̽»¨¾«Ñ¡

Background

Comorbidities such as insulin resistance and high blood pressure are early consequences of obesity that can manifest even in young children. However, the exact proportion of children and adolescents with obesity who experience morbidity related to obesity remains unclear.

Additionally, it is not well understood whether there are specific risk factors or success factors that influence the future psychosocial and physiological health of children with obesity. Many published studies are based on small sample sizes with limited representativeness. Fortunately, we have a quality register that allows us to answer several important questions using data from a large number of children.

, is a national quality register for children receiving treatment for overweight or obesity. This register provides a valuable resource for addressing these critical questions and improving our understanding of childhood obesity and its long-term impacts.

Methods

BORIS was initiated in 2005 and is the World’s second largest clinical register of children and adolescents undergoing obesity treatment. At clinical obesity treatment visits, anthropometrical and biochemical data are entered. In December 2020, approximately 32 000 patients were registered in BORIS and were eligible for a register linkage with national registers. 

A contemporaneous comparison group was matched with a ratio of 1:5 by sex, year of birth, and living area (n ≈ 157 000). In addition, were parents identified, both for the individuals in BORIS and for the matched comparison group (n ≈ 336 000). As of today, more than 55 percent in the obesity cohort are over 18 years old and can thereby be followed-up as adults. Data have been retrieved from:

• The Total Population Register contains date of immigration and emigration. 
• The Swedish Medical Birth Register contains characteristics and events at time of delivery. 
• The Medical Drug Register contains data of prescribed and dispensed drugs.
• The Patient Register contains diagnosis and procedure performed in specialized outpatient care and inpatient care.
• The Cause of Death Register contains date and cause of death.
• The Longitudinal Integration Database for Health Insurance and Labor Market Studies contains socio-demographic data such as income, education, employment, sick leave, etc. 

Aim

The overall aim is to investigate short and long-term consequences in young adults who have undergone obesity treatment as children compared to a group from the general population. More specifically, we intend to investigate the risk of future morbidity and identify risk and success factors. We will also evaluate the long-term health economic consequences (consumption and cost).

Originality

The first generation affected by the childhood obesity epidemic has now reached young adulthood. This timing provides a unique opportunity to evaluate the long-term risks associated with childhood obesity, something that previously has been challenging du to limited generalizability. This makes the current epidemiological research exceptionally valuable.

Thanks to the quality register BORIS and the unique register-linking capabilities in Sweden, we can now evaluate and analyze subgroups within the population of children and adolescents with obesity. This allows us to compare these subgroups with a matched control group from the general population, providing unique insights into the long-term impacts of childhood obesity.

Grants

• The Center for Innovative Medicine (CIMED)
• Ã…ke Wiberg’s foundation
• Ollie & Elof Ericssons foundation
• Magnus Bergvalls foundation
• The Freemason Foundation for Children’s Welfare

Publications

Putri RR, Danielsson P, Marcus C, Hagman E.  The Journal of clinical endocrinology and metabolism. 2023;109(1):e314-e320.

Prinz N, Putri RR, Reinehr T, Danielsson P, Weghuber D, Norman M, et al. . PLoS medicine. 2023;20(1):e1004165.

Putri RR, Casswall T, Hagman E. Clin Obes 2021: e12502.

Putri RR, Casswall T, Hagman E. BMC Pediatr 2021; 21(1): 271.

Lindberg L, Persson M, Danielsson P, Hagman E, Marcus C. BMJ Open 2021; 11(3): e040432.

Lindberg L, Hagman E, Danielsson P, Marcus C, Persson M. . BMC medicine. 2020;18(1):30.

Lindberg L, Danielsson P, Persson M, Marcus C, Hagman E. PLoS medicine. 2020;17(3):e1003078.

Brissman M, Lindberg L, Beamish AJ, Marcus C, Hagman E. . Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2020.

Hagman E, Ek AE, Marcus C. . Pediatric diabetes. 2019;20(2):160-165.

Hagman E, Danielsson P, Elimam A, Marcus C. . Int J Obes (Lond). 2019;43(10)

Hagman E, Danielsson P, Brandt L, Ekbom A, Marcus C. Nutr Diabetes. 2016;6(8):e227.

Hagman E, Danielsson P, Brandt L, Svensson V, Ekbom A, Marcus C. Childhood Obesity, . The Journal of adolescent health. 2017;61(4):508-513.

Contact