Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes

Reinehr, Thomas; Wabitsch, Martin; Kleber, Michaela; Sousa, Gideon de; Denzer, Christian; Toschke, André Michael

doi:10.1111/j.1399-5448.2008.00492.x

Cited by 41 publications

(44 citation statements)

References 26 publications

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“…12,13,15,18,[77][78][79][80] Impaired glucose tolerance, a strong predictor of future development of T2DM in obese youth, is prevalent among children and adolescents with severe obesity. 77,78,81 In a study of >700 severely obese children of European decent, insulin resistance and insulin secretion were associated with 2-hour postprandial glucose levels.…”

Section: Metabolic Risksmentioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

887

804

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espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

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Section: Metabolic Risksmentioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

887

804

View full text Add to dashboard Cite

show abstract

“…However, the low reproducibility of an oGTT has to be kept in mind [48] . Using the criteria (1) type 2 diabetes mellitus in the first or second degree relatives, (2) onset of puberty, and (3) extreme obesity allows to identify the great majority of overweight European children, which should be screened by oGTT, when two of this three criteria are fulfilled [49] . Studies using HbA1c as screening tool were disappointing, since one third of the asymptomatic children with type 2 diabetes mellitus demonstrated normal values [3] .…”

Section: Screening For Type 2 Diabetes Mel-litus In Children and Adolmentioning

confidence: 99%

Type 2 diabetes mellitus in children and adolescents

Reinehr¹

2013

WJD

Self Cite

289

173

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“…The American Diabetes Association's criteria for selecting children to test for T2DM and criteria specifically designed for screening obese children for IGT in European populations, such as a clinical score issued from a German cohort or the fasting glucose cut-off of 86 mg/dl issued from an Italian cohort [56,57], have recently shown sub-optimal accuracy in identifying IGT when tested in different populations [58]. Also, a clinical score based on data from a multi-ethnic American cohort showed only moderate accuracy [39].…”

Section: Markers Of Co-morbiditiesmentioning

confidence: 99%

Predictors of Metabolic Risk in Childhood Obesity

Morandi

Maffeis²

2014

Horm Res Paediatr

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Most of the complications of juvenile obesity are due to metabolic disturbances induced by an excessive accumulation of fat which leads to chronic diseases like type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Finding effective ways of identifying obese paediatric patients who are at increased risk of developing cardiovascular and metabolic complications has been recognised to be a promising strategy to improve prevention of complications of early obesity. Moreover, correctly identifying obese children who are already affected by metabolic co-morbidities should be a clinical priority. According to the state of the art summarised in this review, traditional metabolic variables included in the definitions of metabolic syndrome (MS), pre-diabetes, non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steato-hepatitis and, in obese girls, the presence of polycystic ovary syndrome are the best available longitudinal predictors of CVD and T2DM among obese children and adolescents. In clinical practice, traditional metabolic variables included in the definitions of MS should be assessed in all obese children and adolescents; fasting metabolic variables have been proposed to identify obese patients likely to be affected by impaired glucose tolerance or T2DM, and ultrasound has proved to be a valid surrogate for biopsy in the diagnosis of NAFLD. Further large longitudinal and cross-sectional studies are needed to improve our chances of identifying obese youth at the highest metabolic risk.

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Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes

Cited by 41 publications

References 26 publications

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Type 2 diabetes mellitus in children and adolescents

Predictors of Metabolic Risk in Childhood Obesity

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