Clinical and metabolic effect of a multidisciplinary intervention through a comprehensive care program for children and adolescents with obesity

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Title Clinical and metabolic effect of a multidisciplinary intervention through a comprehensive care program for children and adolescents with obesity
Efecto clínico y metabólico de una intervención multidisciplinaria en el marco de un programa de atención integral para niños y adolescentes con obesidad
 
Creator Zuluaga, Nora Alejandra
Osorno, Adriana
Lozano, Alba
Villada, Oscar
 
Subject Metabolic syndrome
body mass index
obesity
risk factors
children
adolescents
exercise
healthy diet
education
síndrome metabólico
índice de masa corporal
obesidad
factores de riesgo
niño
adolescentes
ejercicio
dieta saludable
educación
 
Description Introduction: The approach to childhood obesity requires multidisciplinary programs including all the dimensions susceptible to management.Objective: To describe the clinical and metabolic changes in patients with obesity after a comprehensive care program for childhood obesity.Materials and methods: We conducted a retrospective observational and analytical study in a cohort of patients between 6 and 17 years old treated in the obesity program at the Hospital Universitario San Vicente Fundación (2012-2015). We carried out multidisciplinary care and educational intervention. Anthropometric and laboratory variables were evaluated both at admission to the program and in the last evaluation and statistical differences were sought according to the follow-up time.Results: We evaluated 53 patients, of whom 52.8% were men, with an average age of 11 ± 2 years. The follow-up extended for 18 ± 6 months though 30% of the patients were followed for 31 to 36 months. There was a decrease in the BMI (Z score) between admission (2.75 ± 0.58 and the last control (2.32 ± 0.63) with a p-value of 0.000 (95% CI: 0.27 -0.58); 79.25% of the patients reduced the BMI Z score. This decrease was significant regardless of the follow-up time. The proportion of patients with a BMI Z score >3 decreased from 33.4% to 14.6%. The number of positive criteria for metabolic syndrome decreased in the follow-up. Triglycerides and HbA1c were the metabolic variables that improved significantly.Conclusions: The management of childhood obesity with an interdisciplinary intervention associated with continuous group educational support can significantly impact on clinical and metabolic changes. It is necessary to continue monitoring over time to prevent relapse.
Introducción. La obesidad infantil requiere una atención con programas multidisciplinarios que integren todas sus dimensiones.Objetivo. Describir los cambios clínicos y metabólicos en pacientes con obesidad después de su participación en un programa de atención integral en obesidad infantil.Materiales y métodos. Se hizo un estudio observacional y analítico retrospectivo de una cohorte de pacientes de 6 a 17 años de edad atendidos en el programa de obesidad del Hospital Universitario de San Vicente Fundación (2012-2015), el cual incluyó la atención multidisciplinaria y una intervención educativa. Se evaluaron variables antropométricas y de laboratorio en el momento del ingreso al programa y en la última evaluación. Se exploraron las diferencias según el tiempo de seguimiento.Resultados. Se evaluaron 53 pacientes con una edad promedio de 11 ± 2 años, 52,8 % de los cuales eran hombres. El seguimiento de los pacientes fue de 18 ± 6 meses, aunque en el 30 % de ellos fue de 31 a 36 meses. Se encontró una disminución del índice de masa corporal (IMC; puntaje Z) entre el ingreso (2,75 ± 0,58) y el último control (2,32 ± 0,63) con un valor de p de 0,000 (IC95% 0,27-0,58). El 79,25 % de los pacientes redujo el puntaje Z del IMC. Esta disminución fue significativa independientemente del tiempo de seguimiento. La proporción de pacientes con un puntaje Z del IMC mayor de 3 pasó del 33,4 al 14,6 %. El número de criterios positivos para el síndrome metabólico disminuyó en el seguimiento. Los niveles de triglicéridos y de hemoglobina 'glicada' o 'glicosilada' (HbA1c) mejoraron significativamente.Conclusiones. El manejo de la obesidad infantil con una intervención multidisciplinaria asociada a apoyo educativo grupal continuo puede influir significativamente en los cambios clínicos y metabólicos. Es necesario prolongar el tiempo de seguimiento para prevenir las recaídas.
 
Publisher Instituto Nacional de Salud
 
Date 2020-03-01
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
text/xml
 
Identifier https://revistabiomedica.org/index.php/biomedica/article/view/4593
10.7705/biomedica.4593
 
Source Biomedica; Vol. 40 No. 1 (2020); 166-184
Biomédica; Vol. 40 Núm. 1 (2020); 166-184
2590-7379
0120-4157
 
Language spa
 
Relation https://revistabiomedica.org/index.php/biomedica/article/view/4593/4365
https://revistabiomedica.org/index.php/biomedica/article/view/4593/4547
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