Obesity in Children Workup

  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Jatinder Bhatia, MBBS   more...
 
Updated: Feb 15, 2012
 

Approach Considerations

Identify any genetic or hormonal disorder that may be a cause of obesity in a child.

In the evaluation of type II diabetes mellitus, a serum hemoglobin A1c level as well as fasting and 2-hour post glucola glucose and insulin levels (for evaluation of glucose tolerance and insulin resistance) are recommended. To identify high-risk patients, Maffeis et al reported that obese children and adolescents with a fasting plasma glucose value greater than or equal to 86 mg/dL are most likely to manifest impaired glucose tolerance.[19]

The following laboratory studies may also be indicated in patients with obesity:

  • Fasting lipid panel for detection of dyslipidemia
  • Thyroid function tests
  • Serum leptin
  • Adrenal function tests, when indicated, to assess the possibility of Cushing syndrome
  • Karyotype (with fluorescence in situ hybridization [FISH] for Prader-Willi [15q-]), when indicated by clinical history and physical examination
  • Growth hormone secretion and function tests, when indicated
  • Assessment of reproductive hormones (including prolactin), when indicated
  • Serum calcium, phosphorus, and parathyroid hormone levels to evaluate for suspected pseudohypoparathyroidism

When clinically indicated, obtain magnetic resonance imaging (MRI) of the brain with focus on the hypothalamus and pituitary.

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Contributor Information and Disclosures
Author

Steven M Schwarz, MD, FAAP, FACN, AGAF  Professor of Pediatrics, Children's Hospital at Downstate, State University of New York Downstate Medical Center

Steven M Schwarz, MD, FAAP, FACN, AGAF is a member of the following medical societies: American Academy of Pediatrics, American College of Nutrition, American College of Physician Executives, American Gastroenterological Association, American Pediatric Society, Gastroenterology Research Group, New York Academy of Medicine, North American Society for Pediatric Gastroenterology and Nutrition, and Society for Pediatric Research

Disclosure: Curemark, LLC Consulting fee Board membership; Centocor, Inc. Grant/research funds Independent contractor; Johnson & Johnson, Inc. Grant/research funds Independent contractor

Specialty Editor Board

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Jatinder Bhatia, MBBS  Professor of Pediatrics, Chief, Section of Neonatology, Department of Pediatrics, Medical College of Georgia

Jatinder Bhatia, MBBS is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Dietetic Association, American Pediatric Society, American Society for Clinical Nutrition, American Society for Parenteral and Enteral Nutrition, Society for Pediatric Research, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Michael Freemark, MD, to the development and writing of the source article.

References

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Central nervous system (CNS) neurocircuitry for satiety and feeding cycles. AGRP = Agouti-related protein; CB = cannabinoid; CCK = cholecystokinin; CRH = corticotropin-releasing hormone; GLIP = glucagonlike peptide; Mc-3 and 4 = melanocortin-3 and 4; MCH = melanin concentrating hormone; α-MSH = alpha–melanocyte-stimulating hormone; POMC = pro-opiomelanocortin; TNF = tumor necrosis factor.
 
 
 
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