Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지

The Factors Associated with Change in Percent Obesity after Obesity Treatment among Obese Children and Adolescents

비만 소아 및 청소년의 치료 후 비만도 변화와 관련된 요인

Lee, Ka-Young;Kim, Jin-Kyung;Lee, Nam-Su;Han, Jeong-Hee;Park, Tae-Jin;Jeon, Hye-Nyeon
이가영;김진경;이남수;한정희;박태진;전혜년

  • Published : 20030000
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Abstract

Background : The purpose of this study was to find changes in percentage obesity and the factors associated with the changes after its treatment in obese children and adolescents. Methods : A total of 42 obese children from 3- to 17- year-olds (males 60%) were enrolled in an obesity treatment program at least 3 times. They were provided with an individual weight control program that included dietary, activity, and behavioral change information. The paired t-test, Kruskal-Wallis test, Mann-Whitney test, and linear regression were used for analyses. Results : The means of BMI, percent body fat, and percent obesity were 27.4 kg/m2, 39.4%, and 52.3%, respectively. Among them, 85.3% of obese children had one or more abnormalities on biochemical tests and 32.4% of them had 3 or more abnormalities. There was a significant reduction in weight (1.4 kg), BMI (1.1 kg/m2), percent body fat (1.8%) and percent obesity (7.1%), whereas height increased significantly by 1.3 cm after the treatment. The decrease in percent obesity was associated significantly with the number of follow-up, the number of accompanied biochemical abnormality, and the duration of treatment. The decrease in percent obesity was 12.9% among obese children who were followed-up 6 times or more, by 12.2% among those who did not accompany biochemical abnormality and by 13.3% among those who were retained in the program for 76 days or over. However, the change in % obesity was not associated with sex, age groups (＜12, ≥12-year-old), severity of obesity and parental obesity. The percent obesity decreased by 5.2% as the number of follow-up (n=3/4, 5/6∼17) increased after adjusting for sex, age groups and the number of biochemical abnormalities. The number of follow-up also explained 38% for the variance of change in percent obesity in that model. Conclusion : Continuous program retention was an effective factor to reduce percent obesity. Therefore, further investigation is needed to develop methods to enforce program retention.

연구배경 : 비만 소아와 청소년에서 비만 치료 후 비만도 변화 및 비만도 변화와 관련된 요인을 알아보고자 하였다. 방법 : 1개 대학병원 비만클리닉에서 3회 이상 비만치료에 참여한 3세에서 17세에 해당하는 소아 및 청소년 42명(남아 60%)과 보호자에게 개인별로 식이, 운동, 행동 변화를 위한 치료를 실시하였다. 비만도 변화와 관련된 변수를 파악하기 위하여 paired t-test, Kruskal-Wallis test, Mann-Whitney test, 다중 선형회귀분석을 실시하였다. 결과 : 소아의 평균 체질량지수는 27.4 kg/m2, 체지방률 평균은 39.4%, 비만도 평균은 52.3%이었고, 85.3%에서 한 가지 이상, 32.4%에서 세 가지 이상의 생화학적 이상을 동반하고 있었다. 치료 후 평균 변화량은 신장이 1.3 cm 유의하게 증가하였으며 체중이 1.4 kg, 체질량지수가 1.1 kg/m2, 체지방률이 1.8%, 비만도가 7.1% 유의하게 감소하였다. 소아의 성별, 연령층(11세 이하와 12세 이상), 고도 비만 유무, 부모의 비만 유무에 따라 비만도 변화량은 유의한 차이가 없었다. 그러나 치료 참여 횟수가 많거나 생화학적 이상이 동반되지 않거나 치료기간이 긴 경우에 비만도 감소가 유의하게 커서(P＜0.05) 6회 이상 치료받은 경우에 12.9%, 생화학적 이상이 동반되지 않은 경우에 12.2%, 치료 기간이 76일 이상인 비만아에서 13.3% 감소하였다. 성별, 연령층, 생화학적 이상 유무를 보정한 후 치료를 받은 횟수가 늘수록(3회/4, 5회/6∼17회) 비만도가 5.2% 감소하였고, 이 모델은 치료 전후의 비만도 변화를 38% 설명하였다. 결론 : 지속적인 비만 치료 참여가 비만도 감소에 효과적이었으므로 비만 치료에 지속적으로 참여하게 하기 위한 방법을 개발하여야 할 것으로 생각한다.

Keywords

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