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Table 1 Cardiometabolic risk factors among children with severe compared to mild obesity in cross-sectional studies

From: Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity

Article Age range   Cardiometabolic risk factors
    Total Cholesterol LDL HDL Triglycerides Systolic BP Diastolic BP Fasting Glucose HbA1c
Cho et al. [46]
(n = 1 328) 		10–18 Mean values Mild: 163.9 (160.9–166.8)
Class 2: 171.6 (167.5–175.6) 		Mild: 93.6 (90.9–96.4)
Class 2: 100.7 (97.1–104.3) 		Mild: 48.6 (47.6–49.6)
Class 2: 46.0 (44.6–47.4) 		Mild: 94.3 (88.5–100.4)
Class 2: 109.0 (102.3–116.0) 		NS NS NS NS
Zhang et al. [26]
(n = 44 630) 		7–18 Prevalence of abnormal values      Boys: mild: 39.93% Class 3: 50.54%
Girls: Mild: 39.53% Class 3: 53.66% 		  
Skinner et al. [28]
(n = 8 579) 		3–19 Mean values* Mild: 167.2 (165.3–169.1)
Class 2: 166.0 (163.0–169.0)
Class 3: 169.6 (163.4–175.9) 		NS Mild: 46.7 (46.1–47.3)
Class 2: 43.5 (42.6–44.5)
Class 3: 41.3 (40.2–42.4) 		Mild: 113.2 (103.5–123.0)
Class 2: 113.3 (103.3–123.3)
Class 3: 143.2 (113.6–172.8) 		Mild: 111.0 (110.4–111.7)
Class 2: 112.6 (111.6–113.7)
Class 3: 116.2 (114.6–117.8) 		Mild: 58.8 (57.8–59.9)
Class 2: 58.7 (57.4–60.1)
Class 3: 64.5 (62.7–66.4) 		Mild:95.1 (93.8–96.3)
Class 2: 96.7 (94.6–98.7)
Class 3: 96.5 (94.0–98.9) 		Mild: 5.20 (5.17–5.24)
Class 2: 5.30 (5.25–5.35)
Class 3:
5.37 (5.29–5.44)
Prevalence of abnormal values* Mild: 14.27 (12.46–16.07)
Class 2: 16.19 (12.35–20.03)
Class 3: 18.59 (12.86–24.32) 		NS Mild: 11.40 (9.84–12.97)
Class 2: 18.18 (14.35–22.00)
Class 3: 19.53 (13.94–25.12) 		Mild: 20.35 (16.48–24.22)
Class 2: 18.81 (12.76–24.86)
Class 3: 28.82 (18.22–39.42) 		Mild: 5.02 (3.87–6.17)
Class 2: 8.52 (5.76–11.27)
Class 3: 11.10 (6.10–16.09) 		Mild: 1.20 (0.47–1.94)
Class 2: 0.60 (0.16–1.37)
Class 3: 4.66 (1.92–7.39) 		Mild: 19.42 (14.32–24.52)
Class 2: 31.77 (23.90–39.65)
Class 3: 24.27 (14.54–34.00) 		Mild: 3.40 (2.26–4.53)
Class 2: 6.38 (4.02–8.73)
Class 3: 13.19 (8.07–18.30)
RR NS NS Class 2: 1.65 (1.31–2.01)
Class 3: 1.89 (1.35–2.66) 		Class 2: NS
Class 3: 1.63 (1.08–2.47) 		Class 2: NS
Class 3: 2.24 (1.42–3.54) 		Class 2: NS
Class 3: 4.57 (1.88–11.06) 		Class 2: 1.67 (1.26–2.22)
Class 3:
1.24 (0.78–1.96) 		Class 2: NS
Class 3: 2.59 (1.55–4.34)
Propst et al. [38]
(n = 1 111) 		12.7 ± 3.4 Mean Values NS NS Mild: 44.9 ± 14.0
Severe: 43.1 ± 11.9 		  NS NS  
Prevalence of abnormal values    NS   NS   
Shah et al. [47]
(n = 447) 		10–24 Mean Values NS NS NS NS Mild: 117 ± 11
severe: 121 ± 12 		NS NS NS
Marcus et al. [48]
(n = 1 305) 		~11 (6th grade) Mean Values NS NS Mild: 47.1 ± 9.9
severe:
43.8 ± 9.3 		Mild: 108.8 ± 59.3
severe:
125.9 ± 70.9 		Mild: 110.2 ± 9.7
severe:
112.0 ± 11.1 		Mild: 66.0 ± 7.8
severe:
70.4 ± 8.6 		NS
Prevalence of abnormal values NS NS Mild: 27.2%
Severe:
38.9% 		Mild: 26.6%
Severe:
34.3% 		Mild: 23.8%
Severe:
37.4% 		NS  
Rank et al. [49]
(n = 43) 		6–19 Mean Values NS Boys: Mild:
98.8 ± 32.7
Severe: 110.0 ± 36.5 		Girls:
NS 		Boys:
Mild: 55.1 ± 12.9
Severe: 44.2 ± 10.4 		Girls:
Mild: 53.1 ± 13.3
Severe:
47.0 ± 10.5 		Boys:
Mild: 53.7 ± 27.4
Severe:
71.9 ± 31.3 		Girls:
Mild: 59.8 ± 20.9
Severe:
77.0 ± 29.7 		Boys:
Mild: 124 ± 11
severe: 135 ± 14 		Girls:
Mild: 122 ± 8
Severe:
128 ± 10 		Boys:
Mild: 78 ± 7
Severe: 84 ± 9 		Girls:
Mild: 77 ± 6
Severe: 82 ± 7 		NS
Prevalence of abnormal values    Mild: 16%
Severe: 32% 		NS Mild: 26%
Severe: 58% 		NS  
Calcaterra et al. [45]
(n = 191) 		11.15 ± 3.4 OR** Metabolic syndrome**: 3.3 (1.6–7.0)
Boyd et al. [27]
(n = 497) 		2–18 Prevalence of abnormal values Boys:
Mild: 32.1
Severe: 15.4 		Girls:
NS 		Boys:
Mild: 25.9
Severe: 12.2 		Girls:
NS 		Boys:
Mild: 29.3
Severe: 40.3 		Girls:
NS 		Boys:
NS 		Girls:
Mild: 24.1
Severe: 11.1 		    
  1. LDL: low-density lipoprotein cholesterol; HDL: high-density lipoprotein cholesterol; BP: blood pressure; HbA1c: hemoglobin A1c; NS: not statistically significant; RR: relative risk; OR: odds ratio
  2. Total cholesterol, LDL, HDL, triglycerides and fasting glucose are given in mg/dl values. Systolic and diastolic blood pressure are given in mmHg values. HbA1c is given in % units. Presented are mean values, prevalences and risk ratios for different cardiometabolic risk factors. Shown are only articles that statistically compared cardiometabolic risk factors in severe obesity with those in mild obesity. The definition of severe obesity varied between the studies. Class 2 obesity and class 3 obesity are used to further stratify obesity severity. Different methods and cut-off points were used to define abnormal values of cardiometabolic risk factors. These are detailed in Additional file 1: Table S2. For articles that did not report the age range, the mean age ± standard deviation is presented. Plus-minus values are means ± standard deviations. Numbers in parenthesis represent 95% confidence intervals
  3. * P-values were calculated for trends across weight categories. ** Metabolic syndrome was determined as three and above of the following: (1) BMI > 97th percentile, (2) Triglycerides>95th percentile, (3) HDL<5th percentile, (4) Systolic BP OR Diastolic BP> 95th percentile, (5) Impaired glucose tolerance
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