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Posted May 07 2009 9:22pm

Higher blood pressures and a higher prevalence of hypertension occur in overweight children, independent of race, sex, and age. The metabolic syndrome confers an high risk of cardiovascular disease, with an overall prevalence of 4% in adolescents and approximately 30% in overweight adolescents. In childhood obesity Orthopedic complications are very important. This include Blount disease, characterized by an overgrowth of the medial aspect of the proximal tibial metaphysis, leading to bowing of the legs and slipped capital femoral epiphysis, where the epiphysis of the proximal femur slips off the metaphysis posteriorly and medially due to increased weight on the cartilaginous growth plate of the hip.Some prospective studies suggest a causal link between obesity and asthma, but it is unclear what role this plays in childhood. Obstructive sleep apnea is more common in overweight children and may contribute to problems such as hypertension, daytime fatigue, and pulmonary hypertension. Nonalcoholic fatty liver disease (NAFLD) has been reported in 10–25% of very overweight adolescents.NAFLD is characterized by a mild increase in transaminases, a hyperechoic liver on ultrasound, and evidence of steatosis and periportal fibrosis on histologic examination. Progression to liver cirrhosis may occur with time. Proteinuria caused by focal segmental glomerulosclerosis has been reported in severely obese African-American adolescents. In addition to these complications that may present in adolescents, obesity in adults is associated with increased risk of malignancies and osteoarthritis.

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