Abstract 544 Poster Session II, Sunday, 5/2 (poster 209)

While the incidence and significant co-morbidities of adult obesity have been well documented, childhood obesity and its consequences during childhood are not well studied. Dyslipidemia, hypertension, and insulin resistance are well-known co-morbidities in adults, however, in pediatric obese patients they are not well studied. The likelihood of becoming an obese adult increases the longer the child remains obese, thus, pediatricians must be proactive and intervene early. Aim: To determine the severity of obesity and presence of co-morbidities in children referred for enrollment in a multidisciplinary obesity treatment program. Method: 172 patients (M85/F87) were referred over 14 mos to our center. History was reviewed for evidence of sleep apnea and joint pains. The family was screened for history of obesity, diabetes mellitus, hypertension, dyslipidemia, CAD/CVA, and thyroid disorder. Stadiometer was used to measure height. The body mass index (BMI) was calculated at the initial (BMI-0) and all revisits (BMI-x). The SDS was determined using age and sex specific data. Elevated blood pressure was defined as systolic or diastolic > 90%ile. Hg A1c, lipid profile, and thyroid function were assessed. All variables were compared to normals for age and sex. Results: At entry, the mean age was 10.6 yr (M 10.7, F 10.4), range 0.8 - 18 yrs. Similar number of boys and girls were referred at each age group. The severity, mean BMI-0 SDS, was not different for sex (M=4.4±2.5, F=4.48±3.1), or age (0-5 yr >4, 5-9 yr = 5.2±2.5, 9-13 yr=3.88 ±1.7, 13-18 yr = 4.83 ±3.4). Symptoms suggestive of sleep apnea were reported in 4.5% (M= 2.8% F=6.7%). Joint pain was reported in 4.5% (M= F). Elevated blood pressure was documented in 52% of boys and 41% of girls. Acanthosis nigricans was present in 37% (M=36% F=38%). Elevated HgA1c was found in M=8% and F=15%. Of the lipid profiles performed (M 73, F 73), solitary elevation in TG in M=26% F=27%, 2 abnormal parameters (cholesterol, TG, LDL, HDL) in M=29% F=27%, ≥3 abnormal parameters in M=8% F=16% were found. Isolated low HDL was seen in M=3% and F=8%. Family history was significant for obesity 66%, diabetes 66%, hypertension 28%, dyslipidemia 31%, CAD/CVA 30%, and thyroid disorders 15%. Of the 305 visits recorded, 99 initial visits were without follow up. Summary: We demonstrate severe obesity and the co-morbidities of obesity, particularly dyslipidemia and glucose intolerance, are already evident and common in childhood. The co-morbidities affected boys and girls equally except that more girls had elevated Hg A1c at presentation. Greater emphasis on prevention and treatment of overweight children must be addressed early in order to have impact on altering the familial and environmental contributors to obesity and its sequelae.