title: Cardiovascular risk factors in overweight German children and adolescents: relation to gender, age and degree of overweight.
abstract: OBJECTIVE
  So far in Europe, no large studies have been published on the frequencies of the cardiovascular risk factors hypertension and dyslipidaemia in overweight children.
  
  
  METHODS
  Diagnosis of hypertension, decreased HDL-cholesterol, increased triglycerides, total and LDL-cholesterol were documented for 1004 overweight children and adolescents (aged 4-8 years, 52% girls, BMI-SDS in median 2.43) referred to four obesity centres. Hypertension and dyslipidaemia were defined by cut off points above the 95th percentile of healthy children. Multivariate linear regression was conducted for the dependent variables systolic and diastolic blood pressure, triglycerides, HDL-, LDL-, and total cholesterol, including gender, degree of overweight (SDS-BMI) and age as independent variables.
  
  
  RESULTS
  Thirty-seven percent of the children studied suffered from hypertension, 27% displayed increased total cholesterol, 26% increased LDL-cholesterol, 20% increased triglycerides and 18% decreased HDL-cholesterol. Seventy percent of all children had at least one unfavourable cardiovascular risk factor. Hypertension and dyslipidaemia were observed in any age group and in any degree of overweight at least twofold above the suspected rate of 5%. SDS-BMI was significantly related to blood pressure (systolic: coefficient 7.26, p < 0.001, diastolic: coefficient 3.21, p < 0.001), weakly to triglycerides (coefficient 0.12, p = 0.007), slightly negatively to HDL-cholesterol (coefficient -0.06, p = 0.001) and not related to total and LDL-cholesterol. Age was positively related to blood pressure (systolic: coefficient 2.436, p < 0.001, diastolic: coefficient 0.54, p < 0.001) and negatively to HDL cholesterol (coefficient -0.02, p < 0.001).
  
  
  CONCLUSIONS
  Cardiovascular risk factors were frequently present in a large collective of overweight European children and adolescents. They occurred mostly independently of age, gender and degree of overweight. Therefore, screening for cardiovascular risk factors seems meaningful at any age and degree of overweight in childhood.
authors.affiliation: Department of Pediatrics, University of Witten-Herdecke, Dr. F. Steiner Str. 5, 45711 Datteln, Germany. t.reinehr@kinderklinik-datteln.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Werner
authors.initials: W
authors.lastname: Andler
authors.forename: Christian
authors.initials: C
authors.lastname: Denzer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Siegried
authors.forename: H
authors.initials: H
authors.lastname: Mayer
authors.forename: Martin
authors.initials: M
authors.lastname: Wabitsch
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors