Medical care of obese children and adolescents |
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Authors: | Thomas Reinehr Martin Wabitsch Werner Andler Peter Beyer Antje Böttner Annette Chen-Stute Carmen Fromme Olaf Hampel Klaus M. Keller Uwe Kilian Hilde Kolbe Thomas Lob-Corzilius Wolfgang Marg Hermann Mayer Klaus Mohnike Johannes Oepen Clemens Povel Brunhild Richter Nikola Riedinger Gerd Schauerte Gernot Schmahlfeldt Wolfgang Siegfried Peer Smuda Rainer Stachow Andreas van Egmond-Fröhlich Jannie Weiten Susanna Wiegand Sabine Witte Volker Zindel Reinhard W. Holl |
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Affiliation: | (1) Department of Paediatrics, University of Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany;(2) Vest Youth Hospital, University of Witten-Herdecke, Dr. Friedrich Steiner Straße 5, 45711 Datteln, Germany |
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Abstract: | So far in Europe, no studies have been published on the structuring of medical care for obese children and adolescents. Besides anthropometric parameters, evaluations of the cardiovascular risk factors hypertension, dyslipidaemia, impaired glucose metabolism and treatment modalities were documented in a standardised multicentre evaluation survey (APV) of 18 primarily outpatient and nine rehabilitation institutions. In total, 3837 children (aged 2–20 years) took part in the years 2000 up to March 2003, of whom 1985 were treated in outpatient institutions and 1852 in rehabilitation institutions. Of these children, 10% were overweight, 37% obese, 49% extremely obese and 4% of normal weight at initial presentation. The frequencies of diagnostic procedures performed and documented were low (measurement of blood pressure 43%, lipids 40%, glucose metabolism 21%). In the subgroup of obese children who were screened for cardiovascular risk factors, 23% suffered from hypertension, 11% displayed increased cholesterol, 9% increased low-density lipoprotein-cholesterol, 29% increased triglycerides, 11% decreased high-density lipoprotein-cholesterol and 6% had impaired glucose metabolism. Conclusion: despite the high prevalence of cardiovascular risk factors in obese children and adolescents confirmed in this report, diagnostic procedures failed in a considerable percentage even in specialised treatment centres for obese children and adolescents. In future, the feedback based on standardised evaluation of diagnostic and treatment procedures should aim to improve the quality of medical care.Abbreviations BMI body mass index - HDL high-density lipoprotein - LDL low-density lipoprotein - SDS standard deviation scoreOn behalf of the APV Study Group, Department of Paediatrics, University of Ulm, Germany |
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Keywords: | Cardiovascular risk factors Childhood Medical care Obesity Quality of assessment |
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