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Archives of Disease in Childhood

Clinical Articles, News & Views

Obese children already have heart disease risk factors



Two out of three severely obese children already have at least one risk factor for heart disease, suggests research published recently online in Archives of Disease in Childhood.1

The authors base their findings on data supplied by paediatricians to the Dutch Paediatric Surveillance Unit between 2005 and 2007.
During this period, doctors treating all new cases of severe obesity in children from the ages of 2 to 18 across The Netherlands were asked to supply information on their patients’ cardiovascular risk factors, including high blood pressure, fasting blood glucose levels, and lipids.

The definition of severe obesity started at a body mass index (BMI) of 20.5 for a 2 year old, at 31 for a 12 year old, and at 35 for an 18 year old.
Over the three years, 87%–94% of paediatricians submitted their monthly findings on 500 severely obese children.
When paediatricians were contacted again, with a request for further data, 363 responded and 307 of their children were correctly classified as severely obese.

52% of these were boys. They tended to be more severely obese at the younger end of the age spectrum; the reverse was true of girls. Full information on cardiovascular risk factors was available for 83%.

67% had at least one cardiovascular risk factor. 56% had high blood pressure; a similar proportion had high levels of low density cholesterol; 14% had high fasting blood glucose; and just under one percent already had type 2 diabetes.

The authors note that almost two thirds of those aged 12 and under had one or more cardiovascular risk factors. Only one child’s obesity was attributable to medical rather than lifestyle factors.
Nearly one in three severely obese children came from one parent families.

“The prevalence of impaired fasting glucose in [these children] is worrying, considering the increasing prevalence worldwide of type 2 diabetes in children and adolescents,” write the authors. “Likewise, the high prevalence of hypertension and abnormal lipids may lead to cardiovascular disease in young adulthood,” they add.

And they conclude: “Internationally accepted criteria for defining severe obesity and guidelines for early detection and treatment of severe obesity and [underlying ill health] are urgently needed”.

References

1. van Emmerik NMA, Renders CM, van de Veer M, et al. High cardiovascular risk in severely obese young children and adolescents. Arch Dis Child 2012;0:1–4. http://dx.doi.org/10.1136/archdischild-2012-301877

Published on: August 24, 2012

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