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Medical care of obese children and adolescents

APV: a standardised multicentre documentation derived to study initial presentation and cardiovascular risk factors in patients transferred to specialised treatment institutions

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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.

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Abbreviations

BMI :

body mass index

HDL :

high-density lipoprotein

LDL :

low-density lipoprotein

SDS :

standard deviation score

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Authors and Affiliations

  1. Department of Paediatrics, University of Ulm, Prittwitzstrasse 43, 89075, Ulm, Germany

    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

  2. Vest Youth Hospital, University of Witten-Herdecke, Dr. Friedrich Steiner Straße 5, 45711, Datteln, Germany

    Thomas Reinehr

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  1. Thomas Reinehr
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APV Study Group

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Correspondence to Thomas Reinehr.

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On behalf of the APV Study Group, Department of Paediatrics, University of Ulm, Germany

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Reinehr, T., Wabitsch, M., Andler, W. et al. Medical care of obese children and adolescents. Eur J Pediatr 163, 308–312 (2004). https://doi.org/10.1007/s00431-004-1421-1

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  • DOI: https://doi.org/10.1007/s00431-004-1421-1

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