과체중 아동에서 신장 성장과 비만도 변화간의 관계
The Relationship between Relative BMI Change and Height Growth among Overweight Children
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연구배경: 과체중 자녀를 둔 부모들의 상당수에서 ‘신장이 자 라면서 비만도가 개선 될 것’이라고 믿고 있다. 이러한 통념이 근거가 있는지 알기 위해 과체중 학동기 아동들을 대상으로 2 년간의 전향적 연구를 시행하였다. 방법: 김해시에 소재한 2개 초등학교에서 2003년에 과체중으 로(1999년 대한소아과학회 성별 연령별 체질량지수 기준으 로 85 백분위수 이상) 파악되었고, 2년 후 체중과 신장 측정 자 료를 추적할 수 있었던 6-11세 190명의 아동(남아 113명, 여아 77명)과 부모가 연구 대상이었다. 아동들의 식사습관, 신체활 동, 체중 감량 시도 유무와 부모들의 자녀 체중에 대한 태도를 2003년에 설문지로 조사하였다. 비만도는 상대 체질량지수로 평가하였다. 다중회귀분석으로 2년간의 신장 증가량과 2년간 의 비만도 변화량간의 관련성을 분석하였다. 결과: 아동들의 초기 비만도는 134.9±13.8%이었다. 63%에서 체중 감량을 시도하였고, 부모의 49%에서 자녀의 체중을 감 량하려고 시도하였다. 2년간 체질량지수는 1.62.1 ㎏/㎡ 증가 하였고, 비만도는 1.2±12.1% 감소하였다. 아동 본인의 감량 시 도, 부모의 체중 관련 태도, 아동의 식사습관, 신체활동은 2년 간 비만도 변화량과 유의한 관련성이 없었다. 성별, 연령, 초기 비만도, 2년간 신장 변화량은 2년간 비만도 변화량의 변이를 15% 설명하였고(R2=0.15, P<0.001) 성별, 연령, 초기 비만도를 보정한 후 2년간 신장이 많이 자랄수록 2년간 비만도가 많이증가하였다(B=0.86, SE=0.28, P=0.002). 결론: 과체중 학동기 아동에서 2년간 신장 증가는 비만도 증 가와 관련이 있으므로 신장 증가로 비만도가 개선될 것이라 는 통념에 대한 교육이 필요하다.
Abstract
Background: Many parents of overweight children have believed that their children's weight may be lost with the increase of their height. The purpose of this 2-year prospective study was to examine whether such belief is valid. Methods: A total of 190 children (113 boys and 77 girls) aged 6-11 years who were overweight (BMI > 85th percentile of age and gender-specific 1999 Korean children standard) from two elementary schools were the subjects. Their height and weight were measured again after 2 years. Children and their parents completed questionnaires on eating habits and physical activity, and their attitude on weight in the beginning of study. Children's weight status was evaluated using relative BMI. Results: Children's baseline relative BMI was 134.9 ± 13.8%. About 60% of the children reported weight loss attempt and 49% of their parents tried to persuade their child to lose weight. Children's BMI increased by 1.6 ± 2.1 ㎏/㎡ and their relative BMI decreased by 1.2 ± 12.1% over 2 years. While children's eating habits and physical activity, and their attitude on the child's weight were not related to the 2-year relative BMI change, the child's age, gender, baseline relative BMI, and the 2-year height change were associated with the 2-year relative BMI change (R2 = 0.15, P < 0.001). The 2-year relative BMI increased with the 2-year height increase after controlling for the three predictors (B = 0.86, SE = 0.28, P = 0.002). Conclusion: We found the 2-year height change positively associated with the 2-year relative BMI change among schoolaged overweight children. Then, the belief that children's weight status may be improved with the increase of their height should be denied.
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