ESPE Abstracts (2018) 89 P-P1-133

Severe Obesity and Cardiometabolic Comorbidities in Adolescents: Chronology of an Epidemic

Orit Pinhas-Hamiela,b, Brian Reichmanb,c, Arnon Afekb,d, Estela Derazneb,e, Uri Hamielf, Ariel Furere, Liron Gershovitze, Jeremy D Karkg, Tarif Badere & Gilad Twigb,e,h


aPediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel; bSackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; cThe Women and Children’s Health Research Unit, Gertner Institute, Tel Hashomer, Ramat-Gan, Israel; dCentral Management Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel; eThe Israel Defense Forces Medical Corps, Ramat-Gan, Israel; fDepartment of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel; gHebrew University-Hadassah School of Public Health and Community Medicine, Ein Kerem, Jerusalem, Israel; hThe Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel


Aims: To assess trend in the prevalence of severe obesity in a national population-based sample of adolescents and to evaluate the association of severe obesity with major cardio-metabolic morbidities.

Methods: Prevalence and severity of obesity was determined among 373,226 Israeli adolescents with abnormal BMI (≥85th percentile for age and sex) examined in an obligatory health assessment at mean age 17.3±0.5 years between 1967 and 2015. Data on abnormal blood pressure measurements and type 2 diabetes (T2DM) were considered in a subgroup of 230,639 adolescents examined from 1997 through 2015. Participants were classified into overweight (≥85th to <95th percentile), class I obesity (≥95th percentile to <120% of the 95th percentile), class II obesity (≥120% to <140% of the 95th percentile), and class III obesity (≥140% of the 95th percentile).

Results: There were 2, 4, 16 and 67 fold increases in the prevalence of overweight and class I, II, and III obesity, respectively, between 1967 and 2015, with an accelerated increase in class II and III obesity during the last two decades. Compared to the overweight adolescents, the odds ratios (OR) for hypertension in the class I, II and III obesity groups respectively were 1.4, 2.1, and 2.9 in males, and 1.8, 2.6 and 3.4 in females. The OR for T2DM increased markedly in class I, II and III obesity compared to the overweight groups, from 5.6 to 38 fold in males and from 4.7 to 25 fold in females.

Conclusion: The increase in the prevalence of obesity is differential and was more pronounced for all classes of severe obesity. This steep increase in ORs for hypertension and particularly T2DM along the obesity classes suggests that the burden of cardio-metabolic morbidities is expected to increase.