BACKGROUND: Increasing prevalence of childhood obesity has resulted in an accelerating rate of referrals of overweight patients to pediatric clinics for exclusion of endocrine or metabolic etiologies. The exclusion of Cushing's disease (CD) requires complex and potentially invasive investigations. OBJECTIVE: To evaluate the sensitivity of accurate measurements of height, weight and body mass index (BMI) in discriminating between simple obesity and CD. METHODS AND PATIENTS: Height, weight and BMI were measured at diagnosis in 25 patients with CD; 14 males, 11 females, mean age 12.9 yr (6.4-17.8) and 41 patients with simple obesity (SO), defined as BMI >2.0 SD; 20 males, 21 females, mean age 9.4 yr (3.5-15.6). RESULTS: Mean (+/-SE) BMI SDS in the CD patients was 2.41+/-0.5 and in the SO patients 3.71+/-1.3. Height SDS in the CD patients was -1.88+/-0.24 and in the SO patients 1.18+/-0.19 (p<0.05). The mean (+/-SE) BMI SDS to height SDS ratio was significantly decreased in the CD compared with the SO patients; -1.81+/-0.54 vs +0.90+/-1.17 (p<0.0001). CONCLUSIONS: Simple, accurate measurement of height and BMI SDS values provides a quick, and sensitive diagnostic discriminator in pediatric patients with CD or SO, thus potentially avoiding complex investigations.
BACKGROUND: Increasing prevalence of childhood obesity has resulted in an accelerating rate of referrals of overweight patients to pediatric clinics for exclusion of endocrine or metabolic etiologies. The exclusion of Cushing's disease (CD) requires complex and potentially invasive investigations. OBJECTIVE: To evaluate the sensitivity of accurate measurements of height, weight and body mass index (BMI) in discriminating between simple obesity and CD. METHODS AND PATIENTS: Height, weight and BMI were measured at diagnosis in 25 patients with CD; 14 males, 11 females, mean age 12.9 yr (6.4-17.8) and 41 patients with simple obesity (SO), defined as BMI >2.0 SD; 20 males, 21 females, mean age 9.4 yr (3.5-15.6). RESULTS: Mean (+/-SE) BMI SDS in the CDpatients was 2.41+/-0.5 and in the SO patients 3.71+/-1.3. Height SDS in the CDpatients was -1.88+/-0.24 and in the SO patients 1.18+/-0.19 (p<0.05). The mean (+/-SE) BMI SDS to height SDS ratio was significantly decreased in the CD compared with the SO patients; -1.81+/-0.54 vs +0.90+/-1.17 (p<0.0001). CONCLUSIONS: Simple, accurate measurement of height and BMI SDS values provides a quick, and sensitive diagnostic discriminator in pediatric patients with CD or SO, thus potentially avoiding complex investigations.
Authors: Phyllis W Speiser; Mary C J Rudolf; Henry Anhalt; Cecilia Camacho-Hubner; Francesco Chiarelli; Alon Eliakim; Michael Freemark; Annette Gruters; Eli Hershkovitz; Lorenzo Iughetti; Heiko Krude; Yael Latzer; Robert H Lustig; Ora Hirsch Pescovitz; Orit Pinhas-Hamiel; Alan D Rogol; Shlomit Shalitin; Charles Sultan; Daniel Stein; Pnina Vardi; George A Werther; Zvi Zadik; Nehama Zuckerman-Levin; Zeev Hochberg Journal: J Clin Endocrinol Metab Date: 2004-12-14 Impact factor: 5.958
Authors: Helen L Storr; Farhad Afshar; Matthew Matson; Ian Sabin; Kate M Davies; Jane Evanson; P Nicholas Plowman; G Michael Besser; John P Monson; Ashley B Grossman; Martin O Savage Journal: Eur J Endocrinol Date: 2005-06 Impact factor: 6.664
Authors: Maria Güemes; Philip G Murray; Caroline E Brain; Helen A Spoudeas; Catherine J Peters; Peter C Hindmarsh; Mehul T Dattani Journal: Eur J Pediatr Date: 2016-05-12 Impact factor: 3.183