Referring pediatric patients to a multidisciplinary pediatric obesity center resulted in decreased BMI z scores and improved markers of comorbidities, according to data presented at the 2012 Pediatric Academic Societies Annual Meeting.
Ximena Lopez, MD, assistant professor of pediatrics in the division of pediatric endocrinology at the University of Texas Southwestern and Children’s Medical Center, and colleagues designed a retrospective chart review of 1,250 patients aged 5 to 18 years who were seen October 2008 to January 2011 to analyze the outcomes of the Center for Obesity and its Consequence in Health (COACH) program on BMI and obesity-related comorbidities.
“Multidisciplinary obesity clinics are emerging throughout the country as a measure to fight the pediatric epidemic of obesity, but there is no long-term data on the outcomes of these types of programs,” Lopez told Endocrine Today.
The evaluation and treatment in such a clinic was examined up to a 15-month follow-up period, Lopez said. According to data, BMI z scores displayed modest improvement, as well as in HbA1c, liver enzymes, 25-hydroxyvitamin D levels and diastolic blood pressure, Lopez said. Younger patients had improved BMI outcome. However, a high attrition rate (50%) was an important barrier.
Average scores were: BMI, 31.9; BMI z score, 2.4; HbA1c, 5.6% and homeostasis model assessment–insulin resistance (HOMA-IR), 7.4. Researchers reported a 5% prevalence of type 2 diabetes. Of 816 patients with a baseline oral glucose tolerance test, 25% were considered “at risk” for diabetes and 2.4% had diabetes, the researchers wrote.
In addition, the average BMI z score decreased at each visit, and about 65% of patients displayed a decrease at all time points, the researchers wrote. Patients identified as at risk for diabetes experienced a decrease in HbA1c from 5.72% to 5.5% (P≤.0007) at 15 months.
Diastolic BP decreased from 65.2 mm Hg to 63.9 mm Hg (P<.003) at the 5-month follow-up. However, systolic BP, triglycerides, LDL and HDL concentrations did not change, the researchers said.
“More studies are needed to evaluate the clinical significance of these findings, particularly the long-term outcome on diabetes and cardiovascular risk. Further changes are needed to improve the outcomes of these clinics, with particular attention to the high attrition rate,” Lopez said.
Disclosure: Dr. Lopez reports no relevant financial disclosures.