Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

Abstract

Objective: To examine whether characteristics of children and adolescents who start lifestyle intervention (LI) for obesity in Germany changed over the last decade. Methods: 65,453 subjects (<21 years) from the APV database (Adiposity Patients Registry) with a BMI ≥ 90th percentile were included (years 2005-2015). Logistic regression models (confounders: age, sex, migration background) were created for overweight, obesity, extreme obesity, and obesity-related comorbidities. Comorbidities were further adjusted for weight category. Results were stratified by inpatient or outpatient care. Results: Extreme obesity was found to be more frequent at the onset of LI (2005: 11.6; 2015: 12.7%) with a similar trend in subgroups (p < 0.001). Obesity increased (2005: 50.3%; 2015: 55.1%), and overweight decreased (2005: 34.1%; 2015: 29.0%) in the whole study population. Trends were similar for inpatient or outpatient care (all p < 0.001). Hypertension increased from 45.7% to 49.2% in the whole study population, and similar data were obtained in the subgroup of inpatients (both p < 0.0001). Dyslipidemia increased in all patients (2005: 21.9%; 2015: 28.0%) and in inpatients (2005: 20.2%; 2015: 25.7%; both p < 0.0001). Abnormal carbohydrate metabolism rose in all patients (from 5.2 to 6.4%; p = 0.0002) without significant trends in subgroups. Conclusion: During the last decade, children and adolescents presented with higher BMI SDS at the onset of LI and the proportion with obesity-related comorbidities increased. Particularly the presence of comorbidities differed between outpatients and inpatients.

Cardiometabolic risk factors differ among adolescents with obesity in three European countries – a cross‐sectional study

“…The high blood pressure levels observed in the present study in the German cohort were in line with a European health interview survey, which reported higher prevalence of hypertensive diseases in the population aged 15 years and over in Germany (28.5%) than in Norway (12.7%) and Italy (20.6%) . A study published in 2017 also showed a very high frequency of elevated BP in German adolescents with obesity , although using different cut‐off values than this study. Our findings of lowest prevalence of metabolic syndrome in the Norwegian cohort are also in consistence with an international comparison that showed children from Germany in the highest cardiovascular risk tertile, Italy in the middle and children from Norway in the tertile with most favourable cardiovascular risk profile overall .…”

Клінічні Та Лабораторні Критерії Цукрового Діабету 2-Го Типу В Дітей

“…Суть цієї гіпотези полягає в тому, що недостатнє харчування в період внутрішньоутробного розвитку або раннього періо-УДК 616.379-008.64-085-035.2-008. 9 ду життя дитини є однією з основних причин уповільненого розвитку ендокринної функції підшлункової залози і схильності до ЦД 2-го типу. Може здатися сумнівним, що явища, які розвиваються в перші два роки життя дитини, здатні викликати зміни ендокринних функцій до 50-70 років життя.…”

“…На сьогодні ожиріння у світі набуло характеру епідемії, в тому числі і в дитячій популяції. Отже, очікується подальше неухильне зростання числа випадків ЦД 2-го типу [7][8][9].…”

Obesity, lifestyle behaviors and dyslipidemia among Chinese adults aged 45 and older

“…Physical activity has been recommended in the prevention of obesity and dyslipidemia by health organizations around the world, because it costs less and generates fewer side effects than isolated medicine (20,23). Most studies on prevention of dyslipidemia adopted the traditional statistical methods and the interaction between demographic characteristics, lifestyle behaviors and dyslipidemia has rarely been incorporated into the research (17,24,25).…”