A shift from underweight to overweight and obesity in Asian children and adolescents with congenital heart disease.
BACKGROUND
In Western countries, obesity is a common problem in children with congenital heart disease (CHD). However, this problem may have racial difference, and little is known about the shift of this trend as patients grow up. The present study sought to investigate the prevalence and trends of being underweight, overweight and obesity in an Asian CHD cohort using a 5-year citywide school survey database.


METHODS
Patient group consisted of 705 first grade elementary school students (children) and 219 first grade senior high school students (adolescents), while 18753 healthy children and 15014 healthy adolescents served as controls. Body mass index (BMI) percentile was calculated to define underweight (BMI < 15(th) percentile) and overweight (BMI 85(th) -95(th) percentile)/obesity (BMI ≥ 95(th) percentile).


RESULTS
In CHD children, the prevalence of underweight and overweight/obesity was 21.0% (control 16%, P < 0.001) and 14.5% (control 19.8%, P < 0.001), respectively. Children with moderate to severe CHD, especially cyanotic CHD, were more underweight and less overweight/obese than children with non-cyanotic CHD. The prevalence of underweight (23.3%) and overweight/obesity (26.5%) in CHD adolescents became close to that in controls. From childhood to adolescence, different shifts in BMI distribution were noted; controls became more underweight and overweight/obese for males and more underweight and less overweight/obese for females, while CHD patients became more overweight/obese for both genders, including cyanotic CHD.


CONCLUSIONS
In this Asian CHD cohort, we demonstrates a shift of BMI distribution from more underweight and less overweight/obese compared with healthy children, to a pattern similar to that in healthy adolescents.
Department of Pediatrics, National Taiwan University Hospital, Taipei             Cardiac Children's Foundation, Taipei, Taiwan.
Chun-An
CA
Chen
Jou-Kou
JK
Wang
Hung-Chi
HC
Lue
Yu-Chuan
YC
Hua
Mei-Hwei
MH
Chang
Mei-Hwan
MH
Wu
D000293:Adolescent; D044466:Asian People / Q000208:ethnology*; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000208:ethnology* / Q000235:genetics; D006801:Humans; D008297:Male; D009765:Obesity / Q000208:ethnology*; D050177:Overweight / Q000208:ethnology*; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D013851:Thinness / Q000208:ethnology*