OBESITY
- Obesity: a comprehensive review of frequency, aetiology, pathology, clinical manifestations, diagnostic work-up and management of obesity cases - http://www.emedicine.com/med/topic1653.htm
- Obesity in children: a comprehensive review - http://www.emedicine.com/ped/topic1699.htm
- Obesity-Hypoventilation Syndrome and Pulmonary Consequences of Obesity (Synonyms: Pickwick syndrome, pickwickian syndrome, obstructive sleep apnoea / hypoventilation, OSA/H: a comprehensive review - http://www.emedicine.com/ped/topic1627.htm
- Breathing-Related Sleep Disorder Review - http://www.emedicine.com/med/topic3130.htm
- Insulin Resistance: a metabolic syndrome: review - http://www.emedicine.com/med/topic1173.htm
- Prader-Willi Syndrome Review: Babies with this chromosomal microdeletion / disomy disorder are obese, short statured with small hands and feet, mentally retarded, physically hypoactive and have strabismus and hypogonadotropic hypogonadism - http://www.emedicine.com/ped/topic1880.htm
- Leptin: an overview from Wikipedia, the free encyclopaedia - http://en.wikipedia.org/wiki/Leptin
Measures:
Lab Studies:
- American Association of Clinical Chemistry: Lipid Profile - http://www.labtestsonline.org/understanding/analytes/lipid/glance.html
- American Association of Clinical Chemistry: Lipoprotein Subfraction Profile (includes LDL Subfractions & HDL Subfractions) - http://www.labtestsonline.org/understanding/analytes/lipoprotein_subfractions/glance.html
- American Association of Clinical Chemistry: Liver Panel - http://www.labtestsonline.org/understanding/analytes/liver_panel/glance.html
- American Association of Clinical Chemistry: Total T3 and Free T3 - http://www.labtestsonline.org/understanding/analytes/t3/glance.html
- American Association of Clinical Chemistry: Total T4 and Free T4 - http://www.labtestsonline.org/understanding/analytes/t4/glance.html
- American Association of Clinical Chemistry: TSH (Thyrotropin) - http://www.labtestsonline.org/understanding/analytes/tsh/glance.html
- American Association of Clinical Chemistry: Cortisol level - http://www.labtestsonline.org/understanding/analytes/cortisol/glance.html
- American Association of Clinical Chemistry: ACTH (also called Corticotropin) - http://www.labtestsonline.org/understanding/analytes/acth/glance.html
- American Association of Clinical Chemistry: Fasting blood sugar - http://www.labtestsonline.org/understanding/analytes/glucose/glance.html
Additional Lab Studies: May be required in a child with obesity:
- American Association of Clinical Chemistry: Leptin Level - http://www.alpco.com/pdfs/20/20-DR-1863.pdf
- American Association of Clinical Chemistry: Growth Hormone Level - http://www.labtestsonline.org/understanding/analytes/growth_hormone/glance.html
- American Association of Clinical Chemistry: Prolactin - http://www.labtestsonline.org/understanding/analytes/prolactin/glance.html
- American Association of Clinical Chemistry: Parathyroid Hormone (PTH) - http://www.labtestsonline.org/understanding/analytes/pth/glance.html
- American Association of Clinical Chemistry: Calcium - http://www.labtestsonline.org/understanding/analytes/calcium/glance.html
- American Association of Clinical Chemistry: Phosphorus - http://www.labtestsonline.org/understanding/analytes/phosphorus/glance.html
Imaging Studies:
-
ACR Practice Guideline for the Performance and Interpretation of Magnetic Resonance Imaging (MRI) of the Brain - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12250&CID=542&VID=2&DOC=File.PDF
Additional Studies for Obesity-Hypoventilation Syndrome:
- Medline Plus: Polysomnogram - http://www.nlm.nih.gov/medlineplus/ency/article/003932.htm
- Obstructive Sleep Apnoea Diagnosis - http://www.pulmonologychannel.com/osa/diagnosis.shtml
- American Association of Clinical Chemistry: Arterial Blood Gases (ABGs): The aim is to rule out daytime hypoxemia and hypercarbia - http://www.labtestsonline.org/understanding/analytes/blood_gases/glance.html
- American Association of Clinical Chemistry: Hematocrit (also known as Packed Cell Volume - PCV): The test is done because PCV may be elevated in children with chronic hypoxemia - http://www.labtestsonline.org/understanding/analytes/hematocrit/glance.html
- Medline Plus: Chest X-ray: The aim is to determine the heart size, rule out any visible chest wall deformity and also to look for any radiological evidence of congestive heart failure - http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm
- ACR Practice Guideline for the Performance of Paediatric and Adult Chest Radiography - http://www.acr.org/s_acr/bin.asp? TrackID=&SID=1&DID=12194&CID=545&VID=2&DOC=File.PDF
- Medline Plus: Echocardiogram: The aim is to rule out right ventricular hypertrophy that can develop in patients of sleep apnoea syndrome due to chronic hypoxemia -
- http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm
- Pulmonary Function Testing: a comprehensive review - http://www.emedicine.com/med/topic2972.htm
- American Sleep Disorders Association: The Clinical Use of the Multiple Sleep Latency Test - http://www.aasmnet.org/PDF/MSLTReview.pdf
- ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography - http://www.acc.org/clinical/guidelines/echo/index_clean.pdf
Additional Studies for Insulin Resistance:
- American Association of Clinical Chemistry: Insulin Level - http://www.labtestsonline.org/understanding/analytes/insulin/glance.html
- American Association of Clinical Chemistry: Haemoglobin A1c (HbA1c): also known as Glycohemoglobin or Glycated haemoglobin - http://labtestsonline.org/understanding/analytes/a1c/test.html
- American Association of Clinical Chemistry: Apolipoprotein A-I (Apo A) - http://labtestsonline.org/understanding/analytes/apoa/glance.html
- American Association of Clinical Chemistry: Apolipoprotein B-100 (Apo B) - http://labtestsonline.org/understanding/analytes/apob/glance.html
- American Association of Clinical Chemistry: Apolipoprotein E (Apo E) genotyping - http://labtestsonline.org/understanding/analytes/apoe/glance.html
- American Association of Clinical Chemistry: Blood Urea Nitrogen (BUN) - http://labtestsonline.org/understanding/analytes/bun/glance.html
- American Association of Clinical Chemistry: Creatinine - http://labtestsonline.org/understanding/analytes/creatinine/glance.html
- American Association of Clinical Chemistry: Uric Acid - http://labtestsonline.org/understanding/analytes/uric_acid/glance.html
- American Association of Clinical Chemistry: Urine Protein - http://labtestsonline.org/understanding/analytes/urine_protein/glance.html
- American Association of Clinical Chemistry: Plasma Total Homocysteine (raised level is a risk factor for atherosclerosis) - http://labtestsonline.org/understanding/analytes/homocysteine/glance.html
-
American Association of Clinical Chemistry: Fibrinogen (elevated levels are seen in cases of insulin resistance) - http://labtestsonline.org/understanding/analytes/fibrinogen/glance.html
- American Association of Clinical Chemistry: Angiotensin Converting Enzyme (ACE) level: also known as SACE (Serum Angiotensin Converting Enzyme) - http://labtestsonline.org/understanding/analytes/ace/sample.html
- American Association of Clinical Chemistry: C-Reactive Protein (CRP) - http://labtestsonline.org/understanding/analytes/crp/glance.html
- American Association of Clinical Chemistry: High-sensitivity C-reactive protein (hs-CRP) - http://labtestsonline.org/understanding/analytes/hscrp/glance.html
Additional Studies for Prader-Willi Syndrome:
-
Genetic testing can be done for PWS. The
tests include:
- Chromosomal analysis and assessment for methylation patterns in the PWS region. Methylation patterns can be determined by PCR using DNA primers, which detect methylated cytosine, or by Southern blot hybridization. Samples should be taken from both parents and the child with PWS. This would enable analysis for uniparental disomy.
- Prenatal diagnosis requires chorionic villus sampling or amniocentesis in the first hand. If deletion in the 15q region is suspected, it can be confirmed by Fluorescent in situ hybridization (FISH).
- If imprinting centre mutation is found in a given patient, we should proceed to testing both parents of the given patient for the presence of asymptomatic mutations in the imprinting centre. If found, it suggests a high likelihood of recurrence.
- Medline Plus: Karyotyping (when Prader-Willi syndrome [15q-] is suspected) - http://www.nlm.nih.gov/medlineplus/ency/article/003935.htm
- American Association of Clinical Chemistry: Insulin-like Growth Factor - 1 (IGF-1) - also known as Somatomedin C - http://www.labtestsonline.org/understanding/analytes/igf1/glance.html
- Medline Plus: Bone mineral density (BMD) test: The aim is to detect and monitor osteoporosis- http://www.nlm.nih.gov/medlineplus/ency/article/007197.htm
- Medline Plus: Chest X-ray: Done if cor-pulmonale is suspected- http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm
Standard Anthropometric Measurements: The aim is to estimate the degree of visceral and subcutaneous fat.
-
Anthropometric Indicators Measurement Guide - http://www.fantaproject.org/downloads/pdfs/anthro_2003.pdf
- Centre For Ergonomics University of Michigan: Anthropometric Measurements - http://www.engin.umich.edu/dept/ioe/HUMOSIM/docs/AnthroDoc.pdf
Estimation of Skin Thickness:
- Measurement of subcutaneous fat thickness with high frequency pulsed ultrasound: comparisons with a calliper and a radiographic technique - http://ej.iop.org/links/q70/+VjY,LFNpNTba,imgUZUZw/pmv9i1p57.pdf
- The Ultimate Body Fat Testing Guide - http://www.abcbodybuilding.com/magazine/ultimatebodyfattestingguide.htm
Risk Assessment Tools:
- Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - This tool uses information from the Framingham Heart Study - http://hp2010.nhlbihin.net/atpiii/calculator.asp
Questionnaire:
- Morbid Obesity Questionnaire - http://dukehealth1.org/obesity/questionnaire.pdf
- Questionnaire to select the suitable candidate for the surgical treatment of obesity - http://www.surgery.ch/en/default.asp?id=27510
- Harvard School of Public Health: Questionnaire for estimating the risk of osteoporosis - http://www.yourdiseaserisk.harvard.edu/hccpquiz.pl?lang=english&func=start&quiz=osteoporosis
Statistics:
- UK National Statistics: Eating & exercise: 1 in 6 children were obese in 2002 - http://www.statistics.gov.uk/CCI/nugget.asp?ID=1329&Pos=6&ColRank=2&Rank=176
- UK National Statistics: Social Inequalities: More low birth weight in deprived areas - http://www.statistics.gov.uk/CCI/nugget.asp?ID=723&Pos=4&ColRank=2&Rank=176
- UK National Statistics: Obesity among adults: by sex and NS-SeC, 2001: Social Trends 34 - http://www.statistics.gov.uk/StatBase/ssdataset.asp?vlnk=7447&Pos=&ColRank=1&Rank=208
- UK National Statistics: Obesity among people aged 16 and over: by social class of head of household and gender, 1998: Social Trends 32 - http://www.statistics.gov.uk/StatBase/ssdataset.asp?vlnk=5233&Pos=1&ColRank=1&Rank=208
- UK National Statistics: Body mass among men, 1993 and 1999: Social Focus on Men - http://www.statistics.gov.uk/StatBase/ssdataset.asp?vlnk=4452&Pos=2&ColRank=2&Rank=896
- UK National Statistics: Body mass: by sex, 2001: Social Trends 33 - http://www.statistics.gov.uk/StatBase/ssdataset.asp?vlnk=6420&Pos=1&ColRank=2&Rank=672
- UK National Statistics: Percentage of people aged 16 and over who are obese: by ethnic group and gender, 1999: Social Trends 31 - http://www.statistics.gov.uk/StatBase/ssdataset.asp?vlnk=3538&Pos=4&ColRank=2&Rank=448
- US National Centre for Health Statistics: Overweight Prevalence - http://www.cdc.gov/nchs/fastats/overwt.htm
Document Provenance and History
Document Author: Dr. Fazal Danish
Document Created: 29th March 2006
Document Edits: