小児肥満患者におけるハンドヘルド型筋力計を用いた筋力に関する研究

To evaluate muscle strength based on grip strength in children and adolescents with obesity and comparing it with reference values. To analyse the association with body composition findings obtained by bioelectrical impedance analysis as well as clinical and biochemical variables.

Retrospective observational cohort study in pediatric patients with obesity (6-16 years) followed up in an outpatient clinic in a tertiary care hospital. We collected data on physical activity and anthropometric, biochemical, sonographic, bioimpedance and dynamometry parameters.

The sample included 125 patients (mean age, 12.06 years; 50.4% female; body mass index [BMI] Z-score, 3.87 [SD, 1.46]). Male participants were less severely obese and had a healthier body composition. Prepubertal patients were less physically active and had a higher fat mass (FM) percentage. The prevalence of metabolic comorbidities, such as hyperuricemia and insulin resistance, increased with the degree of obesity. Children with obesity had a mean muscle strength Z-score of +0.71 in the dominant hand, with differences based on sex and stage of pubertal development. We found dynapenia in 4.8%, with a greater prevalence in prepubertal children. Muscle strength was positively correlated to physical activity, fat-free mass and phase angle and negatively correlated to FM percentage. Fat-free mass was the strongest predictor of muscle strength.

In this sample of children with obesity, muscle strength was not decreased compared to the healthy reference population. Fat-free mass is the strongest predictor of muscle strength. The findings highlight the positive influence of physical activity and the amount of lean mass on strength in children and adolescents with obesity.