PDF(Pubmed)
Abstract：
Dietary behavior is a main contributing yet modifiable factor to the body weight status of children and may be involved in the pathophysiology of childhood obstructive sleep apnea (OSA). This study aimed to investigate the dietary profile of pediatric OSA patients, effects of educational counseling after adenotonsillectomy, and predictor for disease resolution.
This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control). The three groups were matched by age. The consumption frequency of 25 food items/groups was assessed by the Short Food Frequency Questionnaire. Quality of life was evaluated by the OSA-18 questionnaire. Sleep architecture and OSA severity were measured by standard polysomnography. Between- and within-group comparisons were analyzed by non-parametric approaches and generalized estimating equations. Prediction of disease recovery was performed by multivariable logistic regression models.
Group 1 children consumed fruit drinks with sugar, vegetables, sweets, chocolate, rice, and noodles more frequently than Control Group children. At baseline, the distributions of sex, weight status, OSA-18 scores, and polysomnographic variables were comparable between Group 1 and Group 2. After a 12-month follow-up, Group 1 had better improvements in physical suffering, caregiver concerns, sleep architecture, and mean peripheral oxygen saturation compared to Group 2. Furthermore, Group 1 no longer had excessive consumption of fruit drinks with sugar, chocolate, and noodles; however, food consumption frequencies did not change significantly. Notably, younger age and reduced intake of butter/margarine on bread and noodles were independent predictors of cured OSA in Group 1.
The present study preliminarily characterized an unhealthy dietary profile among pediatric OSA patients and suggested that routine educational counseling in addition to adenotonsillectomy yielded some clinical benefits. Certain items/groups of food frequencies may be associated with disease recovery and further investigations are warranted.
This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control). The three groups were matched by age. The consumption frequency of 25 food items/groups was assessed by the Short Food Frequency Questionnaire. Quality of life was evaluated by the OSA-18 questionnaire. Sleep architecture and OSA severity were measured by standard polysomnography. Between- and within-group comparisons were analyzed by non-parametric approaches and generalized estimating equations. Prediction of disease recovery was performed by multivariable logistic regression models.
Group 1 children consumed fruit drinks with sugar, vegetables, sweets, chocolate, rice, and noodles more frequently than Control Group children. At baseline, the distributions of sex, weight status, OSA-18 scores, and polysomnographic variables were comparable between Group 1 and Group 2. After a 12-month follow-up, Group 1 had better improvements in physical suffering, caregiver concerns, sleep architecture, and mean peripheral oxygen saturation compared to Group 2. Furthermore, Group 1 no longer had excessive consumption of fruit drinks with sugar, chocolate, and noodles; however, food consumption frequencies did not change significantly. Notably, younger age and reduced intake of butter/margarine on bread and noodles were independent predictors of cured OSA in Group 1.
The present study preliminarily characterized an unhealthy dietary profile among pediatric OSA patients and suggested that routine educational counseling in addition to adenotonsillectomy yielded some clinical benefits. Certain items/groups of food frequencies may be associated with disease recovery and further investigations are warranted.
摘要：
■饮食行为是儿童体重状况的主要影响因素，可能与儿童阻塞性睡眠呼吸暂停（OSA）的病理生理有关。本研究旨在调查儿童OSA患者的膳食结构,扁桃腺切除术后教育咨询的效果，和预测疾病的解决。
■这项观察性研究包括50名接受常规教育咨询的儿童OSA患者（第1组），50例小儿OSA患者接受腺样体扁桃体切除术而未接受正规教育咨询（第2组），和303名没有OSA的健康儿童（对照）。三组按年龄匹配。通过短期食物频率问卷评估了25种食物/组的消费频率。通过OSA-18问卷评估生活质量。通过标准多导睡眠图测量睡眠结构和OSA严重程度。通过非参数方法和广义估计方程分析了组间和组内比较。通过多变量逻辑回归模型进行疾病恢复的预测。
■第一组儿童食用含糖的水果饮料，蔬菜,糖果，巧克力,大米,和面条比对照组的孩子更频繁。在基线,性别的分布，体重状态,OSA-18得分,多导睡眠图变量在第1组和第2组之间具有可比性。经过12个月的随访，第一组在身体痛苦方面有更好的改善，照顾者的担忧，睡眠建筑，和与第2组相比的平均外周血氧饱和度。此外，第1组不再过量食用含糖的水果饮料，巧克力,和面条；然而，食物消费频率没有显著变化。值得注意的是,年龄较小以及面包和面条上黄油/人造黄油的摄入量减少是第1组OSA固化的独立预测因素。
■本研究初步表征了小儿OSA患者的不健康饮食状况，并建议除了腺样体扁桃体切除术外，常规教育咨询也会产生一些临床益处。某些项目/组的食物频率可能与疾病恢复有关，需要进一步调查。
■这项观察性研究包括50名接受常规教育咨询的儿童OSA患者（第1组），50例小儿OSA患者接受腺样体扁桃体切除术而未接受正规教育咨询（第2组），和303名没有OSA的健康儿童（对照）。三组按年龄匹配。通过短期食物频率问卷评估了25种食物/组的消费频率。通过OSA-18问卷评估生活质量。通过标准多导睡眠图测量睡眠结构和OSA严重程度。通过非参数方法和广义估计方程分析了组间和组内比较。通过多变量逻辑回归模型进行疾病恢复的预测。
■第一组儿童食用含糖的水果饮料，蔬菜,糖果，巧克力,大米,和面条比对照组的孩子更频繁。在基线,性别的分布，体重状态,OSA-18得分,多导睡眠图变量在第1组和第2组之间具有可比性。经过12个月的随访，第一组在身体痛苦方面有更好的改善，照顾者的担忧，睡眠建筑，和与第2组相比的平均外周血氧饱和度。此外，第1组不再过量食用含糖的水果饮料，巧克力,和面条；然而，食物消费频率没有显著变化。值得注意的是,年龄较小以及面包和面条上黄油/人造黄油的摄入量减少是第1组OSA固化的独立预测因素。
■本研究初步表征了小儿OSA患者的不健康饮食状况，并建议除了腺样体扁桃体切除术外，常规教育咨询也会产生一些临床益处。某些项目/组的食物频率可能与疾病恢复有关，需要进一步调查。
