급성 세기관지염 영아에서 비만과 연관된 요인들: 비만과 중증도의 연관성
Factors associated with obesity of acute bronchiolitis in infants: association of obesity with disease severity
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Purpose: Both under-nutrition and obesity may be associated with severity of viral infection. We investigated the association of obesity with clinical factors and the severity of acute bronchiolitis in infants. Methods: We reviewed 740 infants younger than 1 year of age who were admitted with the first episode of acute bronchiolitis between 2010 and 2013. Subjects were classified into 3 groups according to the weight-for-length Z-score. Results: Younger age (3.6±2.6 months) was more frequent in the obesity group (P<0.001). Infants aged ≤6 months (90%) dominantly included in the obesity group. Logistic regression showed that age (younger than 3 months) was independently associated with the overweight and obesity groups with acute bronchiolitis in infants (odds ratio [OR], 1.77; P=0.001 for overweight; OR, 4.67; P<0.001 for obesity). Moreover, the obesity group was associated with an increased risk of chest retraction, hypoxia, respiratory syncytial virus detection, length of stay (more than 5 days), and need for oxygen supplement. These factors tended to increase from the overweight group toward the obesity group. Conclusion: Younger than 3 months of age was a risk factor for developing worse clinical course in overweight and obesity groups with acute bronchiolitis in infants. Careful attention should be paid to the clinical course of younger obese infants with acute bronchiolitis.
Abstract
Purpose: Both under-nutrition and obesity may be associated with severity of viral infection. We investigated the association of obesity with clinical factors and the severity of acute bronchiolitis in infants. Methods: We reviewed 740 infants younger than 1 year of age who were admitted with the first episode of acute bronchiolitis between 2010 and 2013. Subjects were classified into 3 groups according to the weight-for-length Z-score. Results: Younger age (3.6±2.6 months) was more frequent in the obesity group (P<0.001). Infants aged ≤6 months (90%) dominantly included in the obesity group. Logistic regression showed that age (younger than 3 months) was independently associated with the overweight and obesity groups with acute bronchiolitis in infants (odds ratio [OR], 1.77; P=0.001 for overweight; OR, 4.67; P<0.001 for obesity). Moreover, the obesity group was associated with an increased risk of chest retraction, hypoxia, respiratory syncytial virus detection, length of stay (more than 5 days), and need for oxygen supplement. These factors tended to increase from the overweight group toward the obesity group. Conclusion: Younger than 3 months of age was a risk factor for developing worse clinical course in overweight and obesity groups with acute bronchiolitis in infants. Careful attention should be paid to the clinical course of younger obese infants with acute bronchiolitis.
참고문헌 (29)
- Bueno FU, "Outcome and characteristics of infants with acute viral bronchiolitis submitted to mechanical ventilation in a Brazilian pediatric intensive care", Rev Bras Ter Intensiva, 21, pp.174~182 (2009)
- Simoes EA., "Environmental and demographic risk factors for respiratory syncytial virus lower respiratory tract disease", J Pediatr, 143(5 Suppl), pp.S118~S126 (2003)
- 김현정, "호흡기 바이러스 및 아토피 소견이 세기관지염의 중증도에 미치는 영향", Allergy Asthma & Respiratory Diseases, 21(4), pp.302~312 (2011), 대한 소아알레르기 호흡기학회
- Morgan OW, "Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease", PLoS One, 5, pp.e9694~ (2010)
- Akiyama N, "Bimodal effects of obesity ratio on disease duration of respiratory syncytial virus infection in children", Allergol Int, 60, pp.305~308 (2011)
- Tracey VV, "Obesity and respiratory infection in infants and young children", Br Med J, 1, pp.16~18 (1971)
- Shibli R, "Morbidity of overweight(>or=85th percentile)in the first 2 years of life", Pediatrics, 122, pp.267~272 (2008)
- Jedrychowski W, "Predisposition to acute respiratory infections among overweight preadolescent children : an epidemiologic study in Poland", Public Health, 112, pp.189~195 (1998)
- Rivera Claros R, "Nutritional status and clinical evolution of hospitalized Chilean infants with infection by respiratory syncytial virus(RSV)", Arch Latinoam Nutr, 49, pp.326~332 (1999)
- 정효진, "영아에서 반복적 천명에 영향을 미치는 요인: Respiratory Syncytial Virus 감염과 반복적 천명과의 연관성", Allergy Asthma & Respiratory Diseases, 21(4), pp.319~325 (2011), 대한 소아알레르기 호흡기학회
- Cole TJ, "Establishing a standard definition for child overweight and obesity worldwide : international survey", BMJ, 320, pp.1240~1243 (2000)
- 문진수, "2007 한국 소아 청소년 성장도표 : 개발 과정과 전망", Korean Journal of Pediatrics, 51(1), pp.1~25 (2008), 대한소아과학회
- Garcia CG, "Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis", Pediatrics, 126, pp.e1453~e1460 (2010)
- Saunders M, "Nelson textbook of pediatrics", pp.2011, Elsevier
- 김경훈, "급성 세기관지염 영아에서 관찰된 임상 지표들과 질환의 중증도의 연관성", Allergy Asthma & Respiratory Diseases, 1(4), pp.377~382 (2013), 대한 소아알레르기 호흡기학회
- Damore D, "Prospective multicenter bronchiolitis study : predicting intensive care unit admissions", Acad Emerg Med, 15, pp.887~894 (2008)
- Stensballe LG, "Atopic disposition, wheezing, and subsequent respiratory syncytial virus hospitalization in Danish children younger than 18 months: a nested case-control study", Pediatrics, 118, pp.e1360~e1368 (2006)
- Adair LS, "Child and adolescent obesity : epidemiology and developmental perspectives", Physiol Behav, 94, pp.8~16 (2008)
- Victora CG, "The NCHS reference and the growth of breast-and bottle-fed infants", J Nutr, 128, pp.1134~1138 (1998)
- Kramer MS, "Breastfeeding and infant growth: biology or bias?", Pediatrics, 110(2 Pt 1), pp.343~347 (2002)
- Tal A, "Dexamethasone and salbutamol in the treatment of acute wheezing in infants", Pediatrics, 71, pp.13~18 (1983)
- Baumer JH., "SIGN guideline on bronchiolitis in infants", Arch Dis Child Educ Pract Ed, 92, pp.149~151 (2007)
- Shaw KN, "Outpatient assessment of infants with bronchiolitis", Am J Dis Child, 145, pp.151~155 (1991)
- Plint AC, "Practice variation among pediatric emergency departments in the treatment of bronchiolitis", Acad Emerg Med, 11, pp.353~360 (2004)
- Jee HM, "Association of higher adiposity and wheezing in infants with lower respiratory illnesses", Acta Paediatr, 99, pp.1365~1369 (2010)
- Wang EE, "Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections", Am Rev Respir Dis, 145, pp.106~109 (1992)
- Wainwright C, "Acute viral bronchiolitis in children : a very common condition with few therapeutic options", Paediatr Respir Rev, 11, pp.39~45 (2010)
- El-Radhi AS, "Association of fever and severe clinical course in bronchiolitis", Arch Dis Child, 81, pp.231~234 (1999)
- Marguet C, "In very young infants severity of acute bronchiolitis depends on carried viruses", PLoS One, 4, pp.e4596~ (2009)
