{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:16:09Z","timestamp":1789002969684,"version":"build-2803163510"},"reference-count":37,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Slipped capital femoral epiphysis (SCFE) is believed to be associated with childhood obesity, although the strength of the association is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We performed a cohort study using routine data from health screening examinations at primary school entry (5\u20136 years old) in Scotland, linked to a nationwide hospital admissions database. A subgroup had a further screening examination at primary school exit (11\u201312 years old).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>BMI was available for 597\u2009017 children at 5 to 6 years old in school and 39\u2009468 at 11 to 12 years old. There were 4.26 million child-years at risk for SCFE. Among children with obesity at 5 to 6 years old, 75% remained obese at 11 to 12 years old. There was a strong biological gradient between childhood BMI at 5 to 6 years old and SCFE, with the risk of disease increasing by a factor of 1.7 (95% confidence interval [CI] 1.5\u20131.9) for each integer increase in BMI z score. The risk of SCFE was almost negligible among children with the lowest BMI. Those with severe obesity at 5 to 6 years old had 5.9 times greater risk of SCFE (95% CI 3.9\u20139.0) compared with those with a normal BMI; those with severe obesity at 11 to 12 years had 17.0 times the risk of SCFE (95% CI 5.9\u201349.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>High childhood BMI is strongly associated with SCFE. The magnitude of the association, temporal relationship, and dose response added to the plausible mechanism offer the strongest evidence available to support a causal association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2018-1067","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T03:25:51Z","timestamp":1540178751000},"source":"Crossref","is-referenced-by-count":90,"title":["Childhood Obesity and Slipped Capital Femoral Epiphysis"],"prefix":"10.1542","volume":"142","author":[{"given":"Daniel C.","family":"Perry","sequence":"first","affiliation":[{"name":"Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom;"},{"name":"Alder Hey Children\u2019s Hospital, Liverpool, United Kingdom;"},{"name":"Oxford Trauma, Nuffield Department of Orthopaedics Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Oxford Trauma, Nuffield Department of Orthopaedics Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Lane","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Turner","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,11,1]]},"reference":[{"issue":"9945","key":"2021120921393668400_B1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013 [published correction appears in Lancet. 2014;384(9945):746].","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"issue":"3","key":"2021120921393668400_B2","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1001\/jamapediatrics.2017.4301","article-title":"Trends in severe obesity among children aged 2 to 4 years enrolled in special supplemental nutrition program for women, infants, and children from 2000 to 2014.","volume":"172","author":"Pan","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"22","key":"2021120921393668400_B3","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1056\/NEJMoa1703860","article-title":"Simulation of growth trajectories of childhood obesity into adulthood.","volume":"377","author":"Ward","year":"2017","journal-title":"N Engl J Med"},{"key":"2021120921393668400_B4","author":"World Health Organization"},{"issue":"7325","key":"2021120921393668400_B5","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1136\/bmj.323.7325.1320","article-title":"Adult obesity and growth in childhood.","volume":"323","author":"Law","year":"2001","journal-title":"BMJ"},{"issue":"9548","key":"2021120921393668400_B6","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/S0140-6736(06)69703-1","article-title":"Epidemic obesity and type 2 diabetes in Asia.","volume":"368","author":"Yoon","year":"2006","journal-title":"Lancet"},{"issue":"9888","key":"2021120921393668400_B7","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0140-6736(13)60311-6","article-title":"Effect of fetal and child health on kidney development and long-term risk of hypertension and kidney disease.","volume":"382","author":"Luyckx","year":"2013","journal-title":"Lancet"},{"issue":"6","key":"2021120921393668400_B8","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1056\/NEJMoa0904130","article-title":"Childhood obesity, other cardiovascular risk factors, and premature death.","volume":"362","author":"Franks","year":"2010","journal-title":"N Engl J Med"},{"issue":"322","key":"2021120921393668400_B9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00003086-199601000-00004","article-title":"A worldwide study on the seasonal variation of slipped capital femoral epiphysis.","author":"Loder","year":"1996","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"2021120921393668400_B10","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1302\/0301-620X.90B1.19502","article-title":"Changing incidence of slipped capital femoral epiphysis: a relationship with obesity?","volume":"90","author":"Murray","year":"2008","journal-title":"J Bone Joint Surg Br"},{"issue":"10","key":"2021120921393668400_B11","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1302\/0301-620X.93B10.26852","article-title":"Slipped capital femoral epiphysis: rising rates with obesity and aboriginality in South Australia.","volume":"93","author":"Nguyen","year":"2011","journal-title":"J Bone Joint Surg Br"},{"issue":"6","key":"2021120921393668400_B12","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1097\/01.bpo.0000184651.34475.8e","article-title":"Relationship between body mass index and slipped capital femoral epiphysis.","volume":"25","author":"Manoff","year":"2005","journal-title":"J Pediatr Orthop"},{"issue":"6","key":"2021120921393668400_B13","first-page":"369","article-title":"Body mass index and slipped capital femoral epiphysis.","volume":"12","author":"Poussa","year":"2003","journal-title":"J Pediatr Orthop B"},{"issue":"2","key":"2021120921393668400_B14","first-page":"276","article-title":"The body build of patients with slipped capital femoral epiphysis.","volume":"124","author":"Kelsey","year":"1972","journal-title":"Am J Dis Child"},{"key":"2021120921393668400_B15","unstructured":"American Academy of Orthopedic Surgeons\n          . 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