Diabetes Care
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Diabetes Care 31:S310-S316, 2008
DOI: 10.2337/dc08-s273
© 2008 by the American Diabetes Association
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Section III: Obesity-The Rising Epidemic
Original Article

Metabolic Complications of Childhood Obesity

Identifying and mitigating the risk

Ram Weiss, MD, PHD1 and Francine Ratner Kaufman, MD2

1 Department of Human Nutrition and Metabolism and the Diabetes Center, Hadassah Hebrew University School of Medicine, Jerusalem, Israel
2 Department of Pediatrics, Keck School of Medicine, and the University of Southern California and the Division of Endocrinology and Metabolism, Children's Hospital of Los Angeles, Los Angeles, California

Address correspondence and reprint requests to Ram Weiss, MD, PhD, Department of Pediatrics and the Diabetes Center, Hadassah Hebrew University School of Medicine, PO Box 12000, Jerusalem 91120, Israel. E-mail: weissr{at}hadassah.org.il

The growing number of obese children and adolescents across the world creates a diagnostic challenge to caregivers. The early clinical manifestations of abnormalities related to childhood obesity, attributed to obesity-driven insulin resistance, are impaired glucose metabolism and nonalcoholic fatty liver disease. Both have no symptoms and demand a high index of suspicion and the proper choice of tests for establishing the diagnosis. The clinician should gather information derived from thoroughly taken history and a focused physical examination to stratify patients by their risk. Focused lifestyle modification–aimed interventions are showing promising results in improving the metabolic profile of obese children. Early diagnosis may help allocate resources for intensive interventions that may benefit individuals at greatest risk for early obesity-related morbidity.

Abbreviations: ALT, alanine transaminase • IGT, impaired glucose tolerance • IMCL, intra-myocellular lipid • NAFLD, nonalcoholic fatty liver disease


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Copyright © 2008 by the American Diabetes Association.