Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity

• Published in: Cardiovascular diabetology Vol. 19; no. 1; pp. 79 - 14
• Main Authors: Bendor, Cole D, Bardugo, Aya, Pinhas-Hamiel, Orit, Afek, Arnon, Twig, Gilad
• Format: Journal Article
• Language: English
• Published: England BioMed Central 13.06.2020; BMC
• Subjects: Adipose tissue; Adiposity; Adolescence; Adolescent; Adolescents; African Americans; Age Factors; Blood pressure; Body Mass Index; Cancer; Cardiomyopathy; Cardiovascular; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Child; Child, Preschool; Children; Children & youth; Comorbidity; Coronary artery disease; Cross-sectional studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Dyslipidemia; Epidemiology; Ethnicity; Fasting; Fatty liver; Female; Gastrointestinal surgery; Glucose; Heart diseases; Hemoglobin; Humans; Hypertension; Kidney diseases; Liver diseases; Male; Morbid obesity; Morbidity; Mortality; Neoplasms - diagnosis; Neoplasms - epidemiology; Obesity; Paediatrics; Pediatric Obesity - diagnosis; Pediatric Obesity - epidemiology; Pediatric Obesity - physiopathology; Pediatrics; Prevalence; Prognosis; Public health; Review; Risk Assessment; Risk Factors; Severe obesity; Severity of Illness Index; Teenagers; Time Factors; Triglycerides; Young Adult; Young adults; Youth; United States > US; Hypertension; Adolescence; NAFLD; Cardiovascular; Severe obesity; Mortality; Youth; Diabetes; Morbid obesity; Paediatrics; Cancer
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-020-01052-1

Severe obesity among children and adolescents is a significant global public health concern. The prevalence has markedly increased over the last decades, becoming common in many countries. Overwhelming rates of obesity among youth have prompted efforts to identify an evidence-based immediate- and long-term cardiometabolic risk factor profile in childhood-onset severe obesity, and to highlight gaps that require further investigation. The PubMed database was systematically searched in accordance with PRISMA guidelines. The search yielded 831 results, of which 60 fulfilled stringent criteria and were summarized in this review. The definition of severe obesity was variable, with only one half the publications using the definition BMI > 120% of the 95th percentile. Point estimates of the prevalence of at least one cardiometabolic risk factor in children with severe obesity reportedly range from 67 to 86%. Cross-sectional studies indicate that children and adolescents with severe obesity are at greater risk than those with mild obesity for type 2 diabetes, hypertension, fatty liver disease and dyslipidemia, already at childhood and adolescence. Robust epidemiological data on the long-term risk and actual point estimates in adulthood are lacking for these diseases as well as for other diseases (coronary heart disease, stroke, chronic kidney disease and cancer). Recent longitudinal studies indicate an increased risk for cardiomyopathy, heart failure, cardiovascular mortality and all-cause mortality in adulthood for adolescents with severe obesity compared to those with mild obesity. Given the alarming increase in the prevalence of severe obesity, the persistence of adiposity from childhood to adulthood and the precarious course of young adults with chronic comorbidities, the economic and clinical services burden on the healthcare system is expected to rise.