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Cardiovascular risk in 26,008 European overweight children as established by a multicenter database
Authors:I'Allemand Dagmar  Wiegand Susanna  Reinehr Thomas  Müller Jörg  Wabitsch Martin  Widhalm Kurt  Holl Reinhard;APV-Study Group
Institution:Children's Hospital of Eastern Switzerland, St Gallen, Switzerland. dagmar.lallemand@kispisg.ch
Abstract:Objective: Although the obesity epidemic is progressing in European children too, there is no consensus on the population‐specific prevalence of comorbidities or efficient diagnostic strategies. Therefore, weight‐related risk factors, their interrelationship, and association with biological parameters were assessed in a large group of overweight (OW) children, documented by an electronic database. Methods and Procedures: Data of 26,008 children (age 12.6 ± 2.9 years, 56% females) presented for OW (BMI > 90th percentile) or obesity (>97th percentile) in 98 specialized centers were evaluated using a simple software (Adipositas Patienten Verlaufsbeobachtung (APV)) for standardized longitudinal documentation. After local anonymization, data were transmitted for central analysis including multiple logistic regression. Results: A total of 5.9% of the children were normal weight, 41% obese (OB), and 37% extremely OB (>99.5th percentile, XXL; 41% of the girls). In 50%, at least one risk factor and in 11% a cluster of two were found, comprising increased blood pressure (BP): 35.4%, dyslipidemia: 32% (total cholesterol: 14.1%, low‐density lipoprotein (LDL)‐cholesterol: 15.8%, high‐density lipoprotein (HDL)‐cholesterol: 11.1%, triglycerides: 14.3%), impaired glucose tolerance (IGtT): 6.5% and suspicion of diabetes: 0.7%. The degree of OW was inversely associated with HDL‐cholesterol and directly with clustered risk factors, impaired glucose metabolism, increased BP and triglycerides (odds ratios (ORs) XXL vs. normal = 6.15, >10, 4.3, 3.0 and 2.5, respectively), but not with LDL‐cholesterol. Discussion: In a very large cohort of young Europeans risk factors for cardiovascular (CV) diseases are frequently found, related to the degree of OW and tend to cluster, thus a comprehensive screening is justified in all OW or OB children. Electronic patient documentation is feasible in a large obesity care network.
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