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From the Divisions of Neurology (Z.S.D., T.A.G.) and Biostatistics and Epidemiology (T.G.N., C.L., A.C.), Cincinnati Children’s Hospital Medical Center; and Department of Pediatrics (T.G.N., T.A.G.), College of Medicine, University of Cincinnati, OH. Dr. Nick is currently with the Biostatistics Program, Arkansas Children’s Hospital, and Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Address correspondence and reprint requests to Dr. Tracy A. Glauser, Division of Neurology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2015, Cincinnati, OH 45229-3039 Tracy.Glauser{at}cchmc.org
Objective: This study aimed to determine the frequency and factors associated with obesity in a cohort of children and adolescents with newly diagnosed untreated epilepsy.
Methods: Body mass index (BMI) Z-scores and percentiles, both adjusted for age, were used as measures for obesity. Potential covariates associated with these BMI measures included age, etiology (cryptogenic, idiopathic, symptomatic), seizure type (generalized, partial, unclear), concomitant medications (stimulants, nonstimulants, none), and insurance status (privately insured, Medicaid). The primary analysis compared the epilepsy patients’ BMI Z-scores to Centers for Disease Control and Prevention data for healthy children. The secondary analysis compared the epilepsy patients’ BMI Z-scores to those of a regional healthy control group. Additional analyses incorporated the secondary outcome measure BMI percentiles indexed for age.
Results: Children with newly diagnosed untreated epilepsy had higher BMI Z-scores compared to standard CDC growth charts (p < 0.0001) and the healthy control cohort (p = 0.0002) specifically at both of the 2 tail ends of the distribution. Overall, 38.6% of the epilepsy cohort were overweight or obese (BMI 
85th percentile for age). Differences in age, etiology, and concomitant nonepilepsy medications were significantly associated with variability in age-adjusted BMI Z-score. Patients in adolescence had higher adjusted BMI Z-scores than younger patients. Patients with symptomatic epilepsy had lower adjusted BMI Z-scores than patients with idiopathic epilepsy. Patients on stimulant psychotropics exhibited lower adjusted BMI Z-scores than patients on no medication.
Conclusion: Obesity is a common comorbidity in children with newly diagnosed untreated epilepsy and correlates with increasing age, idiopathic etiology, and absence of concomitant medication.
Abbreviations: BMI = body mass index; CDC = Centers for Disease Control and Prevention; CI = confidence interval; IRB = institutional review board; WMW = Wilcoxon-Mann-Whitney.
e-Pub ahead of print on May 27, 2009, at www.neurology.org.
Supported in part by NIH grant NS044956 (T.A.G.).
Disclosure: The authors report no disclosures.
Received February 27, 2009. Accepted in final form March 2, 2009.
Related Article
Neurology 2009 73: 654-655.
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  E. Trevathan and W. H. Dietz Obesity in neurology practice: A call to action Neurology, September 1, 2009; 73(9): 654 - 655. [Full Text] [PDF]
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