Data_Sheet_1_Disparities in the Prevalence of Childhood Obesity-Related Comorbidities: A Systematic Review.pdf

BackgroundNon-communicable diseases among children are serious consequences of childhood obesity. However, less is known about the disparities in childhood obesity comorbidities burden. This review describes the salient pattern of disparities in the prevalence of childhood obesity-related non-communicable diseases and relevant inequalities in both high- and low/medium-income countries.
MethodA systematic literature search was performed in MEDLINE, Embase, CINAHL, PsycInfo, Scopus, and Web of Science databases by two independent reviewers. Inclusion criteria were as follows: age 2–18 years; the prevalence or incidence of childhood obesity comorbidities reported; and studies published in English from January 2010 to date. No restrictions on the setting. The prevalence data were analyzed using range and median for subgroups based on the country's development status, gender, and geographical region.
ResultsOur search identified 6,837 articles, out of which we examined 145 full-text articles and included 54 articles in the analysis. The median prevalence of childhood obesity-related hypertension was 35.6 vs. 12.7% among middle- and low-income countries compared with high-income countries; 37.7 vs. 32.9% among boys compared with girls; and 38.6, 25.3, and 20.1% in Asia, South America, and Europe, respectively. For metabolic syndrome, the median prevalence was 26.9 vs. 5.5% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared with girls; and 40.3, 25.8, and 7.7% in South America, Asia, and Europe, respectively. The prevalence of childhood obesity-related non-alcoholic fatty liver disease was 47.5 vs. 23% among middle- and low-income countries compared with high-income countries; and 52.1, 39.7, and 23.0% in Asia, South America, and Europe, respectively. The median prevalence of dyslipidemia was 43.5 vs. 63% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared to girls; and 73.7 and 49.2% in Australia and Europe, respectively.
ConclusionThere are disparities in the prevalence of childhood obesity-related hypertension, metabolic syndrome, and non-alcoholic fatty liver disease, with middle- and low-income countries, boys, and Asian region having higher prevalence. Implementing targeted interventions for childhood obesity comorbidities should consider socioeconomic disparities and strengthening of research surveillance methods for a better understanding of non-communicable disease burden in the pediatric population.
Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021288607.

**背景**：儿童非传染性疾病是儿童肥胖的严重并发症。然而，当前学界对儿童肥胖共病负担的差异情况仍知之甚少。本综述阐述了高收入与中低收入国家中，儿童肥胖相关非传染性疾病患病率的差异特征，以及相关的健康公平性不平等情况。
**方法**：由两名独立审稿人在MEDLINE、Embase、CINAHL、PsycInfo、Scopus及Web of Science数据库中开展系统性文献检索。纳入标准如下：研究对象年龄为2~18岁；报告了儿童肥胖共病的患病率或发病率；研究于2010年1月至今以英语发表；研究场景无限制。基于国家发展水平、性别及地理区域划分亚组，采用极差与中位数对患病率数据进行分析。
**结果**：本次检索共得到6837篇文献，其中对145篇全文文献进行审阅，最终纳入54篇文献进行分析。儿童肥胖相关性高血压的中位患病率：中低收入国家为35.6%，高收入国家为12.7%；男性群体为37.7%，女性群体为32.9%；亚洲、南美洲及欧洲分别为38.6%、25.3%及20.1%。代谢综合征的中位患病率：中低收入国家为26.9%，高收入国家为5.5%；男性群体为55.2%，女性群体为12.0%；南美洲、亚洲及欧洲分别为40.3%、25.8%及7.7%。儿童肥胖相关性非酒精性脂肪性肝病（non-alcoholic fatty liver disease）的患病率：中低收入国家为47.5%，高收入国家为23%；亚洲、南美洲及欧洲分别为52.1%、39.7%及23.0%。血脂异常的中位患病率：中低收入国家为43.5%，高收入国家为63%；男性群体为55.2%，女性群体为12.0%；澳大利亚及欧洲分别为73.7%及49.2%。
**结论**：儿童肥胖相关性高血压、代谢综合征及非酒精性脂肪性肝病的患病率存在显著差异，中低收入国家、男性群体及亚洲地区的患病率更高。针对儿童肥胖共病开展靶向干预时，应考虑社会经济层面的差异，并强化研究监测手段，以更好地了解儿科人群的非传染性疾病负担。
**系统性综述注册信息**：https://www.crd.york.ac.uk/PROSPERO，注册号：CRD42021288607。