Cardiovascular risk factors in overweight German children and adolescents: Relation to gender, age and degree of overweight
Introduction
The worldwide increasing prevalence of obesity in childhood and adolescence poses an ever-increasing problem [1]. The relation between obesity and coronary artery disease is mediated by adverse changes of serum lipids and blood pressure levels [2], [3], [4], [5] rather than obesity being an independent cardiovascular disease risk factor variable [6].
Some obese subjects are characterised by hypertension, reduced high-density-lipoprotein (HDL) cholesterol, increased total cholesterol, low-density-lipoprotein (LDL) cholesterol and triglycerides [7]. Despite the prevalence of obesity in childhood, the atherogenic risk factors in paediatric obesity have been studied in only one large study from North America [8].
In order to (1) address the prevalence of hypertension and dyslipidaemia in a European country and (2) to assess the relationships between these cardiovascular risk factors and age, gender and degree of overweight, over 1000 overweight, obese and extreme obese German children were studied.
Section snippets
Study population
Clinical data (age, gender, degree of overweight) and cardiovascular risk factors of all non-syndromal overweight children and adolescents in four centres for obesity in Germany (Children's Hospital, Murnau; Insula Clinic, Berchtesgaden; Department of Pediatrics, University of Ulm; and Vestische Kinder- und Jugendklinik Datteln, University of Witten-Herdecke) were collected in the time period of 1999–2002. All these children and adolescents were referred to the centres because of their
Results
A total of 1004 overweight children and adolescents aged 4–18 years (52% girls, age in median 12.0 years, interquartile range 9.8–13.8 years) were studied. Fifteen percent of these children were overweight (BMI>90 percentile), 40% obese (BMI>97 percentile) and 45% extreme obese (BMI >99.5 percentile). The BMI was in median 28.2 kg/m2 (interquartile range 25.4–31.8 kg/m2) and SDS-BMI was in median 2.43 (interquartile range 2.07–2.79).
LDL-, HDL-cholesterol and triglyceride levels were
Discussion
This is the first study of a large cohort of predominantly Caucasian overweight and obese children and adolescents in Europe to address the frequencies of cardiovascular risk factors. The results of our study demonstrate that hypertension and dyslipidaemia are frequently present in overweight children. Seventy percent of all overweight children studied demonstrated at least one unfavourable cardiovascular risk factor.
The children of our study were referred to specialised obesity clinics. This
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