目的 了解3~6岁孤独症谱系障碍(ASD)儿童超重/肥胖现况,并探讨超重/肥胖与其情绪行为问题的相关性,为ASD儿童制定综合干预措施提供参考依据。方法 于2022年12月—2023年12月收集南通市定点康复机构康复训练的241例3~6岁ASD儿童为研究对象,对其进行体格测量、评价、分析,采用SDQ量表评价其情绪行为问题,并探讨超重/肥胖与其情绪行为问题的相关性。结果 241例ASD儿童超重/肥胖的人数为88人(36.51%),其中超重32人(13.28%),肥胖56人(23.24%),不同性别间超重/肥胖构成差异无统计学意义(χ2=0.348,P>0.05);超重/肥胖组SDQ情绪症状和困难总分异常率分别为11.36%、82.95%,明显高于体重正常组(4.58%、70.59%),差异有统计学意义(χ2=3.927、4.569,P<0.05)。多重线性回归分析结果显示,ASD儿童体质量指数(BMI)与其情绪症状、困难总分呈正相关(β=0.32,0.31,P<0.01),年龄与困难总分呈正相关(β=0.17,P<0.01)。结论 ASD儿童普遍存在超重/肥胖问题,且超重/肥胖与其情绪行为问题有相关性且呈正相关,提醒相关部门和ASD儿童家长重视科学喂养,定期监测体格发育和情绪行为问题,尤其是年长患儿,提倡早期综合干预,积极改善患儿预后。
Abstract
Objective To investigate the prevalence of overweight/obesity in children aged 3 - 6 years with autism spectrum disorder (ASD),and to explore the correlation between overweight/obesity and emotional-behavioral problems, in order to provide a reference for developing comprehensive intervention strategies for ASD children. Methods From December 2022 to December 2023, 241 ASD children aged 3 - 6 years receiving rehabilitation training at designated rehabilitation institutions in Nantong City were enrolled as study subjects. Physical measurements and evaluations were conducted, and the Strengths and Difficulties Questionnaire (SDQ) was used to assess emotional-behavioral problems. The correlation between overweight/obesity and emotional-behavioral problems was analyzed. Results Among the 241 ASD children, 88 (36.51%) were overweight or obese, including 32 (13.28%) overweight and 56 (23.24%) obese cases. There was no statistically significant difference in the prevalence of overweight/obesity between genders (χ2=0.348, P>0.05). The abnormal rates of SDQ emotional symptoms and total difficulties score in the overweight/obese group were 11.36% and 82.95%, respectively, significantly higher than those in the normal-weight group (4.58% and 70.59%) (χ2=3.927, 4.569, P<0.05). Multiple linear regression analysis showed that BMI in ASD children was positively correlated with emotional symptoms and total difficulties score (P<0.01), and age was positively correlated with the total difficulties score (P<0.01). Conclusions Overweight/obesity is prevalent among ASD children and is positively correlated with emotional-behavioral problems. This highlights the need for relevant departments and parents of ASD children to emphasize scientific feeding practices, regularly monitor physical growth and emotional-behavioral issues, especially in older children, and advocate for early comprehensive interventions to actively improve prognosis.
关键词
孤独症谱系障碍 /
超重 /
肥胖 /
情绪行为问题
Key words
autism spectrum disorder /
overweight /
obesity /
emotional and behavioral problems
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Genovese A,Butler MG.The autism spectrum: Behavioral,psychiatric and genetic associations[J].Genes,2023,14(3): 677-670.
[2] Salari N,Rasoulpoor S,Rasoulpoor S,et al.The global prevalence of autism spectrum disorder: A comprehensive systematic review and meta-analysis[J].Ital J Pediatr, 2022, 48(1): 1-16.
[3] Dell′Osso L,Massoni L,Battaglini S,et al. Emotional dysregulation as a part of the autism spectrum continuum: A literature review from late childhood to adulthood[J].Front Psychiatry,2023,14(3): 518-520.
[4] Distefano G,Calderoni S,Apicella F,et al.Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder[J].Fronti Psychiatry,2023, 14(3): 814-816.
[5] Smolko NA,Valiev R I,Kabdesh I M,et al.Eating disorder in children: Impact on quality of life,with a spotlight on autism spectrum disorder[J].Nutr Res,2023,22(7): 1246-1249.
[6] Lim PY.Parental feeding practices and child-related factors are associated with overweight and obesity in children and adolescents with autism spectrum disorder[J].Autism Dev Disord,2022,52(8):3655-3667.
[7] Mehra S,Salinas-Miranda AA, Buro AW,et al.The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder:National survey of Children′s health 2018-2019[J].Disabil Health J,2023,22(10):1015-1018.
[8] Battle DE.Diagnostic and statistical manual of mental disorders (DSM-5)[J].Codas,2013,25(2):191-225.
[9] Li H,Ji C,Zong X,et al.Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years[J].Chin J Pediatr,2009,47(7):493-498.
[10] 杨玉凤.儿童发育行为心理评定量表[M].北京:人民卫生出版社,2020.
[11] 寇建华,杜亚松,夏黎明.儿童长处和困难问卷(父母版)上海常模的信度和效度[J].上海精神医学, 2005, 47(1): 25-28.
Kou JH, Du YS, Xia LM.Reliability and validity of the Shanghai Norm of the Children′s Strengths and Difficulties Questionnaire (Parent Version)[J] Shanghai Psychiatry,2005,47(1):25-28.(in Chinese)
[12] Kamal NN,Ghozali AH,Ismail J.Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors[J].Front Pediatr,2019,7(4): 381-384.
[13] Corbett BA,Muscatello RA,Horrocks BK,et al.Differences in body mass index (BMI) in early adolescents with autism spectrum disorder compared to youth with typical development[J].J Autism Dev Disord,2021,51(22):2790-2799.
[14] Thom RP, Palumbo ML, Keary CJ, et al. Prevalence and factors associated with overweight, obesity, and hypertension in a large clinical sample of adults with autism spectrum disorder[J].Sci Rep, 2022,12(1): 9737-9740.
[15] Sammels O,Karjalainen L,Dahlgren J,et al.Autism spectrum disorder and obesity in children:A systematic review and meta-analysis[J].Obes Facts,2022,15(3):305-320.
[16] Garcia JM,Odahowski CL.An urban versus rural comparison of obesity between youth with and without autism spectrum disorder[J].Autism Res,2023,16(1): 200-207.
[17] Kahathuduwa CN,West BD,Blume J,et al.The risk of overweight and obesity in children with autism spectrum disorders:A systematic review and meta-analysis[J].Obes Rev,2019,20(12): 1667-1679.
[18] 杨睿博,刘佳雪,韩钰等.天津市3～7岁孤独症谱系障碍儿童体格发育和营养状况研究[J].中国儿童保健杂志,2021,29(10):1058-1062.
Yang RB,Liu JX,Han Y,et al.A Study on the physical development and nutritional status of children with autism spectrum disorder aged 3~7 in Tianjin City[J].Chin J Health Care,2021,29(10):1058-1062.(in Chinese)
[19] 崔立华,杜文冉,杨笑,等.唐山市2～5岁孤独症谱系障碍儿童体格发育及健康状况分析[J].中华疾病控制杂志,2022,26(9):1102-1107.
Cui LH,Du WR,Yang X,et al.Analysis of physical development and health status of children with autism spectrum disorder aged 2-5 in Tangshan city[J].Chin J Dis Control Prev,2022,26(9):1102-1107.(in Chinese)
[20] Butera CD,Harrison L,Kilroy E,et al.Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder[J].Autism,2023,27(3):690-703.
[21] Hastings SE,Hastings RP,Swales MA,et al.Emotional and behavioural problems of children with autism spectrum disorder attending mainstream schools[J].Int J Dev Disabil,2022,68(5):633-640.
基金
南通市卫生健康委面上项目(MS2024100、MSZ2023058);南通市科技局社会民生科技计划项目(MSZ2023011)
PDF(451 KB)
