Table 2.

Suggested screening for comorbidities in obese children and adolescents.

Conditions	Suggested assessment
Prediabetes and diabetes mellitus	Urine for glucose
	HbA1c
	Oral glucose tolerance test
Dyslipidemia	Fasting lipid profile
Prehypertension and hypertension	Blood pressure standardized according to sex, age, and height percentile
Nonalcoholic fatty liver	Liver function test (AST/ALT)
	Hepatobiliary system ultrasound
Obstructive sleep apnea	Clinical history
	If there is a positive history, referral to a respirologist should be made for overnight oximetry or polysomnography
Mental health issues	Clinical history, if positive, should lead to referral to a clinical psychologist or psychiatrist
	Consider use of validated screening tools, for example, PHQ2 for depression in a busy clinic setting
Polycystic ovarian syndrome	Clinical history (oligomenorrhea)
	Physical exam (hirsutism)
	Pelvic ultrasound (look for polycystic ovarian morphology)
	Testosterone and luteinizing hormone (LH)

Abbreviations: ALT, alanine transaminase; AST, aspartate aminotransferase; HbA1c, hemoglobin A1c; PHQ2, Patient Health Questionnaire 2.