Metabolic Complications of Childhood Obesity
Identifying and mitigating the risk
- Ram Weiss, MD, PHD1 and
- Francine Ratner Kaufman, MD2
- 1Department of Human Nutrition and Metabolism and the Diabetes Center, Hadassah Hebrew University School of Medicine, Jerusalem, Israel
- 2Department 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
Abstract
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.
- ALT, alanine transaminase
- IGT, impaired glucose tolerance
- IMCL, intra-myocellular lipid
- NAFLD, nonalcoholic fatty liver disease
Footnotes
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The authors of this article have no relevant duality of interest to declare.
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This article is based on a presentation at the 1st World Congress of Controversies in Diabetes, Obesity and Hypertension (CODHy). The Congress and the publication of this article were made possible by unrestricted educational grants from MSD, Roche, sanofi-aventis, Novo Nordisk, Medtronic, LifeScan, World Wide, Eli Lilly, Keryx, Abbott, Novartis, Pfizer, Generx Biotechnology, Schering, and Johnson & Johnson.
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