Allan C,et al.Clinical practice guideline for the diagnosis,evaluation,and treatment of attention-deficit/hyperactivity disorder in children and adolescents[J].Pediatrics,2019,144(4): e20192528.doi: 10.1542/peds.2019-2528.
[11] Hall CL,Guo BL,Valentine AZ,et al.The validity of the SNAP-Ⅳ in children displaying ADHD symptoms[J].Assessment,2020,27(6): 1258-1271.
[12] 周晋波,郭兰婷,陈颖.中文版注意缺陷多动障碍SNAP-Ⅳ评定量表-父母版的信效度[J].中国心理卫生杂志,2013,27(6): 424-428.
Zhou JB,Guo LT,Chen Y.Reliability and validity of the Chinese version of Swanson,Nolan,and Pelham Version IV Rating Scale-Parent Form for attention-deficit/hyperactivity disorder[J].Chinese Mental Health Journal,2013,27(6): 424-428.
[13] Mueller TF,Brielmaier S,Domsch H,et al.Increased resting energy expenditure in children with attention-deficit-hyperactivity disorder[J].Eat Weight Disord,2010,15(3): e144-151.
[14] Khalife N,Kantomaa M,Glover V,et al.Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence[J].J Am Acad Child Adolesc Psychiatry,2014,53(4):425-436.
[15] Bisset M,Rinehart N,Sciberras E.Body dissatisfaction and weight control behaviour in children with ADHD: A population-based study[J].Eur Child Adolesc Psychiatry,2019,28(11): 1507-1516.
[16] Klein MO,Battagello DS,Cardoso AR,et al.Dopamine: Functions,signaling,and association with neurological diseases[J].Cell Mol Neurobiol,2019,39(1): 31-59.
[17] Hanc T.ADHD as a risk factor for obesity.Current state of research[J].Psychiatr Pol,2018,52(2): 309-322.
[18] Spencer TJ,Faraone SV,Biederman J,et al.Does prolonged therapy with a long-acting stimulant suppress growth in children with ADHD?[J].J Am Acad Child Adolesc Psychiatry,2006,45(5): 527-537.
[19] Vanavanan S,Srisawasdi P,Rochanawutanon M,et al.Performance of body mass index and percentage of body fat in predicting cardiometabolic risk factors in Thai adults[J].Diabetes Metabolic Syndrome and Obesity-Targets and Therapy,2018,11: 241-253.
[20] Tyson N,Frank M.Childhood and adolescent obesity definitions as related to BMI,evaluation and management options[J].Best Practice & Research Clinical Obstetrics & Gynaecology,2018,48: 158-164.
[21] 李颂婷,钟燕.体成分分析在学龄儿童超重肥胖筛查中的应用价值[J].中国儿童保健杂志,2022,30(5): 540-543,552.
Li ST,Zhong Y,Application of body composition analysis in screening overweight and obesity of school-age children[J].Chin J Child Health Care,2022,30(5): 540-543,552.(in Chinese)
[22] Seo YG,Kim JH,Kim Y,et al.Validation of body composition using bioelectrical impedance analysis in children according to the degree of obesity[J].Scand J Med Sci Sports,2018,28(10): 2207-2215.
[23] Col N,Gokcen C,Demircioglu Kilic B,et al.Prevalence of obesity/hypertension in children and adolescents with ADHD and evaluation of total body composition[J].Anadolu Psikiyatri Dergisi-Anatolian Journal of Psychiatry,2019,20(1): 93-100.
[24] Huebel C,Gaspar HA,Coleman JRI,et al.Genetic correlations of psychiatric traits with body composition and glycemic traits are sex-and age-dependent[J].Nat Commun,2019,10:5765.
[25] Bowling AB,Tiemeier HW,Jaddoe VWV,et al.ADHD symptoms and body composition changes in childhood: A longitudinal study evaluating directionality of associations[J].Pediatr Obes,2018,13(9): 567-575.
[26] Castaneda RLA,Kumar S,Voigt RG,et al.Childhood attention-deficit/hyperactivity disorder,sex,and obesity: A longitudinal population-based study[J].Mayo Clin Proc,2016,91(3): 352-361.
[27] 孔凯萌,张璐璐,陶晔璇.注意缺陷/多动障碍儿童青少年的超重肥胖状况——Meta分析[J].教育生物学杂志,2014,2(4): 224-231.
Kong KM,Zhang LL,Tao YX,Overweight and obesity in children and adolescents with attention-deficit hyperactivity disorder—A Meta analysis[J].Journal of Bio-education,2014,2(4): 224-231.(in Chinese)
[28] Turkoglu S,Bilgic A,Akca OF.ADHD symptoms,breast-feeding and obesity in children and adolescents[J].Pediatr Int,2015,57(4): 546-551.
基金
国家自然科学基金青年项目(82001382); 江苏省自然科学基金青年项目(SBK2020040785);江苏省妇幼健康科研项目(F202147); 苏州市科教兴卫项目(KJXW2019018)
PDF(564 KB)
