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The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy

Background: Duchenne muscular dystrophy (DMD) is a severe X-linked neuromuscular disorder. Young people with DMD have high rates of obesity. There is emerging evidence that a higher BMI may negatively affect clinical outcomes in DMD. This study aimed to explore the relationship between obesity and c...

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Autores principales: Billich, Natassja, Adams, Justine, Carroll, Kate, Truby, Helen, Evans, Maureen, Ryan, Monique M., Davidson, Zoe E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9412587/
https://www.ncbi.nlm.nih.gov/pubmed/36014811
http://dx.doi.org/10.3390/nu14163304
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author Billich, Natassja
Adams, Justine
Carroll, Kate
Truby, Helen
Evans, Maureen
Ryan, Monique M.
Davidson, Zoe E.
author_facet Billich, Natassja
Adams, Justine
Carroll, Kate
Truby, Helen
Evans, Maureen
Ryan, Monique M.
Davidson, Zoe E.
author_sort Billich, Natassja
collection PubMed
description Background: Duchenne muscular dystrophy (DMD) is a severe X-linked neuromuscular disorder. Young people with DMD have high rates of obesity. There is emerging evidence that a higher BMI may negatively affect clinical outcomes in DMD. This study aimed to explore the relationship between obesity and clinical outcomes in DMD. Methods: This was a retrospective clinical audit of young people (two–21 years) with DMD. Height and weight were collected to calculate BMI z-scores to classify obesity, overweight and no overweight or obesity (reference category). Cox proportional hazards models determined the impact of obesity at five to nine years on clinical milestones including time to: loss of ambulation, timed function test cut-offs, obstructive sleep apnoea (OSA) diagnosis and first fracture. Results: 158 young people with DMD were included; most (89.9%) were steroid-treated. Mean follow-up was 8.7 ± 4.7 years. Obesity prevalence increased from age five (16.7%) to 11 years (50.6%). Boys with obesity at nine years sustained a fracture earlier (hazard ratio, HR: 2.050; 95% CI: 1.038–4.046). Boys with obesity at six to nine years were diagnosed with OSA earlier (e.g., obesity nine years HR: 2.883; 95% CI: 1.481–5.612). Obesity at eight years was associated with a 10 m walk/run in 7–10 s occurring at an older age (HR: 0.428; 95% CI: 0.207–0.887), but did not impact other physical function milestones. Conclusions: Although 50% of boys with DMD developed early obesity, the impact of obesity on physical function remains unclear. Obesity puts boys with DMD at risk of OSA and fractures at a younger age. Early weight management interventions are therefore important.
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spelling pubmed-94125872022-08-27 The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy Billich, Natassja Adams, Justine Carroll, Kate Truby, Helen Evans, Maureen Ryan, Monique M. Davidson, Zoe E. Nutrients Article Background: Duchenne muscular dystrophy (DMD) is a severe X-linked neuromuscular disorder. Young people with DMD have high rates of obesity. There is emerging evidence that a higher BMI may negatively affect clinical outcomes in DMD. This study aimed to explore the relationship between obesity and clinical outcomes in DMD. Methods: This was a retrospective clinical audit of young people (two–21 years) with DMD. Height and weight were collected to calculate BMI z-scores to classify obesity, overweight and no overweight or obesity (reference category). Cox proportional hazards models determined the impact of obesity at five to nine years on clinical milestones including time to: loss of ambulation, timed function test cut-offs, obstructive sleep apnoea (OSA) diagnosis and first fracture. Results: 158 young people with DMD were included; most (89.9%) were steroid-treated. Mean follow-up was 8.7 ± 4.7 years. Obesity prevalence increased from age five (16.7%) to 11 years (50.6%). Boys with obesity at nine years sustained a fracture earlier (hazard ratio, HR: 2.050; 95% CI: 1.038–4.046). Boys with obesity at six to nine years were diagnosed with OSA earlier (e.g., obesity nine years HR: 2.883; 95% CI: 1.481–5.612). Obesity at eight years was associated with a 10 m walk/run in 7–10 s occurring at an older age (HR: 0.428; 95% CI: 0.207–0.887), but did not impact other physical function milestones. Conclusions: Although 50% of boys with DMD developed early obesity, the impact of obesity on physical function remains unclear. Obesity puts boys with DMD at risk of OSA and fractures at a younger age. Early weight management interventions are therefore important. MDPI 2022-08-12 /pmc/articles/PMC9412587/ /pubmed/36014811 http://dx.doi.org/10.3390/nu14163304 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Billich, Natassja
Adams, Justine
Carroll, Kate
Truby, Helen
Evans, Maureen
Ryan, Monique M.
Davidson, Zoe E.
The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title_full The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title_fullStr The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title_full_unstemmed The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title_short The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy
title_sort relationship between obesity and clinical outcomes in young people with duchenne muscular dystrophy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9412587/
https://www.ncbi.nlm.nih.gov/pubmed/36014811
http://dx.doi.org/10.3390/nu14163304
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