Laboratory screening in overweight/obese adolescents: do the results change the management?
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Reshmi Morris
Abstract
Due to the growth of the epidemic of obesity and the association of obesity with both short-term and long-term medical complications, many professional organizations have recommended performing laboratory testing as part of the initial evaluation of overweight and obese children and adolescents. We report on the results of laboratory testing performed on 110 patients (mean age 14.0 years, range 8–20 years) referred to our weight management program between 2011 and 2013. Our results showed mild abnormalities in levels of cholesterol, glucose, liver enzymes, and thyroid stimulating hormone (TSH) in fewer than 5% of patients for each test and no changes in management based on these results for any of the patients. We call for re-consideration of the recommendations for laboratory testing in children and adolescents being evaluated and treated for overweight and obesity.
References
1. Ogden CL, Carrol MD. Prevalence of obesity in the United States. J Am Med Assoc 2014;312:189–90.10.1001/jama.2014.6228Suche in Google Scholar PubMed
2. Skinner AC, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012. JAMA Pediatr 2014;168:561–6.10.1001/jamapediatrics.2014.21Suche in Google Scholar PubMed
3. Reilly J, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes 2011;35:891–8.10.1038/ijo.2010.222Suche in Google Scholar PubMed
4. Barlow SE, Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120(Suppl 4):S164–92.10.1542/peds.2007-2329CSuche in Google Scholar PubMed
5. Kavey R, et. al. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents; National Heart, Lung and Blood institute. summary report. Pediatrics 2011;128(Suppl 5):S213–56.10.1542/peds.2009-2107CSuche in Google Scholar PubMed PubMed Central
6. Daniels SR (Panel Chair). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Full report. Pediatrics 2011;128(Suppl 5):S213–56.10.1542/peds.2009-2107CSuche in Google Scholar
7. Newman TB, Pletcher MJ, Hulley SB. Overly aggressive new guidelines for lipid screening in children: evidence of a broken process. Pediatrics 2012;130:349–52.10.1542/peds.2012-0481Suche in Google Scholar PubMed
8. Hurt L, Pinto CD, Watson J, Grant M, Gielner J. Diagnosis and screening for obesity-related conditions among children and teens receiving medicaid – Maryland, 2005–2010. Morb Mortal Wkly Rep 2014;63:305–8.Suche in Google Scholar
9. Gillman MW, Daniels SR. Is universal pediatric lipid screening justified? J Am Med Assoc 2012;307:259–60.10.1001/jama.2011.2012Suche in Google Scholar PubMed PubMed Central
10. Li J, Motsko SP, Goehring EL Jr, Tave A, Pezzullo JC, et al. Prevalence of pediatric dyslipidemia: Comparison of a population-based claims database to national surveys. Pharmacoepidemiol Drug Saf 2010;19:1031–40.10.1002/pds.1982Suche in Google Scholar PubMed
11. Dai S, Yang Q, Yuan K, Loustalot F, Fang J, et al. Non-high-density lipoprotein cholesterol: Distribution and prevalence of high serum levels in children and adolescents: United States National Health and Nutrition Examination Surveys, 2005–2010. J Pediatr 2014;164:247–53.10.1016/j.jpeds.2013.08.069Suche in Google Scholar PubMed PubMed Central
12. Bamba V. Update on screening, etiology and treatment of dyslipidemia in children. J Clin Endocrinol Metab 2014;99:3093–102.10.1210/jc.2013-3860Suche in Google Scholar PubMed
13. Moran A, Jacobs DR Jr, Steinberger J, Hong CP, Prineas R, et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 1999;48:2039–44.10.2337/diabetes.48.10.2039Suche in Google Scholar PubMed
14. Abrams P, Levitt Katz, Moore RH, Xanthopoulos MS, Bishop-Gilyard CT, et al. Threshold for improvement in insulin sensitivity with adolescent weight loss. J Pediatr 2013;163:785–90.10.1016/j.jpeds.2013.04.003Suche in Google Scholar PubMed PubMed Central
15. Markus Juonala, Costan G. Childhood obesity, adult obesity and cardiovascular risk factors. N Engl J Med 2011;365:1876–85.10.1056/NEJMoa1010112Suche in Google Scholar PubMed
16. Vasconcellos F, Seabra A, Katzmarzyk PT, Kraemer-Aguiar LG, Bouskela E, et al. Physical activity in overweight and obese adolescents: systematic review of the effects on physical fitness components and cardiovascular risk factors. Sports Med 2014;44:1139–52.10.1007/s40279-014-0193-7Suche in Google Scholar PubMed
17. Hassan K, Bhalla V. Nonalcoholic fatty liver disease: a comprehensive review of a growing epidemic. World J Gastroenterol 2014;20:12082–101.10.3748/wjg.v20.i34.12082Suche in Google Scholar PubMed PubMed Central
18. Welsh JA, Karpen S, Vos MB. Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988–1994 to 2007–2010. J Pediatr 2013;162:496–500.10.1016/j.jpeds.2012.08.043Suche in Google Scholar PubMed PubMed Central
19. Socha P, Horvath A, Vajro P, Dziechciarz P, Dhawan A, et al. Pharmacological interventions for nonalcoholic fatty liver disease in adults and in children: a systematic review. J Pediatr Gastroenterol Nutr 2009;48:587–96.10.1097/MPG.0b013e31818e04d1Suche in Google Scholar PubMed
20. Cho T, Kim Y, Paik SS. The efficacy of pharmacological treatment in pediatric nonalcoholic fatty liver disease. Pediatr Gastroenterol Hepatol Nutr 2012;15:256–65.10.5223/pghn.2012.15.4.256Suche in Google Scholar PubMed PubMed Central
21. Chen H, Zhang H, Tang W, Xi Q, Liu X, et al. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population. J Pediatr Endocrinol Metab 2013;26:489–96.10.1515/jpem-2012-0299Suche in Google Scholar PubMed
22. Longhi S, Radetti G. Thyroid function and obesity. J Clin Res Pediatr Endocrinol 2013;5(Suppl 1):40–4.Suche in Google Scholar PubMed
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- Follow-up and outcomes of pregnancies in French Guiana: the part of teenage pregnancies
- Prevalence and risk factors for traumatic dental injuries in adolescent children attending special needs schools in India: a comparative study
- Prevalence of lesbian, gay, bisexual, and transgender among Japanese university students: a single institution survey
- Personality differences in treatment-seeking and non-treatment-seeking individuals with self-reported anorexia
- Peptic esophageal stricture in an adolescent with Barrett’s esophagus
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