目的 了解不同认知水平的学龄期孤独症谱系障碍（autism spectrum disorder, ASD）儿童体力活动情况，分析其与超重或肥胖的相关性。方法 纳入中山大学儿童青少年心理行为发育研究中心2018年7月—2019年5月就诊的ASD儿童45例，采用中文版韦氏智力量表第4版与临床访谈对入组儿童进行认知能力评估，按照有无智力低下分为高功能ASD组（high function ASD, HFA）和低功能ASD组（low function ASD, LFA），采用Actigraph-GT3X三轴加速度计对两组儿童进行客观的体力活动测量，应用标准方法进行体格测量并根据世界卫生组织（World Health Organization, WHO）的体质指数（body mass index, BMI）标准判断超重或肥胖，运用二元Logistic回归模型分析体力活动相关指标与超重或肥胖患病风险的关联。结果 入组的ASD儿童中超重者为7人（15.6%），肥胖者为8人（17.8%）；平均中高强度体力活动时间为(49.2±20.3) min/d，未达到WHO推荐标准（60 min/d），达标率为26.7%；LFA组的高强度体力活动时间（Z=2.55，P=0.011）和中高强度体力活动时间（Z=1.98，P=0.048）均显著大于HFA组。在HFA组中，控制年龄、性别和平均睡眠时长后，较高水平的中强度、高强度和中高强度体力活动与超重或肥胖低风险有关（依次为 OR=0.09, 95% CI 0.01~0.94; OR=0.06, 95% CI 0.004~0.96; OR=0.06, 95% CI 0.005~0.70）。而在LFA组中，未发现相关指标与超重或肥胖有统计学关联。结论 学龄期ASD儿童存在体力活动不足及较高超重或肥胖患病率问题，不同认知水平的ASD儿童其体力活动与超重或肥胖之间的关联性有差别，在HFA儿童中两者呈负相关关系，可为进一步的干预提供参考依据。
Objective To investigate the physical activity pattern of school-age children with autism spectrum disorder(ASD) at different cognitive levels, and explore its association with the weight status. Methods Forty-five children with ASD from the Research Center for Psycho-behavioral Development of Children and Adolescents at SUN Yat-sen University from July 2018 to May 2019 were included. Participants were divided into the high function ASD(HFA) group and the low function ASD(LFA) group, according to their full-scale IQ score assessed by the Chinese Wechsler intelligence scale for children, 4th edition, and clinical interviews from the professional physician. Anthropometric measures were assessed by standard methods in order to calculate body mass index(BMI). After that, participants were asked to wear the Actigraph GT3X+ accelerometers for 7 continuous days. Multiple logistic regression model was used to analyze the association between physical activity and weight status. Results The prevalence of overweight and obesity were 15.6% and 17.8%, respectively. Average daily minutes of moderate to vigorous physical activity(MVPA) was 49.2±20.3, which failed to meet the WHO recommendations(60 min/d). The compliance rate of MVPA was 26.7%. Besides, we found that the LFA group had higher amounts of vigorous-intensity PA(VPA) (Z=2.55, P=0.011) and MVPA (Z=1.98, P=0.048) than the HFA group. Higher levels of moderate-intensity physical activity(MPA), VPA and MVPA were positively associated with the overweight/obesity in the HFA group, even after adjustment for age, gender and average sleep duration(OR=0.09, 95% CI 0.01-0.94; OR=0.06, 95% CI 0.004-0.96; OR=0.06, 95% CI 0.005-0.70, respectively). No significant association was found in the LFA group. Conclusion A high percentage of school-age children with ASD suffer from physical inactivity, overweight, and obesity. There is a difference in the correlation between physical activity and overweight or obesity among children with different cognitive levels, and a negative correlation is found in the HFA group, which can provide a reference for further targeted intervention.
石碧君，曹牧青，王 馨，罗靓尹，曾晶晶，陈嘉洁，静 进. 不同认知水平的学龄期孤独症谱系障碍儿童体力活动与超重或肥胖的关联性研究[J]. 教育生物学杂志, 2020, 8(1): 12-.
SHI Bijun, CAO Muqing, WANG Xin, LUO Jingyin, ZENG Jingjing, CHEN Jiajie, JING Jin. Association between physical activity and weight status in children with autism spectrum disorder at different cognitive levels. JOURNAL OF BIO-EDUCATION, 2020, 8(1): 12-.
