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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Obesity and cardiometabolic disease risk factors among US adolescents with disabilities
Sarah E Messiah, Denise C Vidot, Gabriel Somarriba, Kanathy Haney, Semra Aytur, Ruby A Natale, Jeffrey P Brosco, Kristopher L Arheart
Sarah E Messiah, Gabriel Somarriba, Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33101, United States
Sarah E Messiah, Denise C Vidot, Kanathy Haney, Kristopher L Arheart, Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33101, United States
Semra Aytur, Department of Health Management and Policy, University of New Hampshire, Durham, NH 03824, United States
Ruby A Natale, Department of Pediatrics, Mailman Center for Childhood Development, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33101, United States
Jeffrey P Brosco, Mailman Center for Childhood Development, Department of Pediatrics, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33101, United States
Author contributions: All authors contributed to this work.
Supported by National Institutes of Health, No. K01 DA 026993.
Ethics approval: The National Center for Health Statistics Ethics Review Board approved the data collection procedures for this study (http://www.cdc.gov/nchs/nhanes/irba98.htm).
Informed consent: Health information collected in the National Health and Nutrition Examination Survey is kept in strictest confidence. During the informed consent process, survey participants are assured that data collected will be used only for stated purposes and will not be disclosed or released to others without the consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242 m).
Conflict-of-interest: There are no conflicts of interest to report for any study authors.
Data sharing: Technical appendix, statistical code, and dataset available from the corresponding author at smessiah@med.miami.edu. The presented data cannot be linked to individuals and risk of personal identification is minimal as such.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sarah E Messiah, PhD, MPH, Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami, Leonard M. Miller School of Medicine, Batchelor Children’s Research Institute Room 541, NW 10
th Avenue (D820), Miami, FL 33101, United States.
smessiah@med.miami.edu
Telephone: +1-305-2431943 Fax: +1-305-2438475
Received: September 20, 2014
Peer-review started: September 20, 2014
First decision: October 16, 2014
Revised: November 13, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: February 15, 2015
Processing time: 133 Days and 8.7 Hours
AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities.
METHODS: Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with (n = 256) and without disabilities (n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome (MetS, ≥ 3 risk factors present) were examined by the following standardized body mass index (BMI) categories for those with and without disabilities; overweight (BMI ≥ 85th - < 95th percentile for age and sex), obesity (BMI ≥ 95th percentile) and severe obesity (BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status.
RESULTS: Adolescents with disabilities were significantly more likely to be overweight (49.3%), obese (27.6%) and severely obese (12%) vs their peers without disabilities (33.1%, 17.5% and 3.6%, respectively, P≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as MetS (18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities (9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have MetS (OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities.
CONCLUSION: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.
Core tip: Our results here show that US adolescents with disabilities are disproportionately affected by obesity and are over three times as likely to have the metabolic syndrome vs their peers with no disabilities. Half of all adolescents with disabilities are overweight, obese or severely obese. In addition to the metabolic syndrome, obese adolescents with disabilities are significantly more likely than their normal weight counterparts to have increased or abnormal systolic blood pressure, lipid and fasting glucose levels, placing them at risk for cardiovascular disease and/or type 2 diabete. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.
