Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis

Abstract

Research Article| February 01 2019 Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis AAP Grand Rounds (2019) 41 (2): 20. https://doi.org/10.1542/gr.41-2-20 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis. AAP Grand Rounds February 2019; 41 (2): 20. https://doi.org/10.1542/gr.41-2-20 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: body mass index procedure, epiphyses, slipped, obesity Source: Perry DC, Metcalfe D, Lane S, et al. Childhood obesity and slipped capital femoral epiphysis. Pediatrics. 2018; 142(5): e20181067; doi: https://doi.org/10.1542/peds.2018-1067Google Scholar Investigators from multiple UK institutions conducted a cohort study to assess the strength of association between childhood obesity and slipped capital femoral epiphysis (SCFE). The cohort was identified using a nationwide child health surveillance program in Scotland, as well as a data set that included 10% of the Scottish population. In both data sets, child demographics, height, and weight were routinely recorded at school entry (5–6 years old) by school nurses. Height and weight among a subgroup of cohort children at 11–12 years old were recorded in a third data set. The primary exposure was BMI, categorized as underweight (<5%), normal weight (5%–85%), overweight (≥85%–94%), mild/moderate obesity (≥95%–99%), or severe obesity (≥99%). The primary outcome was SCFE diagnosed between the ages of 6 and 18 years, as determined by ICD-10 codes in the Scottish Morbidity Record, a registry of patients discharged from all Scottish hospitals. Cohort children contributed to follow-up until they reached 18 years, received a diagnosis of SCFE, or the study period ended. Investigators calculated the incidence of SCFE by BMI category among children 5–6 years old and 11–12 years old. The risk of SCFE attributable to BMI was also calculated. There were 597,017 children 5–6 years old and 39,468 children 11–12 years old included in the analysis, with a total follow-up time of 4.26 million child-years. Among children 5–6 years old, 11.9% were overweight, and 9.2% were obese. Of those obese at 5–6 years old, 75% remained obese at 11–12 years old. There were 209 children diagnosed with SCFE. The incidence of SCFE in children 5–6 years old was 4.7 per 100,000 child-years of risk (95% CI, 4.1–5.4). Compared to children of normal weight at 5–6 years old, those who had severe obesity, had mild/moderate obesity, or were overweight had 5.9 (95% CI, 3.9–9.0), 3.8 (95% CI, 2.6–5.8), and 1.5 (95% CI, 0.9–2.3) times greater risk of developing SCFE, respectively. The risk of SCFE attributable to BMI at 5–6 years old was 78% among children with obesity and 31% among children who were overweight. The incidence of SCFE in children 11–12 years old was 23.8 per 100,000 child-years of risk (95% CI, 14.8–36.4), with a 17 times greater risk of developing SCFE (95% CI, 5.9–49.0) in those with severe obesity (vs normal BMI) at 11–12 years. The investigators conclude that childhood BMI is strongly associated with SCFE. Dr Hennrikus has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Childhood obesity is a global health problem.1 SCFE is a disease that causes lifelong disability due to arthritis, pain, and leg length inequality.2,3 SCFE occurs through the histologic zone of hypertrophy in the open growth plate.4 The peak age for SCFE is around puberty.... You do not currently have access to this content.