期刊
JOURNAL OF PEDIATRICS
卷 192, 期 -, 页码 105-114出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2017.09.066
关键词
-
类别
资金
- National Institutes of Health (NIH) National Institute of Child Health and Human Development [R01-HD-40787, R01-HD-28016, K24-HD-01464]
- Clinical and Translational Science Award from the National Center for Research Resources, a component of the IH [UL1-RR-0249139]
- Distinguished Clinical Scientist Award from the American Diabetes Association
- Diabetes Research Center [P30-DK-045735]
Objective To compare cardiovascular risk factor clustering (CVRFC) in severely obese youth with those with lower degrees of obesity. Study design We divided a childhood obesity clinic derived cohort into the degrees of obesity (class I, II, and III) and added a class IV category corresponding to >160% of the 95th centile of body mass index (BMI) for age and sex. In a cross-sectional analysis, we investigated the presence of CVRFC in 2244 participants; in 621 who were followed longitudinally, we investigated the determinants of endpoint CVRFC. Results Class IV obesity was associated with increased risk for CVRFC compared with overweight (OR = 17.26, P < .001) at a similar magnitude to class III obesity (OR = 17.26, P < .001). Male children were at greater risk for presence of CVRFC (OR = 1.57, P = .03) compared with female children. Adiponectin (OR = 0.90, P < .001) and leptin levels (OR = 0.98, P = .008) were protective, independent of degree of obesity. Baseline class IV obesity was associated with increased risk compared with overweight of having CVRFC at follow-up (OR = 5.76, P = .001), to a similar extent as class III obesity (OR = 5.36, P = .001). Changes in the degree of obesity were significant predictors of CVRFC on follow-up (OR = 1.04, P < .01 per percent BMI change). Conclusions The metabolic risk associated with obesity in childhood is conferred prior to reaching class IV obesity. An individualized risk stratification approach in children with severe obesity should be based on presence of complications rather than simple BMI cutoffs.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据