RESUMO
OBJECTIVE: To investigate whether obesity and cardiovascular risk factors are associated with psoriasis in children and adolescents. STUDY DESIGN: For this population-based, cross-sectional study, measured weight and height, laboratory data, and psoriasis diagnoses were extracted from electronic medical records of 710,949 patients age 2 to 19 years enrolled in an integrated health plan. Weight class was assigned on the basis of body mass index-for-age. RESULTS: The OR for psoriasis was 0.68, 1.00, 1.31, 1.39, and 1.78 (95% CI, 1.49 to 2.14) for underweight, normal-weight, overweight, moderately obese, and extremely obese children, respectively (P for trend < .001). The OR for psoriasis treated with systemic therapy or phototherapy as an indicator of severe or widespread psoriasis was 0.00, 1.00, 2.78, 2.93, and 4.19 (95% CI, 1.81 to 9.68) for underweight, normal-weight, overweight, moderately obese, and extremely obese children, respectively (P for trend < .003). In adolescents, mean total cholesterol, low-density lipoprotein cholesterol, triglycerides, and alanine aminotransferase were significantly higher in children with psoriasis compared with children without psoriasis after adjustment for body mass index. CONCLUSION: Overweight and obesity are associated with higher odds of psoriasis in youths. Independent of body weight, adolescent patients with psoriasis have higher blood lipids. These data suggest that pediatricians and dermatologists should screen youths with psoriasis for cardiovascular disease risk factors.
Assuntos
Lipídeos/sangue , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Psoríase/epidemiologia , Adolescente , Alanina Transaminase/sangue , Índice de Massa Corporal , California/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Fototerapia/estatística & dados numéricos , Psoríase/terapia , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVE: To estimate the prevalence of extreme obesity in a large, multiethnic contemporary cohort of children and adolescents. STUDY DESIGN: In a cross-sectional study, measured weight and height were extracted from electronic medical records of 710,949 patients aged 2 to 19 years (87.8% of eligible patients) who were enrolled in an integrated prepaid health plan in 2007 and 2008. Prevalence of extreme obesity was defined as body mass index (BMI)-for-age>or=1.2 times 95th percentile or BMI>or=35 kg/m2. RESULTS: Extreme obesity was observed in 7.3% of boys and 5.5% of girls. The prevalence peaked at 10 years of age in boys and at 12 years of age with a bimodal distribution in girls (second peak at 18 years; P value for sex x age interaction=.036). The prevalence of extreme obesity varied in ethnic/racial and age groups, with the highest prevalence in Hispanic boys (as high as 11.2%) and African-American girls (as high as 11.9%). CONCLUSION: Extreme obesity in Southern California youth is frequently observed at relatively young ages. The shift toward extreme body weights is likely to cause an enormous burden of adverse health outcomes once these children and adolescents grow older.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Índice de Massa Corporal , Hispânico ou Latino/estatística & dados numéricos , Obesidade/diagnóstico , Obesidade/etnologia , Adolescente , Fatores Etários , Estatura , Peso Corporal , California/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVES: To compare measles, mumps, and rubella antibody levels in Somali immigrant, Hispanic migrant, and US children in Rochester, Minn, and to determine whether parental vaccination reports predict seropositivity. SUBJECTS AND METHODS: From 1995 to 1997, we conducted a cross-sectional analysis using measles, mumps, and rubella antibody levels obtained from a sample of Somali, Hispanic, and Rochester children. Volunteers provided blood samples, vaccination histories, and demographic information. We assessed differences in measles, mumps, and rubella antibody levels among the 3 groups of children and calculated positive and negative predictive values to determine whether parental report of vaccination predicted seropositivity. RESULTS: Study participants included 79 Hispanic migrant, 69 Somali immigrant, and 730 Rochester children. Somali children reported vaccination at significantly older ages compared with Hispanic or Rochester children (P<.001). Most children were seropositive for all 3 antibodies. Parental reports of vaccination had high positive predictive values (71%-100%) but low negative predictive values (0%-50%). CONCLUSION: Somali and Hispanic children were as likely as Rochester children to be seropositive for measles, mumps, and rubella antibodies despite poor documentation of vaccination. Somali children, however, tended to receive vaccinations at significantly older ages than Hispanic and Rochester children.