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 The disorder, known as slipped capital femoral epiphysis (SCFE), is
one of the most common hip problems in children and adolescents. It
can lead the ball at the head of the thigh bone to slip backward and
often requires surgery to repair. While the condition has long been
linked to obesity, which can put extra pressure on bones, research
to date hasn't offered decisive evidence that obesity directly
causes SCFE.
For the current study, researchers examined data on weight for more
than 597,000 children when they were 5 to 6 years old, with an
additional record of weight for nearly 39,500 of these youth at 11
to 12 years old. During an average of seven years of follow-up, 209
children were diagnosed with SCFE.
Compared to kids who were a normal weight at the start of the study,
children with severe obesity were almost six times more likely to
develop SCFE and youth who were less obese were almost four times
more likely to develop SCFE, researchers report in Pediatrics.
And by 11 to 12 years old, youth with severe obesity had 17 times
the risk of SCFE that normal weight children had.
"Some doctors, in particular orthopedic surgeons, have long believed
that SCFE is linked to childhood obesity, though this has been very
difficult to prove," said lead study author Daniel Perry of the
University of Liverpool in the UK.
The current study wasn't a controlled experiment designed to prove
whether or how obesity might directly cause SCFE.
But "the strength of this association is striking," Perry said by
email.
Children and teens are considered obese when their body mass index
(BMI) is higher than 95 percent of other youth their same age and
sex. They're considered severely obese when their BMI is higher than
99 percent of other kids.
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At the start of the study when kids were about 5.5 years old on
average, 12 percent of them were overweight and 9.2 percent were
obese.
Among the 3,973 children who were obese at that point, 2,963 (75
percent) remained obese at 11 to 12 years old.
"There are multiple health problems associated with childhood
obesity, and we now know that SCFE is one of them," said Dr Tim
Theologis of Oxford University Hospitals in the UK.
"Although this was beyond the scope of this study, it is logical to
assume that if obese children were to lose weight, this would reduce
their risk of SCFE," Theologis, who wasn't involved in the study,
said by email.
Obesity may add to the risk of SCFE because the growth plate where
the thigh bone meets the hip joint is made of cartilage that's
weaker than bone, noted Dr. Deborah Eastwood of University College
London. Rapid growth during pre-teen and teen years coupled with
excess weight can damage the hip, leading to pain and reduced range
of motion.
"This is the first (of hopefully several studies) that will confirm
that obesity is bad for children - in this case bad because it
increases the risk of a rare but 'nasty' orthopedic condition which
could be disabling," Eastwood, who wasn't involved in the study,
said by email. "Children who are not overweight tend to be more
active, fitter and healthier - and this can only be good for you."
SOURCE: http://bit.ly/2yuan7f Pediatrics, online October 22, 2018.
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