Assessment of Guideline-Recommended Laboratory Screening for Obesity-Related Chronic Conditions in US Youth 10–18 Years

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-08-03 DOI:10.1002/oby.24365

Samantha Lange Pierce, Emily M. Kraus, Renee Porter, Mona Sharifi, Lyudmyla Kompaniyets, Alyson B. Goodman

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Abstract

Objective

The 2023 American Academy of Pediatrics clinical practice guideline (CPG) recommends testing children aged ≥ 10 years with obesity for abnormalities in lipids, glucose metabolism, and liver function. We aimed to assess laboratory screening and test results for three obesity-related chronic conditions in a large cohort of US patients 10–18 years with obesity.

Methods

We used electronic health record data to estimate (1) prevalence of screening for diabetes, dyslipidemia, and nonalcoholic fatty liver disease (NAFLD), individually and in combination, and (2) prevalence of abnormal test results, by obesity severity and demographics.

Results

Among 333,110 patients with obesity, only one-quarter (26%) were screened for diabetes, dyslipidemia, or NAFLD during 2020–2022. Among those screened, complete screening (all three conditions) occurred half of the time. Screening rates were significantly higher in those with more severe obesity, yet 64% of children with class 3 obesity remained unscreened. When screening occurred, results revealed a high proportion of abnormal lipid (56%), NAFLD (44% elevated or borderline), and diabetes markers (14% prediabetes or diabetes).

Conclusions

Most youth with obesity were not screened for chronic conditions. Many who were screened had abnormal results. These findings establish baseline estimates and highlight opportunities for improvement in uptake of CPG recommendations to support evidence-based obesity pediatric care.

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美国10-18岁青少年肥胖相关慢性疾病实验室筛查指南推荐评估

目的：2023年美国儿科学会临床实践指南（CPG）建议对≥10岁的肥胖儿童进行血脂、葡萄糖代谢和肝功能异常检测。我们的目的是评估美国10-18岁肥胖患者中三种肥胖相关慢性疾病的实验室筛查和测试结果。方法：我们使用电子健康记录数据来估计(1)糖尿病、血脂异常和非酒精性脂肪性肝病（NAFLD）筛查的流行程度，无论是单独的还是联合的，以及(2)根据肥胖严重程度和人口统计学的异常检测结果的流行程度。结果：在333,110例肥胖患者中，只有四分之一（26%）在2020-2022年期间进行了糖尿病、血脂异常或NAFLD筛查。在接受筛查的人群中，有一半的时间进行了完全筛查（所有三种情况）。严重肥胖儿童的筛查率明显较高，但仍有64%的3级肥胖儿童未接受筛查。当进行筛查时，结果显示异常脂质（56%）、NAFLD（44%升高或边缘性）和糖尿病标志物（14%为糖尿病前期或糖尿病）的比例很高。结论：大多数青少年肥胖患者没有进行慢性疾病筛查。许多接受筛查的人结果都不正常。这些发现建立了基线估计，并强调了改善CPG建议的机会，以支持循证肥胖儿科护理。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.