Does obesity lead to a specific lipid disorder? Analysis from the German/Austrian/Swiss APV registry

Abstract

Overweight and obese youth represent a challenge for the affected individual, the healthcare system as well as society as a whole. Increased long-term cardiovascular risk is one of the major consequences of early-onset obesity, affecting both life expectancy and quality of life. The aim of this report is to study the effects of age, gender and obesity category on the presence of individual components of dyslipidemia using normal-weight subjects from the population-based German KIGGS study including 17,641 randomly selected children and adolescents, aged 0-18 years (11,110 normal-weight subjects with lipid measurements) and the German-Austrian-Swiss APV registry, including 57,239 overweight or obese children, adolescents and young adults from 162 specialized obesity care centers (lipid measurements available in 29,711 subjects). Subjects were classified according to BMI category based on the age- and gender-adjusted BMI-z-scores as recommended by the AGA (German Pediatric Obesity working group). Cut-offs for dyslipidemia were based on the recommendations by the American Heart Association: total cholesterol: > 5.2 mmol/l, HDL-cholesterol < 0.9 mmol/l, LDL-cholesterol > 3.4 mmol/l, triglycerides > 1.7 mmol/l. Using SAS 9.2-software, hierarchic modeling with both linear and logistic regression analysis was applied. Within the group of normal-weight children, fasting triglycerides were elevated in 3.3%, LDL-cholesterol in 7.2% and HDL-cholesterol was reduced in 3.1%. With increasing BMI-category, the prevalence of hypertriglyceridemia and reduced HDL-cholesterol increased rapidly. A weaker relationship was present for LDL-cholesterol and total cholesterol. Among obese youth, 30.5% displayed any dyslipidemia, underlining the importance of adequate screening and intervention.