Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study


Autoři: Louise Lindberg aff001;  Pernilla Danielsson aff001;  Martina Persson aff002;  Claude Marcus aff001;  Emilia Hagman aff001
Působiště autorů: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden aff001;  Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden aff002;  Department of Diabetes and Endocrinology, Sachsska Children’s Hospital, Södersjukhuset, Stockholm, Sweden aff003;  Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden aff004
Vyšlo v časopise: Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Med 17(3): e32767. doi:10.1371/journal.pmed.1003078
Kategorie: Research Article
doi: 10.1371/journal.pmed.1003078

Souhrn

Background

Pediatric obesity is associated with increased risk of premature death from middle age onward, but whether the risk is already increased in young adulthood is unclear. The aim was to investigate whether individuals who had obesity in childhood have an increased mortality risk in young adulthood, compared with a population-based comparison group.

Methods and findings

In this prospective cohort study, we linked nationwide registers and collected data on 41,359 individuals. Individuals enrolled at age 3–17.9 years in the Swedish Childhood Obesity Treatment Register (BORIS) and living in Sweden on their 18th birthday (start of follow-up) were included. A comparison group was matched by year of birth, sex, and area of residence. We analyzed all-cause mortality and cause-specific mortality using Cox proportional hazards models, adjusted according to group, sex, Nordic origin, and parental socioeconomic status (SES). Over 190,752 person-years of follow-up (median follow-up time 3.6 years), 104 deaths were recorded. Median (IQR) age at death was 22.0 (20.0–24.5) years. In the childhood obesity cohort, 0.55% (n = 39) died during the follow-up period, compared to 0.19% (n = 65) in the comparison group (p < 0.001). More than a quarter of the deaths among individuals in the childhood obesity cohort had obesity recorded as a primary or contributing cause of death. Male sex and low parental SES were associated with premature all-cause mortality. Suicide and self-harm with undetermined intent were the main cause of death in both groups. The largest difference between the groups lay within endogenous causes of death, where children who had undergone obesity treatment had an adjusted mortality rate ratio of 4.04 (95% CI 2.00–8.17, p < 0.001) compared with the comparison group. The main study limitation was the lack of anthropometric data in the comparison group.

Conclusions

Our study shows that the risk of mortality in early adulthood may be higher for individuals who had obesity in childhood compared to a population-based comparison group.

Klíčová slova:

Body mass index – Death rates – Child health – Childhood obesity – Obesity – Self harm – Socioeconomic aspects of health – Suicide


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