Institute of Epidemiology and Medical Biometry, University Ulm, Ulm, Germany.
Obes Facts. 2013;6(4):360-8. doi: 10.1159/000353397. Epub 2013 Aug 17.
The aim of the study was to analyze the adherence to current guidelines for co-morbidity screening in overweight and obese pediatric patients participating in the Adipositas-Patienten-Verlaufsdokumentation (APV) initiative in three German-speaking countries.
APV database: 181 centers from Germany, Austria and Switzerland, specialized in obesity care, contributed standardized, anonymous data of medical examinations from 65,397 patients performed between 2000 and 2010. Completeness of screening for hypertension, dyslipidemia, and impaired glucose metabolism was analyzed using adjusted means.
Mean age of the cohort was 12.5 ± 2.9 years and 46.5% were male. 17.3% were overweight (>90th-97th percentile), 45.1% obese (>97th-99.5th percentile), and 37.7% extremely obese (>99.5th percentile). In 2000, blood pressure was documented for 55.1% of patients, increasing to 88.7% in 2010. The rate of lipid diagnostics also improved from 45.0 to 67.7%, and screening for diabetes rose from 32.7 to 62.3% in the same time period. Blood pressure measurements were performed more often during inpatient care (88.5%) compared to outpatient programs (77.5%). Screening was more complete with increasing age and increasing degree of obesity. In boys screening rate was higher than in girls.
During the 11-year period, screening for co-morbidity improved significantly in overweight or obese children and adolescents. However, adherence to guidelines is still insufficient in some institutions. Quality control based on benchmarking may improve obesity care and outcome.
本研究旨在分析三个德语国家参与肥胖患者纵向记录（APV）计划的超重和肥胖儿科患者对合并症筛查的现行指南的遵循情况。
APV 数据库：2000 年至 2010 年间，来自德国、奥地利和瑞士的 181 个专门从事肥胖症治疗的中心提供了标准化、匿名的 65397 名患者的体检数据。采用调整均值分析高血压、血脂异常和葡萄糖代谢受损筛查的完整性。
队列的平均年龄为 12.5 ± 2.9 岁，46.5%为男性。17.3%为超重（>90 至 97 百分位），45.1%为肥胖（>97 至 99.5 百分位），37.7%为极度肥胖（>99.5 百分位）。2000 年，55.1%的患者记录了血压，2010 年上升至 88.7%。血脂诊断率也从 45.0%提高到 67.7%，同时，糖尿病筛查率从 32.7%提高到 62.3%。住院治疗时（88.5%）血压测量的次数比门诊治疗时（77.5%）更多。随着年龄的增长和肥胖程度的增加，筛查更为完善。在男孩中，筛查率高于女孩。
在 11 年期间，超重或肥胖儿童和青少年的合并症筛查显著改善。然而，一些机构对指南的依从性仍然不足。基于基准的质量控制可能会改善肥胖症的治疗效果和结果。
