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Childhood obesity subtypes

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#Multispeciality  #Pediatrics 

Dr Swati Y Bhave, Adjunct Professor in Adolescent Medicine; Dr D Y Patil Medical College, & Dr D Y Patil Vidyapeeth, Pune; Sr. consultant, Adolescent Pediatrics & Head-In-charge of Adolescent Wellness Clinic, Jehangir Hospital Pune    06 August 2022

The various comorbid conditions associated with childhood obesity can be categorized into eight clinical phenotypes, according to a study published in PLos Digital Health.1

A retrospective cohort study was conducted to identify the common conditions associated with childhood obesity and whether the known comorbidities that are associated with obesity in children were similar enough to be grouped together so as to define potential subtypes. The electronic health record (EHR) data of 49,694 children who were diagnosed with obesity, were analysed using a Latent Class Analysis (LCA) model to identify subtypes.

The authors note that under LCA, participants could likely be categorized into more than one group. But the study results showed that the membership probability for a single class among the subjects was very high amounting to >70%. Eight clusters of disease conditions that were highly common (≥ 10% prevalence) among the obese children in each subtype were therefore defined “suggesting shared clinical characterization within the individual groups”.

Class 1 patients had more of upper respiratory and sleep disorders, including sleep apnea and chronic pharyngitis and tonsillitis, while Class 2 patients had a high prevalence of inflammatory skin conditions such as dermatitis and eczema. Class 3 patients had seizures and other neurological disorders; asthma was predominant in Class 4.

In Class 6, gastrointestinal and genitourinary symptoms were more widespread, whereas in Class 7, neurodevelopmental disorders such as autism were prevalent. Symptoms such as headaches, fever, and nausea/vomiting occurred more frequently among children in Class 8. However, no distinct pattern could be identified among the children categorized as Class 5.

This study has characterized eight clinical phenotypes of childhood obesity based on comorbidities associated with childhood obesity. This distinction may help to individualize care for obese children as per the comorbid conditions and improve outcomes. As the authors also write, “Grouping all types of overweight and obesity into one clinical condition may conceal associations between risk factors and specific subtypes of obesity, which has implications for improving prevention, recognition, and treatment of pediatric obesity”.

Reference

  1. Campbell EA, et al. Characterizing clinical pediatric obesity subtypes using electronic health record data. PLOS Digit Health.2022 Aug 4;1(8):e0000073. https://doi.org/10.1371/journal.pdig.0000073.

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