title: Ethnicity and cardiovascular risk factors: evaluation of 40,921 normal-weight, overweight or obese children and adolescents living in Central Europe.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is a major global health problem and the leading cause of death in Europe. Risk factors such as obesity and hypertension that accelerate the development of CVD begin in childhood. Ethnicity is a known risk factor for CVD in adults. The aim of this study is to explore differences in the prevalence of hypertension and dyslipidemia among overweight/obese and normal-weight children/adolescents of three different ethnic origins living in Central Europe.
  
  
  METHODS
  Prevalence of hypertension and dyslipidemia was calculated among obese/overweight children/adolescents (n = 25,986; mean age 12.7 ± 3.0 years; range: 0-18 years; 46% males) documented in the German-Austrian-Swiss APV (Prospective Documentation of Overweight Children and Adolescents) registry and among normal-weight subjects (n = 14,935; mean age: 8.8 ± 5.1 years; range 0-18 years; 51% males) from the population-based cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. In both cohorts, subjects were categorized into three ethnic groups (Central European: Germany, Austria, Switzerland; Southeastern European: Turkish; Southern European: Spain, Portugal, Italy, Greece, Cyprus, Malta) based on the country of birth of both parents. Regression models were used to examine ethnic differences after adjustment for age and gender and body mass index (BMI) category.
  
  
  RESULTS
  Age-, gender- and BMI category-adjusted prevalence of hypertension were 38% and 39% for the ethnic minority groups, compared with 35% among German/Austrian/Swiss counterparts. Turkish ethnicity was significantly associated with hypertension (odds ratio (OR) 1.14; 95% confidence interval: 1.02-1.27; P = 0.0446). No significant ethnic differences were found in lipid levels. Prevalence of hypertension found among normal-weight subjects (Central European vs Southeastern vs Southern European: 6.8% vs 6.3% vs 7.2%) did not differ significantly.
  
  
  CONCLUSIONS
  Turkish obese/overweight children/adolescents showed a significantly higher prevalence of hypertension relative to their peers of Central European descent. No significant ethnic difference in the prevalence of hypertension was found among normal-weight children/adolescents. The high prevalence of hypertension among Turkish obese/overweight children/adolescents indicates the need for greater preventive and therapeutic efforts to reduce cardiovascular risk factors among vulnerable populations.
authors.affiliation: Department of Pediatric Endocrinology and Diabetology, Charité Children's Hospital, Charité University Medicine, Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Martin
authors.affiliation: Viktoriastift Bad Kreuznach, Rehabilitation Clinic for Children and Adolescents, Bad Kreuznach, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Oepen
authors.affiliation: Vestische Children's Hospital, University of Witten/Herdecke, Datteln, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Reinehr
authors.affiliation: Divison of Pediatric Endocrinology, Diabetes and Obesity Unit, University Children's Hospital, University of Ulm, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wabitsch
authors.affiliation: Spessart-Klinik, Rehabilitation Clinic for Children and Adolescents, Bad Orb, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Claussnitzer
authors.affiliation: Edelsteinklinik, Rehabilitation Clinic for Children and Adolescents, Bruchweiler, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Waldeck
authors.affiliation: Fachklinik Gaißach, Rehabilitation Clinic, Gaißach, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Ingrisch
authors.affiliation: Fachklinik Sylt, Rehabilitation Clinic for Children and Adolescents, Westerland, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Stachow
authors.affiliation: Katholisches Kinderkrankenhaus Wilhelmstift, Wilhelmstift Catholic Children's Hospital, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Oelert
authors.affiliation: Department of Pediatric Endocrinology and Diabetology, Charité Children's Hospital, Charité University Medicine, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wiegand
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Holl
mesh_terms: D001317:Austria / Q000453:epidemiology; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D002648:Child; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology* / Q000208:ethnology; D005006:Ethnicity; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013557:Switzerland / Q000453:epidemiology; D014171:Transients and Migrants / Q000706:statistics & numerical data