Abstract：
Obesity among youth with epilepsy has multifactorial etiology, yet socioecologic obesity risk factors (eg, neighborhood factors) have not been examined in this population. This study examined (1) the prevalence of obesity adjusting for relevant covariates and (2) socioecologic correlates of obesity in adolescents with epilepsy aged 10-17 years.
This cross-sectional study used 2017-2018 National Survey of Children\'s Health data (total n = 27,094; epilepsy n = 184). Chi-square tests compared weighted prevalence of obesity with relevant covariates among all adolescents and adolescents with epilepsy. Weighted multiple logistic regression models were conducted to adjust for covariates.
The prevalence of obesity in adolescents with epilepsy was 27.8% (95% confidence interval [CI] 15.4%-40.3%) vs 15.1% (95% CI 14.1%-16.2%) for the non-epilepsy group. Adolescents with epilepsy also had higher odds of obesity after adjusting for age, gender, race/ethnicity, household income, physical activity, and medical home (odds ratio [OR] 2.1, 95% CI 1.2-3.8). Adjusting for sociodemographics, anxiety (OR 4.5, 95% CI 1.3-15.6), 2 or more adverse childhood experiences (OR 7.3, 95% CI 1.6-33.4), neighborhood detracting elements (eg, OR 5.2, 95% CI 1.5-18.5 for 1 detracting element), and forgone care (ie, unmet health care needs) (OR 22.4, 95% CI 3.8-132.8) were associated with obesity in adolescents with epilepsy. Adjusting for multiple comparisons, neighborhood detracting elements (P < .0001) and forgone care (P < .0007) remained significant.
Variables related to mental health, family functioning, built environment, and forgone care were associated with obesity in adolescents with epilepsy, but the association was not fully explained by these factors. Obesity interventions for this population should consider multiple levels of influence including the community and special health care needs of this population.
This cross-sectional study used 2017-2018 National Survey of Children\'s Health data (total n = 27,094; epilepsy n = 184). Chi-square tests compared weighted prevalence of obesity with relevant covariates among all adolescents and adolescents with epilepsy. Weighted multiple logistic regression models were conducted to adjust for covariates.
The prevalence of obesity in adolescents with epilepsy was 27.8% (95% confidence interval [CI] 15.4%-40.3%) vs 15.1% (95% CI 14.1%-16.2%) for the non-epilepsy group. Adolescents with epilepsy also had higher odds of obesity after adjusting for age, gender, race/ethnicity, household income, physical activity, and medical home (odds ratio [OR] 2.1, 95% CI 1.2-3.8). Adjusting for sociodemographics, anxiety (OR 4.5, 95% CI 1.3-15.6), 2 or more adverse childhood experiences (OR 7.3, 95% CI 1.6-33.4), neighborhood detracting elements (eg, OR 5.2, 95% CI 1.5-18.5 for 1 detracting element), and forgone care (ie, unmet health care needs) (OR 22.4, 95% CI 3.8-132.8) were associated with obesity in adolescents with epilepsy. Adjusting for multiple comparisons, neighborhood detracting elements (P < .0001) and forgone care (P < .0007) remained significant.
Variables related to mental health, family functioning, built environment, and forgone care were associated with obesity in adolescents with epilepsy, but the association was not fully explained by these factors. Obesity interventions for this population should consider multiple levels of influence including the community and special health care needs of this population.
摘要：
背景：患有癫痫的青少年肥胖具有多因素病因，然而，社会生态型肥胖风险因素(例如，邻里因素)尚未在该人群中进行检查。这项研究检查了（1）针对相关协变量进行调整的肥胖患病率，以及（2）10-17岁青少年癫痫患者肥胖的社会生态相关性。
方法：这项横断面研究使用了2017-2018年全国儿童健康调查数据（总计n=27,094；癫痫n=184）。卡方检验比较了所有青少年和患有癫痫的青少年中肥胖的加权患病率和相关协变量。进行加权多元逻辑回归模型以调整协变量。
结果：青少年癫痫患者肥胖患病率为27.8%（95%置信区间[CI]15.4%-40.3%），非癫痫患者为15.1%（95%CI14.1%-16.2%）。调整年龄后，患有癫痫的青少年肥胖的几率也更高，性别,种族/民族,家庭收入,身体活动,和医疗之家（比值比[OR]2.1，95%CI1.2-3.8）。适应社会人口统计学，焦虑（OR4.5，95%CI1.3-15.6），2次或更多次不良儿童经历（OR7.3，95%CI1.6-33.4），邻域缩小元素(例如，或5.2，95%CI1.5-18.5为1个减除元素)，并放弃照顾(即，未满足的医疗保健需求)(OR22.4,95%CI3.8-132.8)与青少年癫痫患者肥胖相关.调整多重比较，邻域减损元素(P<.0001)和放弃照顾(P<.0007)仍然显著。
结论：与心理健康相关的变量，家庭功能,建筑环境，放弃护理与患有癫痫的青少年肥胖有关，但这些因素并不能完全解释这种关联.针对该人群的肥胖干预措施应考虑多个层面的影响，包括该人群的社区和特殊医疗保健需求。
方法：这项横断面研究使用了2017-2018年全国儿童健康调查数据（总计n=27,094；癫痫n=184）。卡方检验比较了所有青少年和患有癫痫的青少年中肥胖的加权患病率和相关协变量。进行加权多元逻辑回归模型以调整协变量。
结果：青少年癫痫患者肥胖患病率为27.8%（95%置信区间[CI]15.4%-40.3%），非癫痫患者为15.1%（95%CI14.1%-16.2%）。调整年龄后，患有癫痫的青少年肥胖的几率也更高，性别,种族/民族,家庭收入,身体活动,和医疗之家（比值比[OR]2.1，95%CI1.2-3.8）。适应社会人口统计学，焦虑（OR4.5，95%CI1.3-15.6），2次或更多次不良儿童经历（OR7.3，95%CI1.6-33.4），邻域缩小元素(例如，或5.2，95%CI1.5-18.5为1个减除元素)，并放弃照顾(即，未满足的医疗保健需求)(OR22.4,95%CI3.8-132.8)与青少年癫痫患者肥胖相关.调整多重比较，邻域减损元素(P<.0001)和放弃照顾(P<.0007)仍然显著。
结论：与心理健康相关的变量，家庭功能,建筑环境，放弃护理与患有癫痫的青少年肥胖有关，但这些因素并不能完全解释这种关联.针对该人群的肥胖干预措施应考虑多个层面的影响，包括该人群的社区和特殊医疗保健需求。
