PMID- 23147116
OWN - NLM
STAT- MEDLINE
DCOM- 20131108
LR  - 20220408
IS  - 1476-5497 (Electronic)
IS  - 0307-0565 (Linking)
VI  - 37
IP  - 4
DP  - 2013 Apr
TI  - Comorbidities in overweight children and adolescents: do we treat them 
      effectively?
PG  - 493-9
LID - 10.1038/ijo.2012.184 [doi]
AB  - OBJECTIVE: The aim was to analyze the effectiveness of treatment concerning 
      obesity-associated comorbidities in clinical practice. METHODS: A total of 11,681 
      overweight children with >/= 6-month follow-up treated at 175 centers specialized 
      in pediatric obesity care in Central Europe were included in this analysis (mean 
      body mass index (BMI) 29.0 +/- 5.6 kg m(-)(2), standard deviation score body mass 
      index (SDS-BMI) 2.48 +/- 0.54, 45% boys, age 11.4 +/- 2.8 years). The changes of 
      weight status, blood pressure, fasting lipids and glucose, and oral glucose 
      tolerance tests were documented by standardized prospective quality documentation 
      software (APV). RESULTS: After follow-up of in median 1.2 (interquartile range 
      0.9-2.2) years, a mean reduction of -0.15 SDS-BMI was achieved. The prevalence of 
      prehypertension (37->33%) and hypertension (17->12%) decreased, while prevalences 
      of triglycerides >150 mg dl(-1) (22->21%), low-density-lipoprotein-cholesterol 
      >130 mg dl(-1) (15->14%), impaired fasting glucose (6->6%) and impaired glucose 
      tolerance (9->8%) remained stable. Drug treatment according to cutoffs 
      recommended in European obesity guidelines were not frequently indicated 
      (hypertension: 10%; dyslipidemia: 1%, type 2 diabetes <1%). None of the children 
      with dyslipidemia received lipid-lowering drugs and only 1.4% of the children 
      with hypertension were treated with antihypertensive drugs. CONCLUSIONS: 
      Achieving sufficient weight loss to improve obesity associated comorbidities was 
      difficult in clinical practice. Drug treatment of hypertension, dyslipidemia and 
      type 2 diabetes was rarely performed even if it was indicated only in a minority 
      of the overweight children. Future analyses should identify reasons for this 
      insufficient drug treatment of comorbidities and analyze whether the benchmarking 
      processes of APV improve medical care of childhood obesity.
FAU - Reinehr, T
AU  - Reinehr T
AD  - Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische 
      Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, 
      Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
FAU - Wiegand, S
AU  - Wiegand S
FAU - Siegfried, W
AU  - Siegfried W
FAU - Keller, K M
AU  - Keller KM
FAU - Widhalm, K
AU  - Widhalm K
FAU - l'Allemand, D
AU  - l'Allemand D
FAU - Zwiauer, K
AU  - Zwiauer K
FAU - Holl, R W
AU  - Holl RW
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20121113
PL  - England
TA  - Int J Obes (Lond)
JT  - International journal of obesity (2005)
JID - 101256108
RN  - 0 (Lipids)
SB  - IM
MH  - Adolescent
MH  - *Adolescent Health Services
MH  - Adult
MH  - Austria/epidemiology
MH  - Body Mass Index
MH  - Cardiovascular Diseases/blood/*epidemiology/prevention & control
MH  - Child
MH  - *Child Health Services
MH  - Child, Preschool
MH  - Comorbidity
MH  - Dyslipidemias/blood/drug therapy/*epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Germany/epidemiology
MH  - Humans
MH  - Hypertension/blood/drug therapy/*epidemiology
MH  - Lipids/blood
MH  - Longitudinal Studies
MH  - Male
MH  - Obesity/blood/drug therapy/*epidemiology
MH  - Prevalence
MH  - Risk Factors
MH  - Switzerland/epidemiology
EDAT- 2012/11/14 06:00
MHDA- 2013/11/10 06:00
CRDT- 2012/11/14 06:00
PHST- 2012/11/14 06:00 [entrez]
PHST- 2012/11/14 06:00 [pubmed]
PHST- 2013/11/10 06:00 [medline]
AID - ijo2012184 [pii]
AID - 10.1038/ijo.2012.184 [doi]
PST - ppublish
SO  - Int J Obes (Lond). 2013 Apr;37(4):493-9. doi: 10.1038/ijo.2012.184. Epub 2012 Nov 
      13.