title: Overweight and Obesity Based on Four Reference Systems in 18,382 Paediatric Patients with Type 1 Diabetes from Germany and Austria.
abstract: OBJECTIVE
  To evaluate the prevalence of overweight and obesity in paediatric type 1 diabetes (T1D) subjects, based on four commonly used reference populations.
  
  
  METHODS
  Using WHO, IOTF, AGA (German pediatric obesity), and KiGGS (German Health Interview and Examination Survey for Children and Adolescents) reference populations, prevalence of overweight (≥90th percentile) and obesity (≥97th percentile) and time trend between 2000 (n = 9,461) and 2013 (n = 18,382) were determined in 2-18-year-old T1D patients documented in the German/Austrian DPV database.
  
  
  RESULTS
  In 2000, the overweight prevalence was the highest according to IOTF (22.3%), followed by WHO (20.8%), AGA (15.5%), and KiGGS (9.4%). The respective rates in 2013 were IOTF (24.8%), WHO (22.9%), AGA (18.2%), and KiGGS (11.7%). Obesity prevalence in 2000 was the highest according to WHO (7.9%), followed by AGA (4.5%), IOTF (3.1%), and KiGGS (1.8%). In 2013, the respective rates were WHO (9.6%), AGA (6.2%), IOTF (4.5%), and KiGGS (2.6%). Overall, the prevalence of overweight and obesity increased from 2000 to 2006 (p < 0.001) but showed stabilization thereafter in girls and overweight in boys.
  
  
  CONCLUSIONS
  Overweight and obesity prevalence in T1D subjects differs significantly if it is assessed by four separate reference populations. More detailed assessment of each child is required to determine obesity-related risks.
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, 89081 Ulm, Germany ; German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Flechtner-Mors
authors.affiliation: Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, 79106 Freiburg, Germany.
authors.forename: K O
authors.initials: KO
authors.lastname: Schwab
authors.affiliation: Department of Paediatrics, Medical University of Graz, 8036 Graz, Austria.
authors.forename: E E
authors.initials: EE
authors.lastname: Fröhlich-Reiterer
authors.affiliation: Hospital for Children and Adolescents, University of Leipzig, 04317 Leipzig, Germany.
authors.forename: T M
authors.initials: TM
authors.lastname: Kapellen
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, 40225 Düsseldorf, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Meissner
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of Düsseldorf, 40225 Düsseldorf, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Rosenbauer
authors.affiliation: Rehabilitation Clinic for Children and Adolescents, Westerland, 25980 Sylt, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Stachow
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, 89081 Ulm, Germany ; German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany.
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007390:International Agencies; D008297:Male; D009749:Nutrition Surveys; D050177:Overweight / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012955:Societies, Medical; D014944:World Health Organization