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Læknablaðið - 01.05.2015, Blaðsíða 16

Læknablaðið - 01.05.2015, Blaðsíða 16
248 LÆKNAblaðið 2015/101 R A N N S Ó K N hjarta-, æða- og efnaskiptasjúkdóma hjá börnum með þroskahöml- un sé alls ekki gott þrátt fyrir ungan aldur. Börn með þroskahöml- un hafa fleiri áhættuþætti hjarta-, æða- og efnaskiptasjúkdóma en jafnaldrar þeirra án þroskahömlunar, sem getur leitt til slæmrar heilsu síðar á lífsleiðinni. Það þarf að kanna betur orsakirnar sem liggja að baki þessari slæmu útkomu hjá þessum hópi svo hægt sé ENgLISH SUMMArY introduction: Little is known about physical activity, body composition and metabolic risk factors among children with intellectual disability (ID). The purpose of this study was to investigate their physical condition. Material and methods: Children with ID (n=91) and a randomly selected age-and-gender matched group of 93 typically developed indi- viduals (TDI) participated and the groups were compared on physical activity, fitness, body composition, blood pressure, blood lipids, and glycemic control. Results: Children with ID were shorter (-8.6 cm, p<0.001), had greater skinfolds (p<0.001), diastolic blood pressure (22.7 mm, p=0,006), and body fat percentage (4.0 percentage points, p=0.008) than TDI children. Boys with ID had larger waist circumference than TDI boys (6.3 cm, p=0.009) but no difference was found among the girls. Higher propor- tion (41%) of children with ID than TDI children (19%) were categorized as obese (p=0.006) based on body fat percentage. No children with ID reached the recommended daily 60 minutes of moderate- to vigorous physical activity compared to 40% of the TDI children. only 25% of children with ID achieved the recommended levels for fitness, whereas the same proportion was 75% among TDI children. over 20% of the children with ID had elevated waist circumference, 34% elevated blood pressure, 13-21% elevated metabolic risk factors in the blood, and 7% were diagnosed with metabolic syndrome. These prevalences were lower among the TDI children. Conclusion: Physical condition of children with ID is poor and inferior to their TDI peers. Further studies are needed to investigate the reasons underlying the poor physical health among children with ID and how it can most effectively be enhanced. 1Rannsóknarstofu í íþrótta- og heilsufræðum, menntavísindasvið HÍ, 2KU LEUVEN, Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Science, Leuven, Belgíu. key words: children, intellectual disability, MVPA, body composition, aerobic fitness, metabolic risk factors. Correspondence: Ingi Þór Einarsson: issi@hi.is Physical activity and physical condition of icelandic primary and secondary school children with intellectual disability Ingi Þór Einarsson1, Erlingur jóhannsson1, Daniel Daly2, Sigurbjörn Árni Arngrímsson1 1. Kasa-Vubu JZ, Lee CC, Rosenthal A, Singer K, Halter JB. Cardiovascular fitness and exercise as determinants of insulin resistance in postpubertal adolescent females. J Clin Endocrinol Metab 2005; 90: 849-54. 2. Jónsson S, Héðinsdóttir M, Erlendsdóttir R, Guðlaugsson J. Börn á Höfuðborgarsvæðinu léttari nú en áður: Niðurstöður úr Ískrá á þyngdarmælingum barna frá 2003/04-2009/10. Landlæknisembættið og Heilsugæsla höfuðborgarsvæðisins. Reykjavík 2011. 3. Johannsson E, Arngrimsson SA, Thorsdottir I, Sveinsson T. Tracking of overweight from early childhood to adoles- cence in cohorts born 1988 and 1994: overweight in a high birth weight population 5. Int J Obes (Lond) 2006; 30: 1265- 71. 4. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352: 1138-45. 5. Rimmer JH, Yamaki K. Obesity and intellectual disability. Ment Retard Dev Disabil Res Rev 2006; 12: 22-7. 6. Reinehr T, Dobe M, Winkel K, Schaefer A, Hoffmann D. Obesity in disabled children and adolescents: an overloo- ked group of patients. Dtsch Arztebl Int. 2010;107(15):268- 75. Epub 2010/05/12. 7. Foley JT, McCubbin JA. An exploratory study of after- school sedentary behaviour in elementary school-age children with intellectual disability. J Intellect Dev Disabil 2009; 34: 3-9. 8. Einarsson IO, Olafsson A, Hinriksdottir G, Johannsson E, Daly D, Arngrimsson SA. Differences in Physical Activity among Youth with and without Intellectual Disability. Med Sci Sports Exerc 2015; 47: 411-8. 9. Phillips AC, Holland AJ. Assessment of objectively measured physical activity levels in individuals with intellectual disabilities with and without Down's syn- drome. PLoS One 2011; 6: e28618. 10. Lin JD, Lin PY, Lin LP, Chang YY, Wu SR, Wu JL. Physical activity and its determinants among adolescents with intellectual disabilities. Res Dev Disabil 2010; 31: 263-9. 11. Pitetti KH, Beets MW, Combs C. Physical activity levels of children with intellectual disabilities during school. Med Sci Sports Exerc 2009; 41: 1580-6. 12. Wallen EF, Mullersdorf M, Christensson K, Malm G, Ekblom O, Marcus C. High prevalence of cardio-metabolic risk factors among adolescents with intellectual disability. Acta Paediatr 2009; 98: 853-9. 13. Draheim CC. Cardiovascular disease prevalence and risk factors of persons with mental retardation. Ment Retard Dev Disabil Res Rev 2006; 12: 3-12. 14. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240-3. 15. Jolliffe CJ, Janssen I. Development of age-specific adoles- cent metabolic syndrome criteria that are linked to the Adult Treatment Panel III and International Diabetes Federation criteria. J Am Coll Cardiol 2007; 49: 891-8. 16. Fernandez JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004; 145: 439-44. 17. Lohman T, Houtkooper L, Going S. Body fat measure- ments goes hi-tech: Not all are created equal. ACSM's Health Fitness J 1997; 1: 30-5. 18. Arngrimsson SA, Sveinsson T, Johannsson E. Peak oxygen uptake in children: evaluation of an older prediction method and development of a new one. Pediatr Exerc Sci 2008; 20: 62-73. 19. Boreham CA, Paliczka VJ, Nichols AK. A comparison of the PWC170 and 20-MST tests of aerobic fitness in adoles- cent schoolchildren. J Sports Med Phys Fitness 1990; 30: 19-23. 20. Ruiz JR, Ortega FB, Rizzo NS, Villa I, Hurtig-Wennlof A, Oja L, et al. High cardiovascular fitness is associated with low metabolic risk score in children: the European Youth Heart Study. Pediatr Res 2007; 61: 350-5. 21. Shvartz E, Reibold RC. Aerobic fitness norms for males and females aged 6 to 75 years: a review. Aviat Space Environ Med 1990; 61: 3-11. 22. Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. J Sports Sci 2008; 26: 1557-65. 23. NIH. The Fourth report on the diagnosis, evaluation, and treatment of high blood. Pressure in children and adoles- cents. Pediatrics 2004; 114: 555-76. 24. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499-502. 25. Chan M, Seiden-Long I, Aytekin M, Quinn F, Ravalico T, Ambruster D, et al. Pediatric reference intervals for an integrated clinical chemistry and immunoassay analyzer, Abbott Architect ci8200. Canadian laboratory initiative on pediatric reference interval database (CALIPER). 2009; 42: 885-91. 26. Soldin OP, Bierbower LH, Choi JJ, Thompson-Hoffman S, Soldin SJ. Serum iron, ferritin, transferrin, total iron binding capacity, hs-CRP, LDL cholesterol and magn- esium in children; new reference intervals using the Dade Dimension Clinical Chemistry System. Clin Chim Acta 2004; 342: 211-7. 27. Ghoshal AK, Soldin SJ. Evaluation of the Dade Behring Dimension RxL: integrated chemistry system-pediatric reference ranges. Clin Chim Acta 2003; 331: 135-46. 28. Lotan M, Isakov E, Kessel S, Merrick J. Physical fitness and functional ability of children with intellectual disability: effects of a short-term daily treadmill intervention. ScientificWorldJournal 2004; 4: 449-57. 29. Arngrimsson SB, Richardsson EB, Jonsson K, Olafsdottir AS. Holdafar, úthald, hreyfing og efnaskiptasnið medal 18 ára íslenskra framhaldsskólanema. Læknablaðið 2012; 98: 277-82. 30. Gillberg C, Soderstrom H. Learning disability. Lancet 2003; 362: 811-21. Heimildir að veita ráðgjöf og meðferð til að fyrirbyggja óhagstæða áhættu- þætti, til dæmis með markvissum íhlutunum. Það má því álykta að skóla- og heilbrigðiskerfið þurfi að taka höndum saman til að auka hreyfingu og bæta úthald, holdafar og almennt líkamlegt ástand hjá þessum börnum með þroskahömlun. Sýklabaninn Azithromycin Actavis – Vinnur gegn bakteríusýkingum H V ÍT A H Ú S IÐ / S ÍA / A C TA V IS 4 1 3 0 8 1 Filmuhúðaðar töur, 500 mg, 2ja og 3ja stykkja pakkningar
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