儿童多动症与肥胖共患机制的研究

Attention Deficit and Hyperactivity Disorder (ADHD) and obesity in children are important public health problems in China. The comorbidity between ADHD and obesity has been suggested by recent studies. However, the possible comorbid mechanisms underlying ADHD and obesity are unclear, as it’s hard to be explained by studies based on small size of clinic samples. It has been suggested that the impulsivity of ADHD is correlated with eating disorder which caused obesity. Whereas, a few factors may associated with both ADHD and obesity haven’t been discussed. The current study aims to explore the potential mechanisms based on the students of primary and middle school by a prospective design. The effect of eating behavior, physical activity, sedentary lifestyle, sleep and rearing environment on the comorbidity between ADHD and obesity will be discussed in the current study. Furthermore, the comorbid psychology and behavior problems among children with both ADHD and obesity also are explored. The study is expected to offer scientific evidences for the prevention and treatment for ADHD and obesity in children.

儿童多动症和肥胖已成我国重要的公共卫生问题。现有研究已经证明了儿童多动症与肥胖共患的事实，然而关于共患机制的研究还很少，共患的影响因素尚不明确。基于临床小样本、横断面的研究结果认为，多动症的冲动症状可能会导致饮食障碍，进而引起肥胖。而更多与多动症和肥胖相关的因素没有得到充分论证。需要采用纵向研究设计，解释儿童多动症与肥胖共患的因果关联机制。因此，本研究将以中小学生为研究对象，通过前瞻性的研究设计，探讨两病共患机制和影响因素。在个体行为和家庭养育层面，探讨饮食行为改变、体力活动水平、静态生活方式、睡眠状况和家庭养育环境对两病共患的作用机制。并进一步阐明共患者的共通心理行为问题特点，为我国儿童多动症与肥胖的防治提供科学依据。

儿童超重肥胖已经成为一个重要的公共卫生问题。我国儿童超重肥胖率迅速增长，已接近发达国家水平。肥胖儿童中一半以上会发展为成人肥胖，成为我国成年人肥胖和慢性病高发的重要因素。因此对儿童肥胖的成因研究和早期干预具有重要意义。儿童肥胖的成因复杂，儿童心理行为健康可能是儿童的重要诱因。本研究以在校中小学生为研究对象，着重在儿童个体行为层面和家庭养育层面探讨两病共患的危险因素。并通过分析共患者的共通心理行为问题特点，进一步解释共患机制。从多动症和其共患病入手探讨儿童多动症与肥胖的共患机制，为儿童肥胖的防控提供新的视角和科学证据。.重要结果一：用结构方程模型探讨了儿童多动症、饮食障碍和超重肥胖的关系，并证明了即使在一般群体中，儿童多动症症状会引起情感饮食和暴饮暴食行为，增加了日后患超重肥胖的风险；.重要结果二：多动症症状组儿童比无症状组儿童有更多的屏前行为、睡前屏前行为、屏前饮食行为和其它的伴随饮食行为等，这些行为潜在的增加了儿童超重肥胖的风险；.重要结果三：考察了儿童青少年焦虑抑郁与多动症的交互作用，及其对睡眠时长、入睡困难和睡眠呼吸障碍的影响。