Overweight and obesity in children with congenital heart disease: combination of risks for the future?

Barbiero, Sandra Mari; Sica, Caroline D’Azevedo; Schuh, Daniela Schneid; Cesa, Cláudia Ciceri; Petkowicz, Rosemary de Oliveira; Pellanda, Lúcia Campos

doi:10.1186/1471-2431-14-271

Cited by 48 publications

(49 citation statements)

References 30 publications

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“…These modifiable risk factors have been well discussed in the literature on children without heart disease. 22 Vitamin E, which in this study was associated with the classification of BMI, is a fat-soluble antioxidant that occurs naturally. This micronutrient has been proposed for the prevention and protection of cardiovascular events.…”

Section: Discussionmentioning

confidence: 90%

Growth curves in Down syndrome with congenital heart disease

Sica

Cesa²,

Pellanda³

2016

Rev. Assoc. Med. Bras.

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Introduction: To assess dietary habits, nutritional status and food frequency in children and adolescents with Down syndrome (DS) and congenital heart disease (CHD). Additionally, we attempted to compare body mass index (BMI) classifications according to the World Health Organization (WHO) curves and curves developed for individuals with DS. Method: Cross-sectional study including individuals with DS and CHD treated at a referral center for cardiology, aged 2 to 18 years. Weight, height, BMI, total energy and food frequency were measured. Nutritional status was assessed using BMI for age and gender, using curves for evaluation of patients with DS and those set by the WHO. Results: 68 subjects with DS and CHD were evaluated. Atrioventricular septal defect (AVSD) was the most common heart disease (52.9%). There were differences in BMI classification between the curves proposed for patients with DS and those proposed by the WHO. There was an association between consumption of vitamin E and polyunsaturated fatty acids. Conclusion: Results showed that individuals with DS are mostly considered normal weight for age, when evaluated using specific curves for DS. Reviews on specific curves for DS would be the recommended practice for health professionals so as to avoid precipitated diagnosis of overweight and/or obesity in this population.

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Section: Discussionmentioning

confidence: 90%

Growth curves in Down syndrome with congenital heart disease

Sica

Cesa²,

Pellanda³

2016

Rev. Assoc. Med. Bras.

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“…In a cross‐sectional study, Moons and colleagues collected data on 1976 adults with CHD (median age 26 years) and demonstrated a higher rate of hypertension, obesity, and T2DM relative to the national population, with only 20% of subjects with CHD abiding by a “heart‐healthy” lifestyle. Barbiero and colleagues demonstrated in 316 CHD outpatients a rate of dyslipidemia, excess weight, and family history of T2DM that equaled the rate of the general population and called for additional attention to the aim for healthy cardiovascular behaviors in the CHD community.…”

Section: Discussionmentioning

confidence: 99%

“…While obesity is a clearly described risk factor for T2DM, we are not able to determine to what extent the elevated rate of DM after age 30 in the CHD population is driven by body habitus. However, we can draw from previous literature on the rate of overweight/obesity in the CHD population from 2 large American centers, as well as data from Belgium and Brazil, that demonstrate a rate of overweight and obesity that is not substantially worse in CHD survivors relative to their general population.…”

Section: Discussionmentioning

confidence: 99%

“…Limited population‐based data exist on long‐term acquired morbidity in the CHD population . Given the escalating prevalence of both CHD survival and T2DM in the general population, we believe it is important to assess its incidence in the CHD population, as subjects with CHD may be both at particular risk of DM and uniquely vulnerable to its effects.…”

Section: Introductionmentioning

confidence: 99%

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Congenital Heart Disease With and Without Cyanotic Potential and the Long‐term Risk of Diabetes Mellitus: A Population‐Based Follow‐up Study

Madsen

Marino

Woo

et al. 2016

JAHA

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BackgroundLong‐term survival for persons born with congenital heart disease (CHD) is improved, but limited knowledge exists of this growing population's acquired cardiovascular risk profile. This study's purpose was to assess CHD survivors’ risk for type 2 diabetes mellitus (T2DM) with attention to the impact of cyanotic CHD.Methods and ResultsThis population‐based cohort study included Danish subjects with CHD who were born between 1963 and 1980 and were alive at age 30 years. For each CHD case, we identified 10 individuals from the general population matched by sex and birth year, by using the Danish Civil Registration System. Complete follow‐up was obtained through Danish public registries for death, emigration, and T2DM (diagnosis and prescriptions record). We computed cumulative incidences and hazard ratios of developing T2DM after age 30 for 5149 CHD subjects compared with the general population. After adjusting for CHD severity, as well as age, sex, preterm birth, and extracardiac defects, we analyzed the impact of cyanotic compared with acyanotic CHD. By age 45 years, the cumulative incidence of T2DM after age 30 was 4% among subjects with CHD. Subjects with CHD were more likely to develop T2DM than the general population (hazard raio 1.4, 95% CI 1.1–1.6). Subjects CHD who had cyanotic defects were more likely to develop T2DM than were subjects with acyanotic CHD (hazard ratio 1.9, 95% CI 1.1–3.3).Conclusions CHD survivors had an increased risk of developing T2DM after age 30. Patients with cyanotic CHD are at particular risk. Given the cardiovascular health burden of T2DM, attention to its development in CHD survivors seems warranted.

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“…However, studies have consistently reported that adults with CHD present with modifiable risk factors at rates that warrant attention . While it is well established that cardiovascular risk factors track from childhood to adulthood in the general population, data on modifiable risk factor prevalence in youth with CHD are scarce, and largely focused on the troubling prevalence of overweight and obesity in these children …”

Section: Introductionmentioning

confidence: 99%