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Ethnicity and cardiovascular risk factors: evaluation of 40 921 normal-weight, overweight or obese children and adolescents living in Central Europe

Abstract

Background and aims:

Cardiovascular disease (CVD) is a major global health problem and the leading cause of death in Europe. Risk factors such as obesity and hypertension that accelerate the development of CVD begin in childhood. Ethnicity is a known risk factor for CVD in adults. The aim of this study is to explore differences in the prevalence of hypertension and dyslipidemia among overweight/obese and normal-weight children/adolescents of three different ethnic origins living in Central Europe.

Methods and procedures:

Prevalence of hypertension and dyslipidemia was calculated among obese/overweight children/adolescents (n=25 986; mean age 12.7±3.0 years; range: 0–18 years; 46% males) documented in the German-Austrian-Swiss APV (Prospective Documentation of Overweight Children and Adolescents) registry and among normal-weight subjects (n=14 935; mean age: 8.8±5.1years; range 0–18 years; 51% males) from the population-based cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. In both cohorts, subjects were categorized into three ethnic groups (Central European: Germany, Austria, Switzerland; Southeastern European: Turkish; Southern European: Spain, Portugal, Italy, Greece, Cyprus, Malta) based on the country of birth of both parents. Regression models were used to examine ethnic differences after adjustment for age and gender and body mass index (BMI) category.

Results:

Age-, gender- and BMI category-adjusted prevalence of hypertension were 38% and 39% for the ethnic minority groups, compared with 35% among German/Austrian/Swiss counterparts. Turkish ethnicity was significantly associated with hypertension (odds ratio (OR) 1.14; 95% confidence interval: 1.02–1.27; P=0.0446). No significant ethnic differences were found in lipid levels. Prevalence of hypertension found among normal-weight subjects (Central European vs Southeastern vs Southern European: 6.8% vs 6.3% vs 7.2%) did not differ significantly.

Conclusions:

Turkish obese/overweight children/adolescents showed a significantly higher prevalence of hypertension relative to their peers of Central European descent. No significant ethnic difference in the prevalence of hypertension was found among normal-weight children/adolescents. The high prevalence of hypertension among Turkish obese/overweight children/adolescents indicates the need for greater preventive and therapeutic efforts to reduce cardiovascular risk factors among vulnerable populations.

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Acknowledgements

The APV standardized documentation was supported by grants of the German Obesity Society (DAG) and German Federal Centre for Health Education (BZgA). The APV Study Group received grant support from the German ‘Competence Network Adipositas’, which is initiated by the German Federal Ministry of Education and Research (grant numbers 01 GI0824 and 01GI1130; APV-LARGE). We are indebted to all health professionals of the APV Study Group taking care of overweight children. SW, TR and RWH received grant support from of the German ‘Competence Network Adipositas’, which is supported by the German Federal Ministry of Education and Research (grant numbers 01 GI0824 and 01GI1130; APV-LARGE).

List of participating centers

Amrum Satteldüne Kinder-Reha, Augsburg Bunter Kreis, Bad Frankenhausen Kinder-Reha, Bad Hersfeld Kinderklinik, Bad Kreuznach Viktoriastift, Bad Kösen Kinder-Reha, Bad Neuenahr—DRK Institutsambulanz, Bad Orb Spessartklinik—Kinder-Reha, Bensheim Ernährungspraxis, Berchtesgaden CJD, Berchtesgaden Klinik Schönsicht Kinder-Reha, Berlin Charité Kinderklinik, Berlin Lichtenberg Kinderklinik, Berlin Pfundskinder, Berlin Vivantes Beh.Zentrum SPZ, Bonn Ernährungsberatung KIDS Schulung, Bremen—ZABS, Bremen-Nord Kinderklinik, Bruchweiler Kinder-Reha, Buchholz Ernährungsberatung, Darmstadt Kinderklinik, Datteln Vestische Kinderklinik, Delmenhorst Kinderklinik, Dinslaken Kinderklinik, Dresden Moby Dick, Düren sozialpäd. Zentrum Marienhospital, Düsseldorf Ernährungsberatung ‘richtig essen’, Eschede Adipositastraining KIDS, Essen Kinder und Jugendpsychiatrie, Ettenheim Kinderarztpraxis, Euskirchen Kinderarztpraxis, Feldberg ITZ Caritas-Haus, Flensburg Fördekids, Frankfurt Päd. Endokrinologie, Freiburg—Fitoc, Freiburg Uni-Kinderklinik, Friedrichsdorf Ernährungsberatung, Fürth Kinderklinik, Gaissach Fachklinik Deutsche Rentenversicherung Bayern-Süd, Garz Fachklinik CJD, Gauting, Kinderarztpraxis, Giffers, Ausbildungszentrum Guglera, Gotha Helios Kinderklinik, Gröbenzell Ernährungsinstitut Kinderleicht, Göttingen Uni-Kinderklinik, Göttingen, KIDS Schulungsprogramm, Hagen Allgemeines Krankenhaus, Hagen Kinderarztpraxis, Hagen Kinderklinik, Hamburg Rallye Energy, Hamburg Wilhelmstift, Hannover Kinderklinik Bult, Haßfurt Adipositasschulung Haßberge, Herrenberg Ernährungsberatung, Hirschberg Praxis Maurer, Homburg CJD, Kiel städt. Krankenhaus Fördekids, Korbach Ernährungsberatung, Krefeld Kinderklinik, Kreischa Klinikum Bavaria Zscheckwitz, Köln—Amsterdamerstrasse, Power Pänz, Köln MeLo KIDS Schulungsprogramm, Köln Sporthochschule, Kölpinsee, Seebad Klaus Störtebecker Kinder-Reha, Leipzig Uni-Kinderklinik, Lindau Forum Adipositas e.V., Lingen Bonifatius-Hospital, Lörrach Elisabethenkrankenhaus, Lörrach Kinderklinik, Lübeck Uni-Kinderklinik, Magdeburg Uni-Kinderklinik, Mahlow Programm TRI FIT junior, Menden BIG, Munster Ernährungs- & Bewegungsschulung für K&J, Mönchengladbach Städt. Kinderklinik, Mühlhausen Präventionspraxis Scherf, München Adieupositas, Münster ADI MOBIL, Neunkirchen Kinderklinik, Neuss Lukaskrankenhaus, Niederkassel Kinderarztpraxis Sprenker, Norden—Klinik Nordendeich, Oberhausen Adipositaszentrum, Oberstaufen Ernährungsmedizin, Oberstenfeld Ernährungspraxis, Oberstenfeld Ernährungspraxis2, Oldenburg Kids-Schulungsprogramm, Osnabrück christliches Kinderhospital, Overath KIDS Schulungsprogramm, Oy-Mittelberg Reha, Paderborn Ernährungspraxis, Passau Kinderklinik, Pocking Kinderarztpraxis, Poppenricht Ernährungsberatung, Potsdam Patienten Trainings Zentrum, Pönitz FiFaFu KIDS-Programm, Ravensburg Ernährung und Diät, Rendsburg Villa Schwensen Praxisgemeinschaft KJPP, Ronneburg Ernährungsberatung, Rosenheim Lufti-Team, Rottweil Kinder-Leicht, Rüsselsheim Gesundheits- und Pflegezentrum, Salzburg Uni-Kinderklinik, Scheidegg Prinzregent Luitpold Reha, Seebad Heringsdorf—Kinder-Reha, Senden Ernährungsberatung, Siegburg KIDS Schulungsprogramm, Siegen DRK Kinderklinik, Simonswald Klinik Eichhof, Solingen Ernährungsberatung, Sonneberg KIDS Ernährungspraxis, St. Pölten Landesklinikum Kinderklinik, Tholey / SPZ Neunkirchen, Tübingen Universitäts-Kinderklinik, Ulm Uni-Kinderklinik, Untergruppenbach Ernährungsberatung, Viersen Kinderklinik Nikolaus, Villingen-Schwenningen Kiarztpraxis, Waldbröl Gemeinschaftspraxis, Westerland/Sylt, Kinder-Reha, Wien Ernährungsakademie, Wien Uni-Kinderklinik, Wiesbaden DKD Kinderklinik, Wiesmoor KIDS Schulungsprogramm, Wustrow Ostseebad Fischland, Würzburg ambulantes Schulungszentrum.

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Martin, L., Oepen, J., Reinehr, T. et al. Ethnicity and cardiovascular risk factors: evaluation of 40 921 normal-weight, overweight or obese children and adolescents living in Central Europe. Int J Obes 39, 45–51 (2015). https://doi.org/10.1038/ijo.2014.167

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