Thirty-year persistence of obesity after presentation to a pediatric obesity clinic.
BACKGROUND
Few large, long-term studies are available on the relationship between childhood and adult obesity.


OBJECTIVE
The present study examined the 30-year association between childhood and adult obesity in a large sample of girls with essential and uncomplicated obesity.


METHODS
318 girls who had visited our Pediatric Obesity Clinic between January 1972 and December 1974 were re-contacted between January 2002 and December 2005. All had undergone an assessment of weight, height and pubertal status at the baseline visit. Anthropometry was performed again on those who agreed to take part in the follow-up visit. The women's general practitioners were also asked to compile a health questionnaire. Hypertension, hypercholesterolemia, hypertriglyceridemia and diabetes were defined according to current guidelines. Rates are expressed as number of cases per 1000 person-years (PY). Multivariable Poisson regression was used to identify predictors of persistent obesity.


RESULTS
224 (70%) of the 318 girls took part to the 30-year follow-up study. They had the same baseline anthropometry of those not available at follow-up. Sixteen per cent of them were still obese at the 30-year follow-up, giving a persistence rate of obesity of 5.2 x 1000 PY. Tanner stages > or = 1 [rate = ratios (RR) from 4.73 to 7.74 for different stages, p < or = 0.021] and Z-score of BMI (RR = 2.72 for one SDS, p = 0.019) were independent predictors of obesity persistence. Having a university degree vs. an elementary degree was instead protective (RR = 0.32, p = 0.009). The most prevalent complication was hypertriglyceridemia (8.8 x 1000 PY), followed by hypercholesterolemia (rate = 8.4 x 1000 PY), hypertension (rate = 5.2 x 1000 PY) and diabetes mellitus (rate = 1.0 x 1000 PY).


CONCLUSIONS
The study reinforces the notion that obesity should be prevented at an early age and shows that adolescents with severe obesity and low educational degree are at greater risk of becoming obese adults.
Iughetti
Lorenzo
L
Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena 41100, Italy. iughetti.lorenzo@unimore.it
De Simone
Michele
M
Verrotti
Alberto
A
Iezzi
Maria Laura
ML
Predieri
Barbara
B
Bruzzi
Patrizia
P
Bernasconi
Sergio
S
Balli
Fiorella
F
Bedogni
Giorgio
G
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D004522:Educational Status; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D016012:Poisson Distribution; D012307:Risk Factors; D013997:Time Factors