Medical care of obese children and adolescents. APV: a standardised multicentre documentation derived to study initial presentation and cardiovascular risk factors in patients transferred to specialised treatment institutions.
So far in Europe, no studies have been published on the structuring of medical care for obese children and adolescents. Besides anthropometric parameters, evaluations of the cardiovascular risk factors hypertension, dyslipidaemia, impaired glucose metabolism and treatment modalities were documented in a standardised multicentre evaluation survey (APV) of 18 primarily outpatient and nine rehabilitation institutions. In total, 3837 children (aged 2-20 years) took part in the years 2000 up to March 2003, of whom 1985 were treated in outpatient institutions and 1852 in rehabilitation institutions. Of these children, 10% were overweight, 37% obese, 49% extremely obese and 4% of normal weight at initial presentation. The frequencies of diagnostic procedures performed and documented were low (measurement of blood pressure 43%, lipids 40%, glucose metabolism 21%). In the subgroup of obese children who were screened for cardiovascular risk factors, 23% suffered from hypertension, 11% displayed increased cholesterol, 9% increased low-density lipoprotein-cholesterol, 29% increased triglycerides, 11% decreased high-density lipoprotein-cholesterol and 6% had impaired glucose metabolism.


CONCLUSIONS
Despite the high prevalence of cardiovascular risk factors in obese children and adolescents confirmed in this report, diagnostic procedures failed in a considerable percentage even in specialised treatment centres for obese children and adolescents. In future, the feedback based on standardised evaluation of diagnostic and treatment procedures should aim to improve the quality of medical care.
Reinehr
Thomas
T
Vest Youth Hospital, University of Witten-Herdecke, Dr. Friedrich Steiner Strasse 5, 45711 Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
Wabitsch
Martin
M
Andler
Werner
W
Beyer
Peter
P
Böttner
Antje
A
Chen-Stute
Annette
A
Fromme
Carmen
C
Hampel
Olaf
O
Keller
Klaus M
KM
Kilian
Uwe
U
Kolbe
Hilde
H
Lob-Corzilius
Thomas
T
Marg
Wolfgang
W
Mayer
Hermann
H
Mohnike
Klaus
K
Oepen
Johannes
J
Povel
Clemens
C
Richter
Brunhild
B
Riedinger
Nikola
N
Schauerte
Gerd
G
Schmahlfeldt
Gernot
G
Siegfried
Wolfgang
W
Smuda
Peer
P
Stachow
Rainer
R
van Egmond-Fröhlich
Andreas
A
Weiten
Jannie
J
Wiegand
Susanna
S
Witte
Sabine
S
Zindel
Volker
V
Holl
Reinhard W
RW
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides