抗肥胖药物疗法的使用对青少年肥胖症种族和民族差异的影响预测。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2024-02-06 DOI:10.1111/ijpo.13103

Mary Ellen Vajravelu, Patricia Y. Chu, David A. Frank, Maya I. Ragavan, Ravy K. Vajravelu

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引用次数: 0

摘要

背景：儿科肥胖症对少数种族和民族背景的人造成了极大的影响。最近的指南支持对患有肥胖症的青少年使用抗肥胖药物治疗，但尚未评估其对肥胖患病率差异的潜在影响：目的：模拟随着青少年使用抗肥胖药物疗法的增加，肥胖患病率的变化情况：方法：从美国国家健康与营养调查（National Health and Nutrition Examination Survey）中获得了 2011 年至 2020 年大流行前的 12-17 岁美国青少年的代表性数据。根据青少年每周皮下注射 2.4 毫克塞马鲁肽的临床试验结果，将每位参与者的体重指数（BMI）降低 16.7%。用药差异是根据成人使用同类药物的情况计算得出的。假设使用率为 10%-100%，按种族和民族分层计算肥胖患病率：在代表 26 247 384 名美国青少年的 4442 名青少年中，预计总体肥胖率从 22.2% 降至 8.4%，使用率为 100%。然而，与非西班牙裔白人青少年相比，差距有所扩大，非西班牙裔黑人和墨西哥裔美国青少年的患病率分别高出 40%-60% 到 90%-120% 不等：增加抗肥胖药物疗法的使用可能会扩大肥胖的相对差异，尤其是在使用不平等的情况下。需要倡导公平使用，以尽量减少肥胖相关差异的恶化。

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Projected impact of anti-obesity pharmacotherapy use on racial and ethnic disparities in adolescent obesity

Background

Paediatric obesity disproportionately impacts individuals from minoritized racial and ethnic backgrounds. Recent guidelines support use of anti-obesity pharmacotherapy for adolescents with obesity, but the potential impact on disparities in obesity prevalence has not been evaluated.

Objectives

To model changes in obesity prevalence with increasing utilization of anti-obesity pharmacotherapy among adolescents.

Methods

Data representative of American adolescents ages 12–17 years were obtained from the National Health and Nutrition Examination Survey, cycles 2011 through pre-pandemic 2020. A body mass index (BMI) reduction of 16.7% was applied to each participant based on clinical trial results of weekly subcutaneous semaglutide 2.4 mg among adolescents. Utilization disparities were based on utilization of the same medication class among adults. Obesity prevalence was calculated assuming utilization of 10%–100%, stratified by race and ethnicity.

Results

Among 4442 adolescents representing 26 247 384 American adolescents, projected overall obesity prevalence decreased from 22.2% to 8.4% with 100% utilization. However, disparities increased relative to Non-Hispanic White youth, with prevalence among Non-Hispanic Black and Mexican American youth ranging from 40%–60% higher to 90%–120% higher, respectively.

Conclusions

Increasing utilization of anti-obesity pharmacotherapy may widen relative disparities in obesity, particularly if utilization is unequal. Advocacy for equitable access is needed to minimize worsening of obesity-related disparities.

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.