Estrada Elizabeth, Eneli Ihuoma, Hampl Sarah, Mietus-Snyder Michele, Mirza Nazrat, Rhodes Erinn, Sweeney Brooke, Tinajero-Deck Lydia, Woolford Susan J, Pont Stephen J
1 Division of Endocrinology, Connecticut Children's Medical Center, University of Connecticut , Hartford, CT.
Child Obes. 2014 Aug;10(4):304-17. doi: 10.1089/chi.2013.0120. Epub 2014 Jul 14.
Childhood obesity and overweight affect approximately 30% of US children. Many of these children have obesity-related comorbidities, such as hypertension, dyslipidemia, fatty liver disease, diabetes, polycystic ovary syndrome (PCOS), sleep apnea, psychosocial problems, and others. These children need routine screening and, in many cases, treatment for these conditions. However, because primary care pediatric providers (PCPs) often are underequipped to deal with these comorbidities, they frequently refer these patients to subspecialists. However, as a result of the US pediatric subspecialist shortage and considering that 12.5 million children are obese, access to care by subspecialists is limited. The aim of this article is to provide accessible, user-friendly clinical consensus statements to facilitate the screening, interpretation of results, and early treatment for some of the most common childhood obesity comorbidities.
Members of the Children's Hospital Association (formerly NACHRI) FOCUS on a Fitter Future II (FFFII), a collaboration of 25 US pediatric obesity centers, used a combination of the best available evidence and collective clinical experience to develop consensus statements for pediatric obesity-related comorbidities. FFFII also surveyed the participating pediatric obesity centers regarding their current practices.
The work group developed consensus statements for use in the evaluation and treatment of lipids, liver enzymes, and blood pressure abnormalities and PCOS in the child with overweight and obesity. The results of the FFFII survey illustrated the variability in the approach for initial evaluation and treatment as well as pattern of referrals to subspecialists among programs.
The consensus statements presented in this article can be a useful tool for PCPs in the management and overall care of children with overweight and obesity.
儿童肥胖和超重影响着约30%的美国儿童。这些儿童中有许多患有与肥胖相关的合并症，如高血压、血脂异常、脂肪肝疾病、糖尿病、多囊卵巢综合征（PCOS）、睡眠呼吸暂停、心理社会问题等。这些儿童需要进行常规筛查，并且在许多情况下需要对这些病症进行治疗。然而，由于初级保健儿科医生（PCP）往往没有足够的能力来处理这些合并症，他们经常将这些患者转诊给专科医生。然而，由于美国儿科专科医生短缺，且考虑到有1250万儿童肥胖，专科医生的医疗服务可及性有限。本文的目的是提供易于理解、用户友好的临床共识声明，以促进对一些最常见的儿童肥胖合并症的筛查、结果解读和早期治疗。
儿童医院协会（前身为NACHRI）“关注更健康的未来II”（FFFII）的成员，这是一个由25个美国儿科肥胖中心组成的合作组织，结合了现有最佳证据和集体临床经验，制定了关于儿科肥胖相关合并症的共识声明。FFFII还就其当前做法对参与的儿科肥胖中心进行了调查。
该工作组制定了共识声明，用于评估和治疗超重和肥胖儿童的血脂、肝酶、血压异常以及PCOS。FFFII调查的结果表明，各项目在初始评估和治疗方法以及转诊至专科医生的模式方面存在差异。
本文提出的共识声明可以成为初级保健儿科医生管理和全面护理超重和肥胖儿童的有用工具。
