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ARTICLES:
Thomas M. K. Völkl, Diemud Simm, Christoph Beier, and Helmuth G. Dörr
Obesity Among Children and Adolescents With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency
Pediatrics 2006; 117: e98-e105 [Abstract] [Full text] [PDF]
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eLetters published:

[Read eLetters] Comparison group may not be valid
Barry J Taylor   (5 January 2006)
[Read eLetters] Re: Comparison group may not be valid
Thomas MK Völkl, and Helmuth G Dörr   (24 January 2006)

Comparison group may not be valid 5 January 2006
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Barry J Taylor,
Paediatrician
University of Otago

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Re: Comparison group may not be valid

barry.taylor{at}stonebow.otago.ac.nz Barry J Taylor

I would have liked to see BMI of a contemporaneous matched control group for this study. They quote the Cole paper and german data for school entry prevalence of obesity, but the cole paper refers to data prior to 1990, and we know that obesity rates in most industrialised countries have dramatically increased in the last 15 years. In New Zealand and Australia, current rates of obesity (bmi>95th centile)are in the order of 6 - 7% and higher again in the USA. It would be nice to see the more recent Cole international standard used with this data (1), as well as some adjustment for socio-economic status which may bias the results somewhat.

1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. Bmj 2000;320(7244):1240-3.

Conflict of Interest:

None declared
Re: Comparison group may not be valid 24 January 2006
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Thomas MK Völkl,
resident
Pediatric Endocrinology, Hospital for Children and Adolescents, University of Erlangen-Nuremberg,
and Helmuth G Dörr

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Re: Re: Comparison group may not be valid

tsvoelkl{at}kinder.imed.uni-erlangen.de Thomas MK Völkl, et al.

Dear Prof. Taylor, we appreciate your P3R-comment concerning two essential topics of our paper. We agree with you that a thorough selecting of underlying reference data is essential when comparing variables as we did. However, we did not use the 1990 Cole references but the current German references published in 2001 (Kromeyer-Hauschild et al.). These data have very recently been confirmed to be valid for the Bavarian children by comparison with the results of school entry-investigations published in 2004 (von Kries et al., 1st paragraph of our discussion). Since these reference data are population-based they certainly cover the whole socio- economic range. Furthermore, CAH is an autosomal-recessive genetic disease and affects therefore the whole socio-economic range (consanguinity was not present in any of our patients).

Conflict of Interest:

None declared