The Influence of Familial Predisposition to Cardiovascular Complications upon Childhood Obesity Treatment

<div><p>Introduction</p><p>The aim was to investigate whether a familial predisposition to obesity related cardiovascular complications was associated with the degree of obesity at baseline and/or changes in the degree of obesity during a multidisciplinary childhood obesity treatment program.</p><p>Methods</p><p>The study included 1421 obese children (634 boys) with a median age of 11.5 years (range 3.1–17.9 years), enrolled in treatment for 0.04 to 5.90 years (median 1.3 years) at the Children's Obesity Clinic, Denmark. At baseline, weight and height were measured, body mass index (BMI) standard deviation score (SDS) calculated, and self-reported information on familial predisposition to obesity, hypertension, type 2 diabetes mellitus (T2DM), thromboembolic events, and dyslipidaemia were obtained. A familial predisposition included events in biological parents, siblings, grandparents, uncles, and aunts. The treatment outcomes were categorically analysed according to the prevalence of familial predispositions.</p><p>Results</p><p>The median BMI SDS at enrolment was 3.2 in boys and 2.8 in girls. One-thousand-and-forty-one children had obesity in their family, 773 had hypertension, 551 had T2DM, 568 had thromboembolic events, and 583 had dyslipidaemia. Altogether, 733 had three or more predispositions. At baseline, familial T2DM was associated with a higher mean BMI SDS (<i>p</i> = 0.03), but no associations were found between the other predispositions and the children's degree of obesity. During treatment, girls with familial obesity lost more weight, compared to girls without familial obesity (<i>p</i> = 0.04). No other familial predispositions were associated with changes in BMI SDS during treatment.</p><p>Conclusion</p><p>Obese children with a familial predisposition to T2DM showed a significantly higher degree of obesity at baseline and girls with familial obesity responded better to treatment. Besides these findings, no other associations were found between the occurrence of familial predispositions and the degree of obesity or changes herein during multidisciplinary childhood obesity treatment.</p></div

Baseline characteristics and median follow-up time.

<p>¹BMI SDS, body mass index standard deviation score.</p><p>Baseline characteristics and median follow-up time.</p

Treatment outcome after one year of treatment in obese children and adolescents.

<p>Treatment outcome after one year of treatment in obese children and adolescents.</p

The prevalence of familial predispositions in obese children and adolescents and the association between familial predispositions and the degree of obesity at baseline.

<p>¹Difference in mean BMI SDS level between disposed and non-disposed adjusted for gender</p><p>*Significant association, <i>p</i><0.05</p><p>The prevalence of familial predispositions in obese children and adolescents and the association between familial predispositions and the degree of obesity at baseline.</p

The influence of familial predispositions and the response to treatment per year in obese children and adolescents.

<p>¹ΔBMI SDS. Difference in change in BMI SDS per year, negative values correspond to faster weight loss in the disposed group</p><p>*Significant association, <i>p</i><0.05.</p><p>The influence of familial predispositions and the response to treatment per year in obese children and adolescents.</p