Gilad Twig1,2,3, Brian Reichman4,5, Arnon Afek4,6, Estela Derazne7,4, Uri Hamiel4,8, Ariel Furer7, Liron Gershovitz7, Tarif Bader7,9, Tali Cukierman-Yaffe4,10, Jeremy D Kark11, Orit Pinhas-Hamiel4,12. 1. Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel. Gilad.Twig@gmail.com. 2. Department of Medicine and the Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel. Gilad.Twig@gmail.com. 3. Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel. Gilad.Twig@gmail.com. 4. Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel. 5. The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel. 6. Central Management, Chaim Sheba Medical Center, Tel Hashomer, Israel. 7. Surgeon General Headquarters, Israel Defense Forces, Ramat Gan, Israel. 8. Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel. 9. Department of Military Medicine, Hebrew University, Jerusalem, Israel. 10. Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel. 11. Hebrew University-Hadassah School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel. 12. Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
Abstract
BACKGROUND: Severe obesity is rising among adolescents, but data on the prevalence of metabolic abnormalities among this group are limited. We assessed the secular trend of severe obesity and its association with major cardio-metabolic morbidities. METHODS: A total of 2,785,227 Israeli adolescents (aged 17.2 ± 0.5 years) who underwent a pre-recruitment medical examination including routine measurements of weight, height and blood pressure between 1967 and 2015 were included. In all, 230,639 adolescents with abnormally excessive BMI were classified into overweight, classes I, II, and III (severe) obesity. Logistic regression was applied to determine the association between BMI groups and prehypertension, high blood pressure and type 2 diabetes (T2DM). RESULTS: There was 45-fold increase in the prevalence of class III obesity during study period. Severe obesity was recorded in 2060 males and 1149 females, in whom nearly 35 and 43% had prehypertension or high blood pressure, respectively. Compared with adolescents with overweight, the odds ratios (ORs) for high blood pressure in classes II and III obesity groups, respectively, were 2.13 (95% CI, 2.04-2.23) and 2.86 (2.60-3.15) in males, and 2.59 (2.43-2.76) and 3.44 (3.04-3.90) in females, whereas the ORs for T2DM were 19.1 (12.3-29.6) and 38.0 (22.6-64.0) in males, and 15.1 (11.4-20.0) and 24.8 (17.2-35.7) in females. Results persisted in extensive sensitivity analyses including a longitudinal follow-up (median: males, 3.4 years; females, 4.9 years). CONCLUSIONS: Severe obesity showed a marked secular increase and was associated with significantly higher risk for abnormal blood pressure and T2DM than lower degrees of obesity, in both males and females.
BACKGROUND: Severe obesity is rising among adolescents, but data on the prevalence of metabolic abnormalities among this group are limited. We assessed the secular trend of severe obesity and its association with major cardio-metabolic morbidities. METHODS: A total of 2,785,227 Israeli adolescents (aged 17.2 ± 0.5 years) who underwent a pre-recruitment medical examination including routine measurements of weight, height and blood pressure between 1967 and 2015 were included. In all, 230,639 adolescents with abnormally excessive BMI were classified into overweight, classes I, II, and III (severe) obesity. Logistic regression was applied to determine the association between BMI groups and prehypertension, high blood pressure and type 2 diabetes (T2DM). RESULTS: There was 45-fold increase in the prevalence of class III obesity during study period. Severe obesity was recorded in 2060 males and 1149 females, in whom nearly 35 and 43% had prehypertension or high blood pressure, respectively. Compared with adolescents with overweight, the odds ratios (ORs) for high blood pressure in classes II and III obesity groups, respectively, were 2.13 (95% CI, 2.04-2.23) and 2.86 (2.60-3.15) in males, and 2.59 (2.43-2.76) and 3.44 (3.04-3.90) in females, whereas the ORs for T2DM were 19.1 (12.3-29.6) and 38.0 (22.6-64.0) in males, and 15.1 (11.4-20.0) and 24.8 (17.2-35.7) in females. Results persisted in extensive sensitivity analyses including a longitudinal follow-up (median: males, 3.4 years; females, 4.9 years). CONCLUSIONS: Severe obesity showed a marked secular increase and was associated with significantly higher risk for abnormal blood pressure and T2DM than lower degrees of obesity, in both males and females.
Authors: Frida Dangardt; Marietta Charakida; Georgios Georgiopoulos; Scott T Chiesa; Alicja Rapala; Kaitlin H Wade; Alun D Hughes; Nicholas J Timpson; Konstantinos Pateras; Nick Finer; Naveed Sattar; George Davey Smith; Debbie A Lawlor; John E Deanfield Journal: Lancet Child Adolesc Health Date: 2019-05-21
Authors: Lyudmyla Kompaniyets; Elizabeth A Lundeen; Brook Belay; Alyson B Goodman; Florence Tangka; Heidi M Blanck Journal: Med Care Date: 2020-08 Impact factor: 3.178