Cardiovascular risk in 26,008 European overweight children as established by a multicenter database.
OBJECTIVE
Although the obesity epidemic is progressing in European children too, there is no consensus on the population-specific prevalence of comorbidities or efficient diagnostic strategies. Therefore, weight-related risk factors, their interrelationship, and association with biological parameters were assessed in a large group of overweight (OW) children, documented by an electronic database.


METHODS
Data of 26,008 children (age 12.6+/-2.9 years, 56% females) presented for OW (BMI >90th percentile) or obesity (>97th percentile) in 98 specialized centers were evaluated using a simple software (Adipositas Patienten Verlaufsbeobachtung (APV)) for standardized longitudinal documentation. After local anonymization, data were transmitted for central analysis including multiple logistic regression.


RESULTS
A total of 5.9% of the children were normal weight, 41% obese (OB), and 37% extremely OB (>99.5th percentile, XXL; 41% of the girls). In 50%, at least one risk factor and in 11% a cluster of two were found, comprising increased blood pressure (BP): 35.4%, dyslipidemia: 32% (total cholesterol: 14.1%, low-density lipoprotein (LDL)-cholesterol: 15.8%, high-density lipoprotein (HDL)-cholesterol: 11.1%, triglycerides: 14.3%), impaired glucose tolerance (IGtT): 6.5% and suspicion of diabetes: 0.7%. The degree of OW was inversely associated with HDL-cholesterol and directly with clustered risk factors, impaired glucose metabolism, increased BP and triglycerides (odds ratios (ORs) XXL vs. normal=6.15, >10, 4.3, 3.0 and 2.5, respectively), but not with LDL-cholesterol.


CONCLUSIONS
In a very large cohort of young Europeans risk factors for cardiovascular (CV) diseases are frequently found, related to the degree of OW and tend to cluster, thus a comprehensive screening is justified in all OW or OB children. Electronic patient documentation is feasible in a large obesity care network.
I'Allemand
Dagmar
D
Children's Hospital of Eastern Switzerland, St Gallen, Switzerland. dagmar.lallemand@kispisg.ch
Wiegand
Susanna
S
Reinehr
Thomas
T
Müller
Jörg
J
Wabitsch
Martin
M
Widhalm
Kurt
K
Holl
Reinhard
R
D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005060:Europe / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016347:Medical Records Systems, Computerized; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D016017:Odds Ratio; D050177:Overweight / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index