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Childhood obesity leads to comorbidities in adults with severe obesity
The onset of obesity in childhood puts men with severe obesity at greater risk for developing coronary heart disease and women with severe obesity at an increased risk for obstructive sleep apnea and type 2 diabetes, according to a study published in Obesity Science & Practice.
“The duration of obesity between those who had childhood, adolescent or adult onset of obesity did not necessarily substantially differ,” Heidi Borgeraas, PhD, of the Morbid Obesity Center at Vestfold Hospital Trust in Norway, and colleagues wrote. “This implies that the specific time of obesity onset, and not only the duration of obesity, may be important when estimating risk of comorbidities later in life.”
To determine whether obesity onset in childhood is a risk factor for comorbidities in adults with severe obesity (BMI 40 kg/m2 in men and 35 kg/m2 in women), researchers conducted a cross-sectional study of 4,583 men and women seeking treatment in Norway between 2006 and March 2017 (97% white; 31% men; mean age of men, 46 years; mean age of women, 43 years; mean BMI of men, 44.06 kg/m2; mean BMI of women, 43.39 kg/m2).
Researchers used clinical records and clinical outcome assessments to collect detailed medical histories. Weight, height, BMI, waist circumference and blood pressure measurements were recorded on-site.
Researchers considered whether participants had a variety of comorbidities, including hypertension (BP 140 mm Hg/90 mm Hg), dyslipidemia (LDL cholesterol 2.6 mmol/L) and nonalcoholic fatty liver disease (NAFLD; 55.6 mg triglyceride/g liver tissue or 5.56% of liver tissue weight). In addition, researchers looked for the presence or absence of CHD, type 2 diabetes, reflux disease, gout, gallbladder disease, asthma, joint pain, obstructive sleep apnea and anxiety and/or depression.
Researchers determined the time of obesity onset through conversations with patients, defining childhood onset as the development of obesity at age 0 to 11 years, adolescent onset as between age 12 and 20 years and adult onset as the development of obesity after age 20 years. Of the men, 35.55% reported obesity onset in childhood, 18.59% in adolescence and 45.87% in adulthood. For women, 33.68% developed obesity in childhood, 26.45% in adolescence and 39.87% in adulthood.
Researchers found that 99.69% of men and 99.18% of women had at least one obesity-related comorbidity, with 97.41% of men and 94.03% of women having two or more (P < .001).
For men, NAFLD was the most common comorbidity, followed by dyslipidemia and hypertension.
For women, dyslipidemia was the most prevalent comorbidity, followed by NAFLD and joint pain.
More men had hypertension, type 2 diabetes, CHD, obstructive sleep apnea and gout than women. Women were more likely to have asthma, gallbladder disease and anxiety and/or depression.
After adjusting for age and BMI, researchers found that men who had childhood obesity onset had higher odds of CHD (OR = 1.82; 95% CI, 1.15-2.89) and lower odds of obstructive sleep apnea (OR = 0.69; 95% CI, 0.53-0.91).
Women who reported developing obesity in childhood had higher odds of type 2 diabetes (OR = 1.25; 95% CI, 1.01-1.54) and obstructive sleep apnea (OR = 1.49; 95% CI, 1.16-1.91) compared with women who developed obesity in adulthood.
“If the results are confirmed, clinicians may use information on obesity debut to identify patients with severe obesity who should be screened for undiagnosed coronary heart disease, [obstructive sleep apnea] and type 2 diabetes,” the researchers wrote. – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.