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.
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
  1. Skelton JA, Cook SR, Auinger P, Klein JD, Barlow SE. Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr 2009; 9:322-9.
    Pubmed KoreaMed CrossRef
  2. Skinner AC, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatr 2014; 168:561-6.
    Pubmed CrossRef
  3. Ministry of education. Announcement of sample examination of student health examination for 2016 [Internet]. Sejong: Ministry of eduation; 2017 [cited 2017 Feb 22].
  4. Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med 2015; 373:1307-17.
    Pubmed CrossRef
  5. Kapiotis S, Holzer G, Schaller G, Haumer M, Widhalm H, Weghuber D, et al. A proinflammatory state is detectable in obese children and is accompanied by functional and morphological vascular changes. Arterioscler Thromb Vasc Biol 2006; 26: 2541-6.
    Pubmed CrossRef
  6. Kelly AS, Hebbel RP, Solovey AN, Schwarzenberg SJ, Metzig AM, Moran A, et al. Circulating activated endothelial cells in pediatric obesity. J Pediatr 2010; 157: 547-51.
    Pubmed KoreaMed CrossRef
  7. Zeller MH, Roehrig HR, Modi AC, Daniels SR, Inge TH. Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Pediatrics 2006; 117: 1155-61.
    Pubmed CrossRef
  8. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents:the Bogalusa Heart Study. J Pediatr 2007; 150: 12-17.e2.
    Pubmed CrossRef
  9. Makkes S, Renders CM, Bosmans JE, van der Baan-Slootweg OH, Seidell JC. Cardiometabolic risk factors and quality of life in severely obese children and adolescents in the Netherlands. BMC Pediatr 2013; 13: 62.
    Pubmed KoreaMed CrossRef
  10. Hur YI, Park H, Kang JH, Lee HA, Song HJ, Lee HJ, et al. Associations between sugar intake from different food sources and adiposity or cardiometabolic risk in childhood and adolescence: the Korean Child-Adolescent Cohort Study. Nutrients 2015; 8. pii: E20.
    Pubmed KoreaMed CrossRef
  11. Korea Center for Disease Control and Prevention, The Korean Pediatric Society. Korean Children and Adolescents Growth Standard 2007. Seoul:Korean CDC; 2007. [Internet]. Seoul: Korea Centers for Disease Control and Prevention; 2007.
  12. Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 2013; 128: 1689-712.
    Pubmed CrossRef
  13. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 2007; 8: 299-306.
    Pubmed CrossRef
  14. Choi HM. Perinatal outcomes associated with prepregnancy body mass index and weight gain during pregnancy. Korean J Obstet Gynecol 2010; 53:981-7.
  15. Oken E, Gillman MW. Fetal origins of obesity. Obes Res 2003; 11: 496-506.
    Pubmed CrossRef
  16. McMillen IC, Rattanatray L, Duffield JA, Morrison JL, MacLaughlin SM, Gentili S, et al. The early origins of later obesity: pathways and mechanisms. Adv Exp Med Biol 2009; 646: 71-81.
    Pubmed CrossRef
  17. Raj M, Kumar RK. Obesity in children & adolescents. Indian J Med Res 2010; 132: 598-607.
    Pubmed KoreaMed
  18. Ford MC, Gordon NP, Howell A, Green CE, Greenspan LC, Chandra M, et al. Obesity severity, dietary behaviors, and lifestyle risks vary by race/ethnicity and age in a northern California cohort of children with obesity. J Obes 2016; 2016: 4287976.
    Pubmed KoreaMed CrossRef
  19. Committee on Nutrition, Korean Pediatric Society. Obesity in children and adolescent. Seoul: Kwangmun Publishing Co; 2006. p. 3-75.
  20. Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120 Suppl 4:S164-92.
    Pubmed CrossRef
  21. Hassink SG, Pediatric Expert Panel. Weighing risk: the expert committee’s recommendations in practice. Semin Pediatr Surg 2009; 18: 159-67.
    Pubmed CrossRef
  22. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997; 337: 869-73.
    Pubmed CrossRef
  23. Grotto I, Huerta M, Kark JD, Shpilberg O, Meyerovitch J. Relation of parental history of coronary heart disease to obesity in young adults. Int J Obes Relat Metab Disord 2003; 27: 362-8.
    Pubmed CrossRef
  24. Albañil Ballesteros MR, Rogero Blanco ME, Olivas Domínguez A, Sánchez Martín M, Rabanal Basalo A, Sanz Bayona MT. [Obesity and cardiovascular risk factors in adolescents. Association with cardiovascular risk factors in first degree relatives]. Med Clin (Barc) 2012; 138: 283-8. Spanish.
    Pubmed CrossRef

This Article

Author ORCID Information

Social Network Service