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. 2016 Jan;37(1):192-200.
doi: 10.1007/s00246-015-1265-7. Epub 2015 Sep 16.

High Overweight and Obesity in Fontan Patients: A 20-Year History

Stephanie T Chung  1   2 , Borah Hong  3   4 , Lance Patterson  3 , Christopher J Petit  3   5 , J Nina Ham  6   5
Affiliations

High Overweight and Obesity in Fontan Patients: A 20-Year History

Stephanie T Chung et al. Pediatr Cardiol. 2016 Jan.

Abstract

The prevalence of obesity in long-term survivors with complex congenital heart disease may be increasing, and little is known about the timing and onset of weight gain and growth patterns in these high-risk patients. Prevalence rates of overweight/obesity and longitudinal changes in body mass index (BMI) with age were determined in 606 patients with Fontan circulation seen at a tertiary care cardiology center from 1992 to 2012. The number of clinic encounters (n) was stratified by age group (n = 401, 2-5 years; n = 333, 6-11 years; n = 217, 12-19 years; and n = 129, >20 years). Among adults, 39% were overweight/obese at last clinic visit; 22% overweight, and 17% obese. Childhood anthropometric data were available for 82 adults, of which 15% (n = 12/82) were overweight/obese in childhood. The likelihood of being overweight/obese as an adult was three times higher if there was a BMI ≥ 85th percentile in childhood (CI 2.1-4.5, P < 0.01). Overweight/obesity in adulthood was associated with lower heart failure rates (4 vs. 19%, P = 0.03). Pediatric rates of overweight/obesity were comparable to national data (NHANES 2011-2012) in every age group: at 2-5 years, (25 vs. 23%), 6-11 years (26 vs. 34%), and 12-19 years (15 vs. 35%). Systolic blood pressure was higher in overweight/obese children as young as 2-5 years of age. Childhood and adult survivors with Fontan circulation have high rates of overweight/obesity. Childhood obesity is a strong predictor of future adiposity and is linked to changes in systolic blood pressure at a very young age.

Keywords: Congenital; Fontan procedure; Growth; Heart defect; Obesity; Pediatrics.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Figure 1:
Figure 1:
Study population of Fontan clinic patients seen between 1992 – 2012.
Figure 2:
Figure 2:
Prevalence of Overweight and Obesity in the Fontan Cohort between 1992–2012.
Figure 3:
Figure 3:
Systolic blood pressure by age and weight status in children with Fontan circulation. Box and whisker plots for age groups A: 2–5 years, B: 6–11 years, C: 12–19 years. *P ≤ 0.001; **P= 0.02 vs. underweight for all comparisons.
Figure 4:
Figure 4:
Longitudinal BMI trajectory throughout childhood in overweight/obese adolescents with Fontan circulation (n=14).
See this image and copyright information in PMC

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