title: Increased Body Mass Index in Parent-Child Dyads Predicts the Offspring Risk of Meeting Bariatric Surgery Criteria.
abstract: BACKGROUND
  Obesity in children is a major public health concern.
  
  
  OBJECTIVE
  This study examined the value of using parent-child dyads' adiposity status for predicting the individual's later eligibility for bariatric surgery (EBS).
  
  
  METHODS
  The cohort consisted of 2647 individuals from the longitudinal Cardiovascular Risk in Young Finns Study. Baseline information included own and parental body mass index (BMI) in 1980 (children aged 3-18 years), whereas adult follow-up assessment examined EBS 21-31 years later.
  
  
  METHODS
  EBS in adulthood was defined as: 1) BMI greater than 40 kg/m(2) or 2) BMI greater than 35 kg/m(2) with at least one of the following metabolic complications: type 2 diabetes, hypertension, or dyslipidemia.
  
  
  RESULTS
  Addition of parents' BMI improved the prediction of adulthood EBS compared to the model including child's BMI, age, and sex (area under the curve values [95% confidence interval] (0.80 [0.74-0.85] vs 0.74 [0.68-0.81], P = .003). Obese children with an obese parent had a 21.2% chance of being EBS in adulthood. Compared to nonobese families, the risk ratio for EBS was 14.2 (95% confidence interval 8.0-25.2, P < .001) in obese children with an obese parent. The absolute risk of EBS was 30.9% if both child and parent were obese on more than one childhood assessment compared to 15.2% if they were obese only once, or 2.1% if they were never obese (P < .05).
  
  
  CONCLUSIONS
  These longitudinal data show that a combination of the child's and parents' BMI at baseline assessment is a useful predictive tool for assessing later EBS, and highlights the importance of accounting for parental BMI in the assessment of child obesity.
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Markus
authors: M
authors: Juonala
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Matthew A
authors: MA
authors: Sabin
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: David
authors: D
authors: Burgner
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Michael
authors: M
authors: Cheung
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Mika
authors: M
authors: Kähönen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Nina
authors: N
authors: Hutri-Kähönen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Terho
authors: T
authors: Lehtimäki
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Eero
authors: E
authors: Jokinen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Juha
authors: J
authors: Koskinen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Päivi
authors: P
authors: Tossavainen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Tomi
authors: T
authors: Laitinen
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Jorma S A
authors: JS
authors: Viikari
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Olli T
authors: OT
authors: Raitakari
authors: Murdoch Childrens Research Institute (M.J., M.A.S., D.B., M.C.), Royal Children's Hospital, Parkville, Victoria 3052, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (J.K., O.T.R., C.G.M.) and Department of Medicine (M.J., J.S.A.V.), University of Turku, 20520 Turku, Finland; Division of Medicine (M.J.), Turku University Hospital, 20520 Turku, Finland; Department of Paediatrics (M.A.S., D.B., M.C.), University of Melbourne, Parkville, Victoria 3052, Australia; Department of Paediatrics (D.B.), Monash University, Clayton, Victoria 3168, Australia; Departments of Clinical Physiology (M.K.), Paediatrics (N.H.-K.), and Clinical Chemistry (T.L.), and Fimlab Laboratories (T.L.), University of Tampere School of Medicine and Tampere University Hospital, 33500 Tampere, Finland; Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, 00029 HUS, Finland; Department of Children and Adolescents (P.T.), Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, 90220 Oulu, Finland. Department of Clinical Physiology (T.L.), Kuopio University Hospital and University of Eastern Finland, 70600 Kuopio, Finland; and Menzies Institute for Medical Research (C.G.M.), University of Tasmania, Hobart, Tasmania 7000, Australia.
authors: Costan G
authors: CG
authors: Magnussen
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000601:surgery*; D011237:Predictive Value of Tests; D018570:Risk Assessment