Korean J Fam Pract. 2018; 8(6): 834-840  https://doi.org/10.21215/kjfp.2018.8.6.834
Analysis of the Associated Factors and Clinical Characteristics of Severe Obesity in Korean Children and Adolescents
Yu-Jeong Choi1, Hyun-Suk Lee1, Won-Wook Jeong1, Young-Gyun Seo1, Hye-Mi Noh1, Hong-Ji Song1, Yu-Jin Paek1, Jae-Heon Kang2, Hye-Ja Lee3, Han Byul Jang3, Sang Ick Park3, Kyung Hee Park1,*
1Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang; 2Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul; 3Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Korea
Kyung Hee Park
Tel: +82-31-380-3805, Fax: +82-31-380-1782
E-mail: beloved920@gmail.com
ORCID: http://orcid.org/0000-0001-9806-0076
Received: August 22, 2017; Revised: September 7, 2017; Published online: December 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study aimed to investigate the associated factors and clinical characteristics of severe obesity in Korean children and adolescents.
Methods: This cross-sectional study examined data collected from the Korean Children and Adolescent Study of 2012?2013. A total of 602 overweight and obese children and adolescents (306 boys, 296 girls) aged 9?17 years were included. The participants were categorized into the obese or severely obese group according to sex- and age-specific body mass index (BMI) percentiles based on the 2007 Korean national growth chart. Obesity-related factors and cardiometabolic risk factors were compared between the groups.
Results: Among the 602 subjects, 80 (2.61%) were severely obese. Maternal pre-pregnancy BMI, parental obesity, screen time, and parental history of cardiovascular disease were higher in the severely obese group than in the obese group (P<0.05). The proportion of two or more cardiometabolic risk factors (31.99% vs. 73.75%, P<0.001) or three or more factors (10.92% vs. 30%, P<0.001) was significantly higher in the severely obese group. On multivariate analysis, higher maternal pre-pregnancy BMI (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.35?1.70), screen time (OR, 2.77; 95% CI, 1.47?5.24), and parental history of cardiovascular disease (OR, 4.49; 95% CI, 2.32?8.69) were associated with severe obesity.
Conclusion: Maternal pre-pregnancy BMI, longer screen time, and parental history of cardiovascular diseases require consideration as major components in the prevention and management of severe obesity in children and adolescents in Korea.
Keywords: Pediatric Obesity; Morbid Obesity; Adolescent; Clinical Characteristics; Cardiovascular Diseases; Screen Time
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