Screening for Metabolic and Reproductive Complications in Obese Children and Adolescents

Abstract

Childhood obesity is associated with a number of metabolic comorbidities. These include glucose intolerance and type 2 diabetes mellitus, hyperlipidemia, fatty liver disease, and reproductive complications, such as polycystic ovary syndrome. The occurrence of these complications in a child or adolescent may result in progressive health decline at an early age. We, therefore, advocate screening and early diagnosis. This purpose of this review is to outline a rational, evidence-based approach to screening obese children and adolescents for metabolic and reproductive complications. In each section, the aim is to provide the primary care provider with a review of the literature supporting current screening practices. As such, this review is designed to assist the primary care provider in the selection and interpretation of screening tests and to make recommendations regarding the referral of patients for subspecialty care.

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis

“…Current general pediatrics guidelines advocate for the consideration of laboratory evaluation of children with a BMI percentile > 85% and risk factors for obesity-related health conditions [33, 34]. Given the high prevalence of obesity observed among survivors of childhood ALL [35, 36], rapid weight gain during obesogenic childhood ALL therapy may have similar health implications and should be considered an indication to screen and intervene.…”

The Potential for Using Sonography to Measure Abdominal Adiposity in Children

“…7 The rising trend in childhood obesity would suggest a need to advocate for screening and early diagnosis of disease and metabolic conditions in children and adolecents. 4 Screening children and adolescents for an earlier diagnosis could promote preventative measures and early treatment. It may also help to lower the risk for future chronic disease implications in adulthood.…”

“…The progression of type 2 diabetes typically begins with the accumulation of abdominal adiposity or abdominal obesity. 4 In addition, childhood obesity is associated with increased risk for atherosclerosis and mortality due to adult cardiovascular disease, regardless of an adult's weight. 5 To define obesity in children, the CDC uses age-and sex-specific body mass index (BMI) percentiles.…”

Avaliação nutricional e do perfil lipídico de crianças e adolescentes, com processo inflamatório, em unidade de emergência de um hospital universitário

“…Crianças e adolescentes com sobrepeso e obesidade, muito provavelmente, se tornarão adultos também com sobrepeso e obesidade (Li et al, 2012). A obesidade está associada a um maior risco de desenvolvimento de complicações como diabetes tipo 2, dislipidemias, síndrome dos ovários policísticos, síndrome metabólica, dentre outros (Weiss et al, 2004;Irizarry et al, 2014). A associação de comorbidades, principalmente da síndrome metabólica, aumenta o risco de desenvolvimento de doença aterosclerótica dentre outras complicações na vida adulta (Magnussen et al, 2012).…”