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Mikilvægi mittismáls við eftirlit barna með offitu. Alvarleg frávik í blóðgildum hjá íslenskum börnum með offitu

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Authors
Ásdís Eva Lárusdóttir
Ragnar Bjarnason
Ólöf Elsa Björnsdóttir
Berglind Brynjólfsdóttir
Anna Sigríður Ólafsdóttir
Tryggvi Helgason
Issue Date
2015-09

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Other Titles
Importance of waist circumference measurements when following children with obesity: Serious abnormalities in blood values of Iceandic children with obesity
Citation
Læknablaðið 2015, 101(9): 399-403
Abstract
Inngangur: Offita barna er vaxandi heilbrigðisvandamál í heiminum. Gegnum tíðina hefur líkamsþyngdarstuðull (Body Mass Index, BMI) verið helsti mælikvarði á offitu en ágæti hans hefur verið dregið í efa hjá börnum. Heilsuskólinn var stofnaður árið 2011 þegar þverfaglegt teymi var sett saman á Barnaspítala Hringsins til að aðstoða börn og fjölskyldur þeirra við að bæta lífsvenjur sínar. Markmið rannsóknarinnar var að finna þann mælikvarða á offitu barna sem hafði mest forspárgildi um frávik í blóðgildum auk þess að fá heildstæða mynd af frávikum í efnaskiptum barna með offitu í Heilsuskólanum. Efniviður og aðferðir: Rannsóknin var afturskyggn, lýsandi og náði til allra barna sem leitað höfðu til Heilsuskóla Barnaspítalans á tímabilinu 1. janúar 2011 til 15. mars 2013 (n=181). Upplýsingatæknisvið Landspítalans tók saman upplýsingar um hæð, þyngd, BMI, mittismál og niðurstöður blóðrannsókna. Niðurstöður: Frávik í einu eða fleiri blóðgildum fundust hjá 54 börnum (47%). Af þeim börnum sem upplýsingar voru til staðar um höfðu fjögur (4%) staðfesta fitulifur og 28 (28%) höfðu insúlínhækkun, þar af átta (8%) að því marki að þörf væri á inngripi (hyperinsulinemia). Eitt barn hafði bæði fitulifur og marktæka insúlínhækkun. Ályktun: Frávik í blóðgildum barna með offitu eru algeng. Mittismál virðist hafa meira forspárgildi um frávik í efnaskiptum tengdum offitu en BMI-SDS. Mittismál mætti nota til að skima fyrir þeim börnum sem þurfa á reglulegu eftirliti að halda með tilliti til frávika í efnaskiptum. Mittismál bætir mikilvægum upplýsingum við í áhættumati á börnum með offitu. Rannsóknin sýnir því mikilvægi þess að heilbrigðisstarfsfólk mæli mittismál barna sem þeir hafa til meðferðar og eftirlits.
Introduction:Childhood obesity is a growing health problem worldwide. Body mass index (BMI) has been used as the main measurement of obesity for years but its quality for children has been questioned. In 2011 the Health School was formed at the Childrens Medical Center at Landspitali University Hospital for treatment of obese children and their families. The aim of this study was to find the best predictor of blood test abnormalities and to get a clear picture of abnormalities in blood values in the group of obese children referred to the Health School. Methods:All children referred to the Health School from January 1st 2011 until March 15th 2013 were retrospectively studied (n=181). Information was gathered on height, weight, BMI, waist circumference and available blood variables. Results:Abnormal blood values were found in 54 cases (47%). Of the children where information was available, four (4%) had Non-Alchoholic Fatty Liver Disease (NAFLD) and 28 (28%) had a raised fasting insulin levels whereof 8 (8%) needed treatment. One child had both NAFLD and raised fasting insulin. Conclusion: Abnormal blood values are common in obese children. Waist circumference appears to have a better predictive value of these abnormalities than BMI-SDS. Waist circumference could be used to screen for children who need physician supervision because of risk of metabolic disorders. Waist circumference adds important information to the risk assessment of obese children. This study emphasises the importance of care givers measuring waist circumference in obese children.
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Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn
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