Socioeconomic position and cardiometabolic risk factors in children and adolescents with obesity: findings from the Bern Obesity in Childhood and Adolescence Biorepository (BOCAB)
- 1Inselspital, Bern University Hospital
Abstract
PurposeIn high-income countries, lower socioeconomic position (SEP) is linked to higher childhood obesity prevalence but its association with cardiometabolic risk in those presenting in pediatric weight management services remain underexplored.
MethodsIn the Bern Obesity in Childhood and Adolescence Biorepository (BOCAB), we used the Swiss neighborhood index of SEP (0-100, 100=highest SEP) to assess cross-sectional associations with obesity severity and cardiometabolic risk factors, mediation by behavioral lifestyle factors and longitudinal associations between SEP and percentage of the 95th BMI percentile (%BMIp95) and waist circumference-to-height ratio (WHtR), adjusted for age and sex.
ResultsAmong 886 participants (52% male, mean age 11.2 years [SD 3.1]), mean %BMIp95 was 124% (SD 17%). A 10-unit higher SEP was associated with lower %BMIp95 ({beta} -2.57; 95% CI -3.84 to -1.31) and lower WHtR ({beta} -0.006; -0.010 to -0.001), both partially mediated by weekly physical activity and screen time. Higher SEP was also associated with lower odds of insulin resistance (OR 0.80; 0.65 to 0.98), low HDL-cholesterol (OR 0.81; 0.67 to 0.98), elevated non-HDL-cholesterol (OR 0.74; 0.59 to 0.92) and elevated triglycerides (OR 0.83; 0.70 to 0.98). Among 419 participants with longitudinal data, annual reduction in %BMIp95 and WHtR did not differ by SEP.
ConclusionLower SEP is associated with greater obesity severity and cardiometabolic risk among children and adolescents with obesity presenting at specialized tertiary care. Screening and early referral of lower-SEP children and adolescents with obesity should be encouraged, before cardiometabolic risk accumulates, particularly since treatment response did not differ once enrolled.
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BibTeX
@misc{koch2026socioeconomic,
title = {{Socioeconomic position and cardiometabolic risk factors in children and adolescents with obesity: findings from the Bern Obesity in Childhood and Adolescence Biorepository (BOCAB)}},
author = {A. Koch and C. Giachino and A. O. Agbaje and M. Juonala and C. G. Magnussen and D. P. Burgner and D. K. Longmore and L. M. Leuenberger and C. E. Kuehni and S. Tschumi and M. V. Kopp and M. Janner and C. Saner},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.24.26362616},
url = {https://www.medrxiv.org/content/10.64898/2026.09.24.26362616v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Socioeconomic position and cardiometabolic risk factors in children and adolescents with obesity: findings from the Bern Obesity in Childhood and Adolescence Biorepository (BOCAB)
AU - A. Koch
AU - C. Giachino
AU - A. O. Agbaje
AU - M. Juonala
AU - C. G. Magnussen
AU - D. P. Burgner
AU - D. K. Longmore
AU - L. M. Leuenberger
AU - C. E. Kuehni
AU - S. Tschumi
AU - M. V. Kopp
AU - M. Janner
AU - C. Saner
PY - 2026
DA - 2026/09/24
PB - medRxiv
DO - 10.64898/2026.09.24.26362616
UR - https://www.medrxiv.org/content/10.64898/2026.09.24.26362616v1
AB - PurposeIn high-income countries, lower socioeconomic position (SEP) is linked to higher childhood obesity prevalence but its association with cardiometabolic risk in those presenting in pediatric weight management services remain underexplored. MethodsIn the Bern Obesity in Childhood and Adolescence Biorepository (BOCAB), we used the Swiss neighborhood index of SEP (0-100, 100=highest SEP) to assess cross-sectional associations with obesity severity and cardiometabolic risk factors, mediation by behavioral lifestyle factors and longitudinal associations between SEP and percentage of the 95th BMI percentile (%BMIp95) and waist circumference-to-height ratio (WHtR), adjusted for age and sex. ResultsAmong 886 participants (52% male, mean age 11.2 years [SD 3.1]), mean %BMIp95 was 124% (SD 17%). A 10-unit higher SEP was associated with lower %BMIp95 ({beta} -2.57; 95% CI -3.84 to -1.31) and lower WHtR ({beta} -0.006; -0.010 to -0.001), both partially mediated by weekly physical activity and screen time. Higher SEP was also associated with lower odds of insulin resistance (OR 0.80; 0.65 to 0.98), low HDL-cholesterol (OR 0.81; 0.67 to 0.98), elevated non-HDL-cholesterol (OR 0.74; 0.59 to 0.92) and elevated triglycerides (OR 0.83; 0.70 to 0.98). Among 419 participants with longitudinal data, annual reduction in %BMIp95 and WHtR did not differ by SEP. ConclusionLower SEP is associated with greater obesity severity and cardiometabolic risk among children and adolescents with obesity presenting at specialized tertiary care. Screening and early referral of lower-SEP children and adolescents with obesity should be encouraged, before cardiometabolic risk accumulates, particularly since treatment response did not differ once enrolled.
ER -