摘要
Objective: To determine whether exercise intolerance and recommended activity restrictions are associated with development of overweight and obesity in childr en with congenital heart disease. Design: Retrospective review. Setting: Pediatr ic cardiology practice at a teaching hospital. Participants: A total of 110 pedi atric congenital heart disease patients followed up for a mean of 8.4 years. Mai n Outcome Measures: Body mass index (BMI),sex-appropriate BMI percentiles, over weight (BMI percentile ≥85), and obesity (BMI percentile ≥95) at followup. Res ults: As a group, the increase in BMI percentiles was close to 10 points, but th e increase was 21.6 points for exercise intolerant children and 27.3 points for activity restricted children. Activity restriction was significantly associated with both overweight (risk ratio [RR], 2.60; 95%confidence interval [CI], 1.34 -3.54) and obesity at follow-up (RR, 4.08; 95%CI, 1.42-7.38) after adjusting for weight at baseline. For the subset of 92 children at a healthy weight at ba seline, activity restriction was again significantly associated with overweight (RR, 2.51; 95%CI, 1.24-3.52) and obesity (RR, 6.14; 95%CI, 2.54-8.82) at fol low-up. Exercise intolerance did not attain statistical significance. Conclusio ns: Exercise intolerant and activity restricted children experienced larger incr eases in absolute BMI and BMI percentile than children with neither exercise int olerance nor activity restriction. Activity restriction was the strongest predic tor of risk of overweight and obesity at follow-up. Elevated weight and obesity may cause these children significant additional health burdens. Theref ore, when patients must be counseled against physical exertion, they also need t o be educated about the importance of appropriate physical activity and good die tary practices.
Objective: To determine whether exercise intolerance and recommended activity restrictions are associated with development of overweight and obesity in childr en with congenital heart disease. Design: Retrospective review. Setting: Pediatr ic cardiology practice at a teaching hospital. Participants: A total of 110 pedi atric congenital heart disease patients followed up for a mean of 8.4 years. Mai n Outcome Measures: Body mass index (BMI),sex-appropriate BMI percentiles, over weight (BMI percentile ≥85), and obesity (BMI percentile ≥95) at followup. Res ults: As a group, the increase in BMI percentiles was close to 10 points, but th e increase was 21.6 points for exercise intolerant children and 27.3 points for activity restricted children. Activity restriction was significantly associated with both overweight (risk ratio [RR], 2.60; 95%confidence interval [CI], 1.34 -3.54) and obesity at follow-up (RR, 4.08; 95%CI, 1.42-7.38) after adjusting for weight at baseline. For the subset of 92 children at a healthy weight at ba seline, activity restriction was again significantly associated with overweight (RR, 2.51; 95%CI, 1.24-3.52) and obesity (RR, 6.14; 95%CI, 2.54-8.82) at fol low-up. Exercise intolerance did not attain statistical significance. Conclusio ns: Exercise intolerant and activity restricted children experienced larger incr eases in absolute BMI and BMI percentile than children with neither exercise int olerance nor activity restriction. Activity restriction was the strongest predic tor of risk of overweight and obesity at follow-up. Elevated weight and obesity may cause these children significant additional health burdens. Theref ore, when patients must be counseled against physical exertion, they also need t o be educated about the importance of appropriate physical activity and good die tary practices.
