title: 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.
abstract: 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.
authors.affiliation: Vest Youth Hospital, University of Witten-Herdecke, Dr. Friedrich Steiner Strasse 5, 45711 Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Martin
authors.initials: M
authors.lastname: Wabitsch
authors.forename: Werner
authors.initials: W
authors.lastname: Andler
authors.forename: Peter
authors.initials: P
authors.lastname: Beyer
authors.forename: Antje
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authors.lastname: Böttner
authors.forename: Annette
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authors.lastname: Chen-Stute
authors.forename: Carmen
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authors.lastname: Fromme
authors.forename: Olaf
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authors.lastname: Hampel
authors.forename: Klaus M
authors.initials: KM
authors.lastname: Keller
authors.forename: Uwe
authors.initials: U
authors.lastname: Kilian
authors.forename: Hilde
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authors.lastname: Kolbe
authors.forename: Thomas
authors.initials: T
authors.lastname: Lob-Corzilius
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Marg
authors.forename: Hermann
authors.initials: H
authors.lastname: Mayer
authors.forename: Klaus
authors.initials: K
authors.lastname: Mohnike
authors.forename: Johannes
authors.initials: J
authors.lastname: Oepen
authors.forename: Clemens
authors.initials: C
authors.lastname: Povel
authors.forename: Brunhild
authors.initials: B
authors.lastname: Richter
authors.forename: Nikola
authors.initials: N
authors.lastname: Riedinger
authors.forename: Gerd
authors.initials: G
authors.lastname: Schauerte
authors.forename: Gernot
authors.initials: G
authors.lastname: Schmahlfeldt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Siegfried
authors.forename: Peer
authors.initials: P
authors.lastname: Smuda
authors.forename: Rainer
authors.initials: R
authors.lastname: Stachow
authors.forename: Andreas
authors.initials: A
authors.lastname: van Egmond-Fröhlich
authors.forename: Jannie
authors.initials: J
authors.lastname: Weiten
authors.forename: Susanna
authors.initials: S
authors.lastname: Wiegand
authors.forename: Sabine
authors.initials: S
authors.lastname: Witte
authors.forename: Volker
authors.initials: V
authors.lastname: Zindel
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides