No abstract available.
Diagnosis* ; Pediatric Obesity*

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

Overweight/obesity has become one of the major public health problems among children and adolescents all over the world. The current screening standards for overweight and obesity in children and adolescents are not unified. It is easy to make mistakes and inefficient to evaluate item by item or develop self-written packages. Taking the"Screening standards for overweight and obesity in Chinese school-age children and adolescents"as an example, this study introduced four methods and procedures for evaluating overweight and obesity among children and adolescents from the world and China and described their application methods in combination with specific cases. At the same time, the SPSS and SAS packages were compiled and the specific application steps were explained, so that users could correctly and quickly screen overweight and obesity among children and adolescents, and conduct horizontal comparisons of similar studies across different regions.
Adolescent ; Body Mass Index ; Child ; China ; Humans ; Overweight ; Pediatric Obesity/diagnosis* ; Prevalence

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

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

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 AND OBJECTIVES: Hypertension is becoming one of the most common health conditions in children and adolescents due to increasing childhood obesity. We aimed to provide the auscultatory blood pressure (BP) normative reference values for Korean non-overweight children and adolescents. METHODS: BP measurements in children and adolescents aged 10 to 18 years were performed in the Korean National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016. BP was measured using a mercury sphygmomanometer. Sex-, age- and height-specific systolic BP (SBP) and diastolic BP (DBP) percentiles were calculated in the non-overweight children (n=10,442). We used the General Additive Model for Location Scale and Shape method to calculate BP percentiles. RESULTS: The 50th, 90th, 95th, and 99th percentiles of SBP and DBP tables and graphs of non-overweight children and adolescents aged 10 to 18 years were presented by age and height percentiles. We found that the SBP and DBP at the 95th percentile were well correlated with height. The BP tables presented by height contained BP values from 124 cm to 190 cm for boys and from 120 cm to 178 cm for girls. Boys had higher SBP and DBP. CONCLUSIONS: We provided the sex-, age- and height-specific auscultatory BP values using the KNHANES big data. These may be useful in diagnosis and treatment of hypertension in Korean children and adolescents.
Adolescent ; Auscultation ; Blood Pressure ; Child ; Diagnosis ; Female ; Humans ; Hypertension ; Korea ; Methods ; Nutrition Surveys ; Pediatric Obesity ; Reference Values ; Sphygmomanometers