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Paediatric obesity complications — RACP Paediatrics MCQ

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ModerateEndocrinology and growthPaediatric obesity complicationsRACP Paediatrics

A 14-year-old has BMI above the 99th centile, acanthosis nigricans and a family history of type 2 diabetes. Blood pressure is high and ALT is mildly elevated. What is the most appropriate investigation?

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Correct answer: C — Screen for type 2 diabetes, dyslipidaemia and fatty liver disease

Severe obesity with acanthosis and raised ALT warrants cardiometabolic screening including glycaemia, lipids and liver assessment. Fasting insulin is not usually needed to diagnose insulin resistance or guide first-line management. The pearl is that obesity assessment should look for complications and contributors while using non-stigmatising, family-centred language.

Reference: RCH Clinical Practice Guidelines: Obesity; Therapeutic Guidelines (eTG)