Obesity in Children Workup

Updated: Dec 01, 2020
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Jatinder Bhatia, MBBS, FAAP  more...
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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. [32]

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

  • Liver function studies (transaminases), to screen for non-alcoholic fatty liver disease (non-alcoholic steatohepatitis)

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