No abstract available.
Diagnosis* ; Pediatric Obesity*

Diagnosis* ; Electric Impedance* ; Humans ; Obesity* ; Pediatric Obesity

30 patients of simple obesity were treated by acupuncture combined with auricular acupoint taping and pressing therapy. After treatment, body weight, total cholesterol, triglyceride and low density lipoproteine cholesterol were decrease significantly
obesity ; Acupuncture, Ear ; Therapeutics ; diagnosis ; Acupuncture

BACKGROUND: Although the obesity prevalence in Korean children and adolescents has stabilized since early 2000s, it is noted that severe obesity is increasing. However, no diagnostic criteria to define severe obesity in Korean children and adolescents has not been recommended yet. METHODS: We established two kinds of diagnostic criteria of severe obesity with the 2007 Korean National Growth Charts; 1) body mass index (BMI) criteria 1: BMI≥120% of 95th percentile or 30 kg/m², whichever is lower, 2) BMI criteria 2: ≥99th percentile. We examined the prevalence of severe obesity among children and adolescents who participated in the Fifth Korea National Health and Nutrition Examination Survey, 2010-2012 based on BMI criteria 1 and 2 as well as percentage-weight-for-height (PWH). RESULTS: We presented the age- and sex-specific BMI cut-offs of BMI criteria 1 and 2. The prevalence of severe obesity was 1.6% and 1.7% based on BMI criteria 1 and 2, respectively. The prevalence of severe obesity based on PWH was 0.8%, which was lower than the prevalences based on BMI criteria 1 and 2. CONCLUSIONS: Our diagnostic criteria of severe obesity can be utilized in the epidemiological surveys and researches before the recommendation of the formal diagnostic criteria.
Adolescent* ; Body Mass Index ; Child* ; Diagnosis* ; Growth Charts ; Humans ; Korea ; Nutrition Surveys ; Obesity ; Obesity, Morbid* ; Prevalence

Child, Preschool ; Humans ; Male ; Obesity Hypoventilation Syndrome ; diagnosis ; therapy

This article outlines the clinical values and limitations of body mass index and waist circumference for nutritional assessment among obese individuals and emphasizes the importance of combining these two parameters for diagnosis of obesity.
Body Mass Index ; Humans ; Nutrition Assessment ; Obesity ; diagnosis ; Waist Circumference

PURPOSE: The childhood obesity is currently increasing. The childhood obesity is difficult to treat and the response of treatment is transitory because it is caused by the hyperplasia of fat cells. The complications of obesity are hyperlipidemia, hypertension, diabetes, artherosclerotic coronary arterial disease and fatty liver. Therefore the early diagnosis and prevention of obesity from childhood is very important. This study was performed to identify the relation between various weight-height indices and serum lipid levels and to seek for the parameters predicting the presence of fatty liver in obese children. METHODS: Between January 1994 to August 1995, 145 children were diagnosed as obesity by height-weight indices or fat % calculated from skin fold thickness among 672 children who were take an health care services at Ewha Womans University Hospital. Thirteen children of them were complicated with fatty liver. Serum lipid levels and abdominal ultrasonography were performed in 145 obese children. RESULTS: Most obese children were 9-13 years of age. The obese children with fatty liver(85.0%) have larger proportion of moderate to severe obesity than those without fatty liver(30.3%). The analysis of height-weight indicies(obesity index, Rohrer index, body mass index) and serum lipid levels revealed that total cholesterol level highly related to RI(r=0.937) and BMI(r=0.805). There are statistically significant differences in height-weight indices between obese children with fatty liver and without fatty liver (p<0.05). There are statistically significant differences in triglyceride level and HDL cholesterol(p<0.05), not in total cholesterol and LDH cholesterol between both groups. The grade of fatty liver is significantly related to serum triglyceride level(r=0.45, p<0.05). CONCLUSIONS: The incidence of fatty liver was significantly associated with the degree of obesity and serum triglyceride level. Therefore, the serum triglyceride level is a good parameter to predict fatty liver in moderate to severe obese children.
Adipocytes ; Body Mass Index ; Child* ; Cholesterol ; Delivery of Health Care ; Early Diagnosis ; Fatty Liver* ; Female ; Humans ; Hyperlipidemias ; Hyperplasia ; Hypertension ; Incidence ; Obesity ; Obesity, Morbid ; Pediatric Obesity ; Skin ; Triglycerides ; Ultrasonography

PURPOSE: The purpose of our study is to provide useful information for diagnostic methods of fatty liver by childhood simple obesity and to provide correlation between serum alanine aminotransferase (ALT) for screening test and abdominal computerized tomography (CT) and liver biopsy for confirmative diagnostic methods of fatty liver. METHODS: Among 78 obese childrens who visited our hospital, CT was carried out in 26 childrens. Of these, liver biopsy was carried out in 15 childrens who had high obesity index or severe elevated ALT. Based on the level of serum ALT, 26 cases were classified into 3 groups, and compared with physical measurements and degree of fatty infiltration on CT and liver biopsy. RESULTS: 1) Correlation between ALT and physical measurements: Of 26 obese children, ALT was abnormally elevated (>30 IU/L) in 17 cases (67.4%) but there was no significant correlation between ALT and physical measurements (p>0.05). 2) Correlation between degree of fatty infiltration on CT and ALT: Of 26 cases, 13 cases (50%) revealed fatty liver on CT. The degree of fatty liver on CT had significant correlation with elevation of ALT (p<0.05). 3) Correlation between the degree of fatty infiltration on liver biopsy and ALT: Liver biopsy was performed in 15 cases of which 14 cases revealed fatty liver. But one case had normal hepatic histology with severe obesity and normal ALT. Fourteen fatty liver cases on liver biopsy were classified into 3 groups by the degree of fatty infiltration and analysed with obesity index and ALT. The histologic hepatic steatosis had no significant correlation with obesity index (p>0.05), but significant correlation with ALT (p<0.05). 4) Correlation between CT and liver biopsy finding: Both CT and liver biopsy were performed in 15 cases of which 6 cases revealed normal finding on CT and 9 cases manifested fatty liver. There was significant correlation between CT and liver biopsy findings (r=0.6094). CONCLUSION: The results of our study suggest that abdominal CT and liver biopsy are useful and accurate methods of estimating fatty liver in the childhood obesity. But biochemical abnormalities of routine liver function tests dot not correlate well with severity of the fatty liver and liver injury.
Alanine Transaminase ; Biopsy* ; Child* ; Diagnosis* ; Fatty Liver* ; Humans ; Liver Function Tests ; Liver* ; Mass Screening ; Obesity* ; Obesity, Morbid ; Pediatric Obesity ; Tomography, X-Ray Computed*

PURPOSE: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. METHODS: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10–18 years of age. Body mass index ≥95th percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. RESULTS: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10–17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level < 40 mg/dL (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.13–7.10; P=0.048), total cholesterol level >200mg/dL (HR, 5.6; 95% CI, 1.23–15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22–4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. CONCLUSION: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.
Body Mass Index ; Cholesterol ; Diagnosis ; Female ; Humans ; Lipoproteins ; Male ; Metabolic Diseases ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Obesity, Abdominal ; Pediatric Obesity ; Retrospective Studies ; Risk Factors ; Triglycerides ; Ultrasonography

Background: Bioelectrical impedance analysis (BIA) is frequently used to diagnose obesity in clinical setting, but the usefulness of BIA in children is not become known accurately. We analyzed the usefulness of BIA and anthropometric measurement compared with Dual-energy X-ray absorptiometry (DXA) as a diagnostic tool of childhood obesity. Methods: 205 volunteer primary and middle school children were recruited. We measured weight and height, and analyzed the body composition by BIA and DXA. By paired t-test and Bland-Altman plots, mean difference and limit of agreement were calculated between DXA and BIA according to sex and age groups. Sensitivity and specificity were displayed with the gold standard of PBF above 35% by DXA. Results: There was significantly positive correlation between DXA and BIA in fat mass (FM) (r=0.982, P<0.001), fat free mass (FFM) (r=0.990, P<0.001), and percent body fat (PBF) (r=0.956, P<0.001). Mean difference between DXA and BIA in FM, FFM, and PBF were -0.4+/-1.4 kg (P<0.001), -0.6+/-1.3 kg (P<0.001), and 0.5+/-2.8% (P=0.016), respectively. Limit of agreement in FM, FFM, and PBF were -0.4+/-2.7 kg, -0.6+/-2.5 kg, and 0.5+/-5.5%, respectively. The most sensitive method of diagnosis of obesity was Korean BMI standards for 85 percentile (94.7%) and IOTF BMI 25 kg/m2 (94.7%). The sensitivity and specificity by BIA were 90.7% and 97.7%. Conclusions: BIA was not interchangeable with DXA. However because of higher diagnostic accuracy and correlation, it could be used to measure body composition as simple field method. We recommend Korean BMI standards for 85 percentile or IOTF BMI 25 kg/m2 as the screening test for diagnosis of Korean childhood obesity.
Absorptiometry, Photon* ; Adipose Tissue ; Body Composition ; Child ; Diagnosis ; Electric Impedance ; Humans ; Mass Screening ; Obesity ; Pediatric Obesity* ; Sensitivity and Specificity ; Volunteers