Socioecologic Factors Associated With Obesity in Adolescents With Epilepsy in the United States.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Child Neurology Pub Date : 2023-10-01 Epub Date: 2023-10-03 DOI:10.1177/08830738231203761

Acadia W Buro, Rachel Sauls, Abraham Salinas-Miranda, Russell S Kirby

{"title":"Socioecologic Factors Associated With Obesity in Adolescents With Epilepsy in the United States.","authors":"Acadia W Buro, Rachel Sauls, Abraham Salinas-Miranda, Russell S Kirby","doi":"10.1177/08830738231203761","DOIUrl":null,"url":null,"abstract":"Background: 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.Methods: 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.Results: 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.Conclusion: 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.","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":" ","pages":"642-652"},"PeriodicalIF":2.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08830738231203761","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/3 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

查看原文本刊更多论文

美国癫痫青少年肥胖的社会经济因素。

背景：青年癫痫患者的肥胖具有多因素病因，但尚未对该人群的社会生态肥胖风险因素（如邻里因素）进行检查。本研究检验了（1）经相关协变量调整后的肥胖患病率，以及（2）10-17岁癫痫青少年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n = 27094；癫痫 = 184）。卡方检验比较了所有青少年和癫痫青少年的肥胖加权患病率和相关协变量。采用加权多元逻辑回归模型对协变量进行调整。结果：青少年癫痫患者的肥胖患病率为27.8%（95%可信区间[CI]15.4%-40.3%），而非癫痫组为15.1%（95%CI14.1%-16.2%）。在调整年龄、性别、种族/民族、家庭收入、体育活动和医疗院后，患有癫痫的青少年肥胖的几率也更高（比值比[OR]2.1，95%CI 1.2-3.8）。调整社会人口统计学、焦虑（OR 4.5，95%CI 1.3-15.6）、2次或2次以上不良童年经历（OR 7.3，95%CI 1.6-33.4），社区减损因素（例如，OR 5.2，1个减损因素的95%CI 1.5-18.5）和放弃护理（即未满足的医疗保健需求）（OR 22.4，95%CI 3.8-132.8）与癫痫青少年的肥胖有关。针对多重比较进行调整，邻域减损元素（P P 结论：与心理健康、家庭功能、建筑环境和放弃护理相关的变量与癫痫青少年的肥胖有关，但这些因素并不能完全解释这种联系。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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Child Neurology 医学-临床神经学

CiteScore

4.20

自引率

5.30%

发文量

111

审稿时长

3-6 weeks

期刊介绍： The Journal of Child Neurology (JCN) embraces peer-reviewed clinical and investigative studies from a wide-variety of neuroscience disciplines. Focusing on the needs of neurologic patients from birth to age 18 years, JCN covers topics ranging from assessment of new and changing therapies and procedures; diagnosis, evaluation, and management of neurologic, neuropsychiatric, and neurodevelopmental disorders; and pathophysiology of central nervous system diseases.