OBJECTIVE: To analyze the frequencies and clinical presentation of definable somatic disorders in children who are overweight. STUDY DESIGN: We assessed prospectively 1405 children aged 4 to 16 years who were overweight and came to our specialized clinic for endocrinology and obesity with a standardized diagnostic procedure. In a subgroup of 223 children, we sought mutations in the melanocortin-4-receptor gene (MC4R). RESULTS: Endocrine or syndromal disorders were diagnosed in 13 children (<1%; 4 with hypothyroidism, 1 with Cushing's syndrome, 1 with growth hormone deficiency, 2 with pseudohypoparathyroidism, 1 with pseudopseudohypoparathyroidism, 2 with Prader-Willi syndrome, 1 with Bardet-Biedl syndrome, 1 with Klinefelter syndrome). A total of 85% of these children had short stature, in marked contrast to only 0.6% of the other children. Moderately elevated thyrotropin and cortisol concentrations were observed in 4% and 5%, respectively, of all children. Non-synonymous MC4R mutations were found in 6% of the children. CONCLUSIONS: In contrast to MC4R mutations, endocrine and clinically identifiable syndromal disorders were rare in children who were overweight and always associated with further symptoms. All children who are overweight with short stature or reduced growth velocity should be carefully examined for endocrine or syndromal disorders. A general screening with laboratory measurements cannot be recommended because thyrotropin and cortisol levels are frequently moderately elevated in children who are overweight, thus entailing further superfluous diagnostic procedures.
OBJECTIVE: To analyze the frequencies and clinical presentation of definable somatic disorders in children who are overweight. STUDY DESIGN: We assessed prospectively 1405 children aged 4 to 16 years who were overweight and came to our specialized clinic for endocrinology and obesity with a standardized diagnostic procedure. In a subgroup of 223 children, we sought mutations in the melanocortin-4-receptor gene (MC4R). RESULTS: Endocrine or syndromal disorders were diagnosed in 13 children (<1%; 4 with hypothyroidism, 1 with Cushing's syndrome, 1 with growth hormone deficiency, 2 with pseudohypoparathyroidism, 1 with pseudopseudohypoparathyroidism, 2 with Prader-Willi syndrome, 1 with Bardet-Biedl syndrome, 1 with Klinefelter syndrome). A total of 85% of these children had short stature, in marked contrast to only 0.6% of the other children. Moderately elevated thyrotropin and cortisol concentrations were observed in 4% and 5%, respectively, of all children. Non-synonymous MC4R mutations were found in 6% of the children. CONCLUSIONS: In contrast to MC4R mutations, endocrine and clinically identifiable syndromal disorders were rare in children who were overweight and always associated with further symptoms. All children who are overweight with short stature or reduced growth velocity should be carefully examined for endocrine or syndromal disorders. A general screening with laboratory measurements cannot be recommended because thyrotropin and cortisol levels are frequently moderately elevated in children who are overweight, thus entailing further superfluous diagnostic procedures.
Authors: Sigri Beckers; Doreen Zegers; Fenna de Freitas; Armand V Peeters; Stijn L Verhulst; Guy Massa; Luc F Van Gaal; Jean-Pierre Timmermans; Kristine N Desager; Wim Van Hul Journal: Obes Facts Date: 2010-10-15 Impact factor: 3.942
Authors: Christian L Roth; Michael Ludwig; Joachim Woelfle; Zhen-Chuan Fan; Harald Brumm; Heike Biebermann; Ya-Xiong Tao Journal: Endocrine Date: 2009-02-12 Impact factor: 3.633
Authors: Carla I G Vogel; André Scherag; Günter Brönner; Thuy T Nguyen; Hai-Jun Wang; Harald Grallert; Alexa Bornhorst; Dieter Rosskopf; Henry Völzke; Thomas Reinehr; Winfried Rief; Thomas Illig; H-Erich Wichmann; Helmut Schäfer; Johannes Hebebrand; Anke Hinney Journal: BMC Med Genet Date: 2009-03-02 Impact factor: 2.103