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Inge TH, King WC, Jenkins TM, Courcoulas AP, Mitsnefes M, Flum DR, Wolfe BM, Pomp A, Dakin GF, Khandelwal S, Zeller MH, Horlick M, Pender JR, Chen JY, Daniels SR. The effect of obesity in adolescence on adult health status. Pediatrics 2013; 132:1098-104. [PMID: 24249816 PMCID: PMC3838536 DOI: 10.1542/peds.2013-2185] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To test the hypothesis that adolescent obesity would be associated with greater risks of adverse health in severely obese adults. METHODS Before weight loss surgery, adult participants in the Longitudinal Assessment of Bariatric Surgery-2 underwent detailed anthropometric and comorbidity assessment. Weight status at age 18 was retrospectively determined. Participants who were ≥80% certain of recalled height and weight at age 18 (1502 of 2308) were included. Log binomial regression was used to evaluate whether weight status at age 18 was independently associated with risk of comorbid conditions at time of surgery controlling for potential confounders. RESULTS Median age and adult body mass index (BMI) were 47 years and 46, respectively. At age 18, 42% of subjects were healthy weight, 29% overweight, 16% class 1 obese, and 13% class ≥2 obese. Compared with healthy weight at age 18, class ≥2 obesity at age 18 independently increased the risk of lower-extremity venous edema with skin manifestations by 435% (P < .0001), severe walking limitation by 321% (P < .0001), abnormal kidney function by 302% (P < .0001), polycystic ovary syndrome by 74% (P = .03), asthma by 48% (P = .01), diabetes by 42% (P < .01), obstructive sleep apnea by 25% (P < .01), and hypertension (by varying degrees based on age and gender). Conversely, the associated risk of hyperlipidemia was reduced by 61% (P < .01). CONCLUSIONS Severe obesity at age 18 was independently associated with increased risk of several comorbid conditions in adults undergoing bariatric surgery.
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Affiliation(s)
- Thomas H. Inge
- Department of Pediatrics and Pediatric Surgery, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Wendy C. King
- Department of Epidemiology, School of Public Health and
| | - Todd M. Jenkins
- Department of Pediatrics and Pediatric Surgery, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Anita P. Courcoulas
- Department of Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark Mitsnefes
- Department of Pediatrics and Pediatric Surgery, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - David R. Flum
- Department of Surgery, University of Washington, Seattle, Washington
| | - Bruce M. Wolfe
- Department of Surgery, Oregon Health and Science University, Portland, Oregon
| | - Alfons Pomp
- Department of Surgery, Weill Cornell Medical College, New York, New York
| | - Greg F. Dakin
- Department of Surgery, Weill Cornell Medical College, New York, New York
| | | | - Meg H. Zeller
- Department of Pediatrics and Pediatric Surgery, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
| | - Mary Horlick
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - John R. Pender
- Department of Surgery, East Carolina University, Greenville, North Carolina; and
| | - Jia-Yuh Chen
- Department of Epidemiology, School of Public Health and
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