Physical examination findings among children and adolescents with obesity: An evidence-based review

Pediatrics

Volumn 137, Issue 2, 2016, Pages

  Armstrong, Sarah ^a   Lazorick, Suzanne ^b   Hampl, Sarah ^c   Skelton, Joseph A ^d   Wood, Charles ^e   Collier, David ^b   Perrin, Eliana M ^e  

^a DUKE UNIVERSITY MEDICAL CENTER   (United States)

^b EAST CAROLINA UNIVERSITY   (United States)

^c CHILDREN S MERCY HOSPITAL   (United States)

^d WAKE FOREST SCHOOL OF MEDICINE   (United States)

^e UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ABDOMINAL PAIN; ACANTHOSIS NIGRICANS; ACNE; ADENOTONSILLAR HYPERTROPHY; ADOLESCENT; ADOLESCENT OBESITY; AWARENESS; BLUNTED AFFECT; CERVICODORSAL HUMP; CHILD; CHILDHOOD OBESITY; CLINICAL FEATURE; DENTAL CARIES; DISEASE ASSOCIATION; DISEASE SEVERITY; FLATFOOT; GAIT DISORDER; GYNECOMASTIA; HEPATOMEGALY; HIRSUTISM; HUMAN; HYPERTENSION; INCONSPICUOUS PENIS; INTERTRIGO; LORDOSIS; OUTCOME ASSESSMENT; PANNUS; PENIS DISEASE; PHYSICAL EXAMINATION; PREVALENCE; PRIORITY JOURNAL; QUANTITATIVE ANALYSIS; RESTING HEART RATE; REVIEW; SCOLIOSIS; SLIPPED CAPITAL FEMORAL EPIPHYSIS; SPINE DISEASE; STRIA; TACHYCARDIA; TREATMENT RESPONSE; VALGUS KNEE; VARUS KNEE; COMPLICATION; OBESITY; PATHOPHYSIOLOGY; PROCEDURES; PSYCHOLOGY; SEVERITY OF ILLNESS INDEX;

ADOLESCENT; CHILD; HUMANS; OBESITY; PHYSICAL EXAMINATION; SEVERITY OF ILLNESS INDEX;

EID: 84958720052     PISSN: 00314005     EISSN: 10984275     Source Type: Journal    
DOI: 10.1542/peds.2015-1766     Document Type: Review

References (154)

1. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(suppl 2, 4th Report):555-576
2. Feld LG, Corey H. Hypertension in childhood. Pediatr Rev. 2007;28(8):283-298
3. Mazor S, Mazor R. Approach to the child with tachycardia. UpToDate. June 23, 2014. Available at: http://www.uptodate. com/contents/approach-to-The-child-withpalpitations. Accessed December 7, 2015
4. Chianese J. Short stature. Pediatr Rev. 2005;26(1):36-37
5. Distelmaier F, Sengler U, Messing-Juenger M, Assmann B, Mayatepek E, Rosenbaum T. Pseudotumor cerebri as an important differential diagnosis of papilledema in children. Brain Dev. 2006;28(3):190-195
6. Georgiadis E, Papandreou L, Evangelopoulou C, et al. Incidence of gynaecomastia in 954 young males and its relationship to somatometric parameters. Ann Hum Biol. 1994;21(6):579-587
7. Einav-Bachar R, Phillip M, Aurbach-Klipper Y, Lazar L. Prepubertal gynaecomastia: aetiology, course and outcome. Clin Endocrinol (Oxf). 2004;61(1):55-60
8. Ersöz H, Onde ME, Terekeci H, Kurtoglu S, Tor H. Causes of gynaecomastia in young adult males and factors associated with idiopathic gynaecomastia. Int J Androl. 2002;25(5):312-316
9. Lo JC, Mulligan K, Tai VW, Algren H, Schambelan M. "Buffalo hump" in men with HIV-1 infection. Lancet. 1998;351(9106):867-870
10. Wolf DC. Evaluation of the size, shape, and consistency of the liver. In: Walker HK, Hall WD, Hurts JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston, MA: Butterworths; 1990
11. Wolf AD, Lavine JE. Hepatomegaly in neonates and children. Pediatr Rev. 2000;21(9):303-310
12. Bergeson PS, Hopkin RJ, Bailey RB Jr, McGill LC, Piatt JP. The inconspicuous penis. Pediatrics. 1993;92(6):794-799
13. Goldberg CJ, Moore DP, Fogarty EE, Dowling FE. Scoliosis: A review. Pediatr Surg Int. 2008;24(2):129-144
14. Houghton KM. Review for the generalist: evaluation of pediatric hip pain. Pediatr Rheumatol Online J. 2009;7:10
15. Stevens PM, Holmstrom MC. Pediatric genu varum. 2013. Available at: http://emedicine. medscape. com/article/1355974-overview. Accessed April 19, 2015
16. Buchanan M, Berlet GC, Raissi A. Pes planus. 2014. Available at: http://emedicine. medscape. com/article/1236652-overview. Accessed April 19, 2015
17. De Sanctis V, Soliman A, Marsciani A, et al. Acanthosis nigricans in adolescents: A practical approach. Georgian Med News. 2013;(222):73-78
18. Higgins SP, Freemark M, Prose NS. Acanthosis nigricans: A practical approach to evaluation and management. Dermatol Online J. 2008;14(9):2
19. Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007;57(3):502-508
20. Burke JP, Hale DE, Hazuda HP, Stern MP. A quantitative scale of acanthosis nigricans. Diabetes Care. 1999;22(10):1655-1659
21. Legro RS, Arslanian SA, Ehrmann DA, et al; Endocrine Society. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565-4592
22. Scheinfeld NS. Obesity and dermatology. Clin Dermatol. 2004;22(4):303-309
23. Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007;56(6):901-916, quiz 917-920
24. Borud LJ, Warren AG. Body contouring in the postbariatric surgery patient. J Am Coll Surg. 2006;203(1):82-93
25. Babinska K, Kovacs L, Janko V, Dallos T, Feber J. Association between obesity and the severity of ambulatory hypertension in children and adolescents. J Am Soc Hypertens. 2012;6(5):356-363
26. Flynn J. The changing face of pediatric hypertension in the era of the childhood obesity epidemic. Pediatr Nephrol. 2013;28(7):1059-1066
27. Becton LJ, Shatat IF, Flynn JT. Hypertension and obesity: epidemiology, mechanisms and clinical approach. Indian J Pediatr. 2012;79(8):1056-1061
28. Csábi GY, Juricskay S, Molnár D. Urinary cortisol to cortisone metabolites in hypertensive obese children. J Endocrinol Invest. 2000;23(7):435-439
29. Baráth A, Túri S, Németh I, et al. Different pathomechanisms of essential and obesity-associated hypertension in adolescents. Pediatr Nephrol. 2006;21(10):1419-1425
30. Li S, Chen W, Yun M, et al. Sex and race (black-white) differences in the relationship of childhood risk factors to adulthood arterial stiffness: The Bogalusa Heart Study. Am J Med Sci. 2014;348(2):101-107
31. Ribstein J, du Cailar G, Mimran A. Combined renal effects of overweight and hypertension. Hypertension. 1995;26(4):610-615
32. Sasatomi Y, Tada M, Uesugi N, Hisano S, Takebayashi S. Obesity associated with hypertension or hyperlipidemia accelerates renal damage. Pathobiology. 2001;69(2):113-118
33. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128(suppl 5):S213-S256
34. Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr. 2008;152(1):73-78.e71
35. Movahed MR, Bates S, Strootman D, Sattur S. Obesity in adolescence is associated with left ventricular hypertrophy and hypertension. Echocardiography. 2011;28(2): 150-153
36. Gillette PC, Garson A Jr, Porter CJ, McNamara DG. Dysrhythmias. In: Adams FH, Emmanouilides GC, Riemenschneider TA, eds. Moss' Heart Disease in Infants, Children and Adolescents. 4th ed. Baltimore, MD: Williams & Wilkin; 1989
37. Baba R, Koketsu M, Nagashima M, Inasaka H, Yoshinaga M, Yokota M. Adolescent obesity adversely affects blood pressure and resting heart rate. Circ J. 2007;71(5):722-726
38. Sorof JM, Poffenbarger T, Franco K, Bernard L, Portman RJ. Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children. J Pediatr. 2002;140(6):660-666
39. Julius S, Valentini M, Palatini P. Overweight and hypertension: A 2-way street? Hypertension. 2000;35(3):807-813
40. Palatini P, Julius S. Elevated heart rate: A major risk factor for cardiovascular disease. Clin Exp Hypertens. 2004;26(7-8):637-644
41. He Q, Karlberg J. BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res. 2001;49(2):244-251
42. Mercille G, Ospina LH. Pediatric idiopathic intracranial hypertension: A review. Pediatr Rev. 2007;28(11):e77-e86
43. Faz G, Butler IJ, Koenig MK. Incidence of papilledema and obesity in children diagnosed with idiopathic "benign" intracranial hypertension: case series and review. J Child Neurol. 2010;25(11):1389-1392
44. Weig SG. Asymptomatic idiopathic intracranial hypertension in young children. J Child Neurol. 2002;17(3):239-241
45. Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol. 2006;5(5):433-442
46. Frisén L. Swelling of the optic nerve head: A staging scheme. J Neurol Neurosurg Psychiatry. 1982;45(1):13-18
47. Hooley M, Skouteris H, Boganin C, Satur J, Kilpatrick N. Body mass index and dental caries in children and adolescents: A systematic review of literature published 2004 to 2011. Syst Rev. 2012;1(1):57
48. Hayden C, Bowler JO, Chambers S, et al. Obesity and dental caries in children: A systematic review and meta-analysis. Community Dent Oral Epidemiol. 2013;41(4):289-308
49. Modéer T, Blomberg CC, Wondimu B, Julihn A, Marcus C. Association between obesity, flow rate of whole saliva, and dental caries in adolescents. Obesity (Silver Spring). 2010;18(12):2367-2373
50. Pannunzio E, Amancio OMS, Vitalle MS, Souza DN, Mendes FM, Nicolau J. Analysis of the stimulated whole saliva in overweight and obese school children. Rev Assoc Med Bras. 2010;56(1):32-36
51. González LC, Villa CG, Cárdenas AC. Prader Willi syndrome: saliva quantification and culture in 10 patients. Med Oral Patol Oral Cir Bucal. 2008;13(12):E774-777
52. Saeves R, Nordgarden H, Storhaug K, Sandvik L, Espelid I. Salivary flow rate and oral findings in Prader-Willi syndrome: A case-control study. Int J Paediatr Dent. 2012;22(1):27-36
53. Must A, Phillips SM, Tybor DJ, Lividini K, Hayes C. The association between childhood obesity and tooth eruption. Obesity (Silver Spring). 2012;20(10):2070-2074
54. Sánchez-Pérez L, Irigoyen ME, Zepeda M. Dental caries, tooth eruption timing and obesity: A longitudinal study in a group of Mexican schoolchildren. Acta Odontol Scand. 2010;68(1):57-64
55. Preis SR, Massaro JM, Hoffmann U, et al. Neck circumference as a novel measure of cardiometabolic risk: The Framingham Heart study. J Clin Endocrinol Metab. 2010;95(8):3701-3710
56. Laakso M, Matilainen V, Keinanen-Kiukaanniemi S. Association of neck circumference with insulin resistancerelated factors. Int J Obes Relat Metab Disord. 2002;26(6):873-875
57. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736-747
58. Androutsos O, Grammatikaki E, Moschonis G, et al. Neck circumference: A useful screening tool of cardiovascular risk in children. Pediatr Obes. 2012;7(3):187-195
59. de Sousa Caixeta JA, Saramago AM, de Cacia Pradella-Hallinan ML, Moreira GA, Tufik S, Fujita RR. Waistto-height ratio distinguish obstructive sleep apnea from primary snoring in obese children. Sleep Breath. 2015;19(1):231-237
60. Lam YY, Chan EY, Ng DK, et al. The correlation among obesity, apneahypopnea index, and tonsil size in children. Chest. 2006;130(6):1751-1756
61. Dayyat E, Kheirandish-Gozal L, Sans Capdevila O, Maarafeya MM, Gozal D. Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy. Chest. 2009;136(1):137-144
62. Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea. PLoS One. 2013;8(10):e78666
63. Hsing AW, McLaughlin JK, Cocco P, Co Chien HT, Fraumeni JF Jr. Risk factors for male breast cancer (United States). Cancer Causes Control. 1998;9(3):269-275
64. Hammond DC. Surgical correction of gynecomastia. Plast Reconstr Surg. 2009;124(1 Suppl):61e-68e
65. Rosen H, Webb ML, DiVasta AD, et al. Adolescent gynecomastia: not only an obesity issue. Ann Plast Surg. 2010;64(5):688-690
66. Joseph PR, Fort P. Observations on the buffalo hump. Clin Pediatr (Phila). 1999;38(10):622-623
67. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118(4):1388-1393
68. Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE. Influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics. 2005;115(5). Available at: www.pediatrics.org/cgi/content/full/115/5/e561
69. Feldstein AE, Charatcharoenwitthaya P, Treeprasertsuk S, Benson JT, Enders FB, Angulo P. The natural history of non-alcoholic fatty liver disease in children: A follow-up study for up to 20 years. Gut. 2009;58(11):1538-1544
70. Baker S, Barlow S, Cochran W, et al. Overweight children and adolescents: A clinical report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005;40(5):533-543
71. Fishbein M, Mogren J, Mogren C, Cox S, Jennings R. Undetected hepatomegaly in obese children by primary care physicians: A pitfall in the diagnosis of pediatric nonalcoholic fatty liver disease. Clin Pediatr (Phila). 2005;44(2):135-141
72. Fishbein MH, Miner M, Mogren C, Chalekson J. The spectrum of fatty liver in obese children and the relationship of serum aminotransferases to severity of steatosis. J Pediatr Gastroenterol Nutr. 2003;36(1):54-61
73. Gupta K, Dhawan A, Abel C, Talley N, Attia J. A re-evaluation of the scratch test for locating the liver edge. BMC Gastroenterol. 2013;13:35
74. Akcam M, Boyaci A, Pirgon O, Koroglu M, Dundar BN. Importance of the liver ultrasound scores in pubertal obese children with nonalcoholic fatty liver disease. Clin Imaging. 2013;37(3):504-508
75. Warren AG, Peled ZM, Borud LJ. Surgical correction of a buried penis focusing on the mons as an anatomic unit. J Plast Reconstr Aesthet Surg. 2009;62(3):388-392
76. King ICC, Tahir A, Ramanathan C, Siddiqui H. Buried penis: evaluation of outcomes in children and adults, modification of a unified treatment algorithm, and review of the literature. ISRN Urol. 2013;2013:109349
77. Crawford BS. Buried penis. Br J Plast Surg. 1977;30(1):96-99
78. Blakemore VJ, Fink PW, Lark SD, Shultz SP. Mass affects lower extremity muscle activity patterns in children's gait. Gait Posture. 2013;38(4):609-613
79. de Sá Pinto AL, de Barros Holanda PM, Radu AS, Villares SM, Lima FR. Musculoskeletal findings in obese children. J Paediatr Child Health. 2006;42(6):341-344
80. Shultz SP, D'Hondt E, Fink PW, Lenoir M, Hills AP. The effects of pediatric obesity on dynamic joint malalignment during gait. Clin Biomech (Bristol, Avon). 2014;29(7):835-838
81. Matusik E, Durmała J, Matusik P, Piotrowski J. Evaluation of nutritional status of children and adolescents with idiopathic scoliosis: A pilot study. Ortop Traumatol Rehabil. 2012;14(4):351-362
82. El-Hawary R, Chukwunyerenwa C. Update on evaluation and treatment of scoliosis. Pediatr Clin North Am. 2014;61(6):1223-1241
83. O'Neill PJ, Karol LA, Shindle MK, et al. Decreased orthotic effectiveness in overweight patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2005;87(5):1069-1074
84. Hardesty CK, Poe-Kochert C, Son-Hing JP, Thompson GH. Obesity negatively affects spinal surgery in idiopathic scoliosis. Clin Orthop Relat Res. 2013;471(4):1230-1235
85. Kenanidis E, Potoupnis ME, Papavasiliou KA, Sayegh FE, Kapetanos GA. Adolescent idiopathic scoliosis and exercising: is there truly a liaison? Spine. 2008;33(20):2160-2165
86. Smith AJ, O'Sullivan PB, Beales DJ, de Klerk N, Straker LM. Trajectories of childhood body mass index are associated with adolescent sagittal standing posture. Int J Pediatr Obes. 2011;6(2-2):e97-e106
87. Gettys FK, Jackson JB, Frick SL. Obesity in pediatric orthopaedics. Orthop Clin North Am. 2011;42(1):95-105, vii
88. Peck D. Slipped capital femoral epiphysis: diagnosis and management. Am Fam Physician. 2010;82(3):258-262
89. Manoff EM, Banffy MB, Winell JJ. Relationship between body mass index and slipped capital femoral epiphysis. J Pediatr Orthop. 2005;25(6):744-746
90. Wilcox PG, Weiner DS, Leighley B. Maturation factors in slipped capital femoral epiphysis. J Pediatr Orthop. 1988;8(2):196-200
91. Loder RT. The demographics of slipped capital femoral epiphysis. An international multicenter study. Clin Orthop Relat Res. 1996; (322):8-27
92. Bhatia NN, Pirpiris M, Otsuka NY. Body mass index in patients with slipped capital femoral epiphysis. J Pediatr Orthop. 2006;26(2):197-199
93. Spero CR, Masciale JP, Tornetta P III, Star MJ, Tucci JJ. Slipped capital femoral epiphysis in black children: incidence of chondrolysis. J Pediatr Orthop. 1992;12(4):444-448
94. Perron AD, Miller MD, Brady WJ. Orthopedic pitfalls in the ED: slipped capital femoral epiphysis. Am J Emerg Med. 2002;20(5):484-487
95. Westberry DE, Davids JR, Cross A, Tanner SL, Blackhurst DW. Simultaneous biplanar fluoroscopy for the surgical treatment of slipped capital femoral epiphysis. J Pediatr Orthop. 2008;28(1):43-48
96. Azzopardi T, Sharma S, Bennet GC. Slipped capital femoral epiphysis in children aged less than 10 years. J Pediatr Orthop B. 2010;19(1):13-18
97. McMillan AG, Pulver AM, Collier DN, Williams DS. Sagittal and frontal plane joint mechanics throughout the stance phase of walking in adolescents who are obese. Gait Posture. 2010;32(2):263-268
98. Kaspiris A, Zaphiropoulou C, Vasiliadis E. Range of variation of genu valgum and association with anthropometric characteristics and physical activity: comparison between children aged 3-9 years. J Pediatr Orthop B. 2013;22(4):296-305
99. Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001;286(2):188-195
100. Zhang AL, Exner GU, Wenger DR. Progressive genu valgum resulting from idiopathic lateral distal femoral physeal growth suppression in adolescents. J Pediatr Orthop. 2008;28(7):752-756
101. Greene WB; American Academy of Orthopedic Surgeons Staff; American Academy of Pediatrics Staff. Essentials of musculoskeletal care. 2nd ed. Rosemont, IL: American Academy of Orthopaedic; 2001
102. Wearing SC, Smeathers JE, Sullivan PM, Yates B, Urry SR, Dubois P. Plantar fasciitis: are pain and fascial thickness associated with arch shape and loading? Phys Ther. 2007;87(8):1002-1008
103. Hills AP, Hennig EM, McDonald M, Bar-Or O. Plantar pressure differences between obese and non-obese adults: A biomechanical analysis. Int J Obes Relat Metab Disord. 2001;25(11):1674-1679
104. Willems TM, De Clercq D, Delbaere K, Vanderstraeten G, De Cock A, Witvrouw E. A prospective study of gait related risk factors for exercise-related lower leg pain. Gait Posture. 2006;23(1):91-98
105. Adoracion Villarroya M, Manuel Esquivel J, Tomas C, Buenafe A, Moreno L. Foot structure in overweight and obese children. Int J Pediatr Obes. 2008;3(1):39-45
106. Chang JH, Wang SH, Kuo CL, Shen HC, Hong YW, Lin LC. Prevalence of flexible flatfoot in Taiwanese schoolaged children in relation to obesity, gender, and age. Eur J Pediatr. 2010;169(4):447-452
107. Chen KC, Yeh CJ, Tung LC, Yang JF, Yang SF, Wang CH. Relevant factors influencing flatfoot in preschoolaged children. Eur J Pediatr. 2011;170(7):931-936
108. Mauch M, Grau S, Krauss I, Maiwald C, Horstmann T. Foot morphology of normal, underweight and overweight children. Int J Obes. 2008;32(7):1068-1075
109. Mickle KJ, Steele JR, Munro BJ. Does excess mass affect plantar pressure in young children? Int J Pediatr Obes. 2006;1(3):183-188
110. Mickle KJ, Steele JR, Munro BJ. The feet of overweight and obese young children: are they flat or fat? Obesity (Silver Spring). 2006;14(11):1949-1953
111. Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics. 2006;118(2):634-639
112. Riddiford-Harland DL, Steele JR, Baur LA. Medial midfoot fat pad thickness and plantar pressures: are these related in children? Int J Pediatr Obes. 2011;6(3-4):261-266
113. Riddiford-Harland DL, Steele JR, Baur LA. Are the feet of obese children fat or flat? Revisiting the debate. Int J Obes. 2011;35(1):115-120
114. Riddiford-Harland DL, Steele JR, Storlien LH. Does obesity influence foot structure in prepubescent children? Int J Obes Relat Metab Disord. 2000;24(5):541-544
115. Tenenbaum S, Hershkovich O, Gordon B, et al. Flexible pes planus in adolescents: body mass index, body height, and gender-an epidemiological study. Foot Ankle Int. 2013;34(6):811-817
116. Villarroya MA, Esquivel JM, Tomás C, Moreno LA, Buenafé A, Bueno G. Assessment of the medial longitudinal arch in children and adolescents with obesity: footprints and radiographic study. Eur J Pediatr. 2009;168(5):559-567
117. Harris EJ, Vanore JV, Thomas JL, Kravitz SR, Mendelson SA, Mendicino RW, et al Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg. 2004;43(6):341-373
118. Rome K, Ashford RL, Evans A. Nonsurgical interventions for paediatric pes planus. Cochrane Database Syst Rev. 2010;(7):CD006311
119. Galhardo J, Hunt LP, Shield JP. Serum levels of pigment epitheliumderived factor (PEDF) are positively associated with acanthosis nigricans in obese adolescents. Diabet Med. 2012;29(7):e117-120
120. Abraham C, Rozmus CL. Is acanthosis nigricans a reliable indicator for risk of type 2 diabetes in obese children and adolescents? A systematic review. J School Nurs. 2012;28(3):195-205
121. Brickman WJ, Huang J, Silverman BL, Metzger BE. Acanthosis nigricans identifies youth at high risk for metabolic abnormalities. J Pediatr. 2010;156(1):87-92
122. Fowler SP, Puppala S, Arya R, et al. Genetic epidemiology of cardiometabolic risk factors and their clustering patterns in Mexican American children and adolescents: The SAFARI Study. Hum Genet. 2013;132(9):1059-1071
123. Kluczynik CE, Mariz LS, Souza LC, Solano GB, Albuquerque FC, Medeiros CC. Acanthosis nigricans and insulin resistance in overweight children and adolescents. An Bras Dermatol. 2012;87(4):531-537
124. Guran T, Turan S, Akcay T, Bereket A. Significance of acanthosis nigricans in childhood obesity. J Paediatr Child Health. 2008;44(6):338-341
125. Reeds DN, Stuart CA, Perez O, Klein S. Adipose tissue, hepatic, and skeletal muscle insulin sensitivity in extremely obese subjects with acanthosis nigricans. Metabolism. 2006;55(12):1658-1663
126. Copeland K, Pankratz K, Cathey V, et al. Acanthosis Nigricans, insulin resistance (HOMA) and dyslipidemia among Native American children. J Okla State Med Assoc. 2006;99(1):19-24
127. Rafalson L, Pham TH, Willi SM, Marcus M, Jessup A, Baranowski T. The association between acanthosis nigricans and dysglycemia in an ethnically diverse group of eighth grade students. Obesity (Silver Spring). 2013;21(3):E328-E333
128. Scott LK, Hall LM. Reliability and validity of the acanthosis nigricans screening tool for use in elementary school-age children by school nurses. J School Nurs. 2012;28(6):442-447
129. Ahmed A, Matthews M, Browning JC. Verruca vulgaris in a plaque of acanthosis nigricans. Dermatol Online J. 2011;17(6):9
130. Felszeghy E, Káposzta R, Juhász E, Kardos L, Ilyés I. Alterations of carbohydrate and lipoprotein metabolism in childhood obesity-impact of insulin resistance and acanthosis nigricans. J Pediatr Endocrinol Metab. 2009;22(12):1117-1126
131. Romo A, Benavides S. Treatment options in insulin resistance obesityrelated acanthosis nigricans. Ann Pharmacother. 2008;42(7):1090-1094
132. Christensen SB, Black MH, Smith N, et al. Prevalence of polycystic ovary syndrome in adolescents. Fertil Steril. 2013;100(2):470-477
133. Knudsen KL, Blank SK, Burt Solorzano C, et al. Hyperandrogenemia in obese peripubertal girls: correlates and potential etiological determinants. Obesity (Silver Spring). 2010;18(11):2118-2124
134. Amato MC, Galluzzo A, Merlino S, Mattina A, Richiusa P, Criscimanna A, et al Lower insulin sensitivity differentiates hirsute from nonhirsute Sicilian women with polycystic ovary syndrome. Eur J Endocrinol. 2006;155(6):859-865
135. Epstein LH, Fletcher KD, O'Neill J, Roemmich JN, Raynor H, Bouton ME. Food characteristics, long-term habituation and energy intake. Laboratory and field studies. Appetite. 2013;60(1):40-50
136. Hsu HS, Chen W, Chen SC, Ko FD. Colored striae in obese children and adolescents. Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi. 1996;37(5):349-352
137. Bruno OD, Juárez-Allen L, Rossi MA, Longobardi V. In what clinical settings should Cushing's syndrome be suspected? Medicina (B Aires). 2009;69(6):674-680
138. Nino M, Franzese A, Ruggiero Perrino N, Balato N. The effect of obesity on skin disease and epidermal permeability barrier status in children. Pediatr Dermatol. 2012;29(5):567-570
139. Yosipovitch G, Tur E, Cohen O, Rusecki Y. Skin surface pH in intertriginous areas in NIDDM patients. Possible correlation to candidal intertrigo. Diabetes Care. 1993;16(4):560-563
140. Gallagher S, Gates JL. Obesity, panniculitis, panniculectomy, and wound care: understanding the challenges. J Wound Ostomy Continence Nurs. 2003;30(6):334-341
141. Vander Wal JS, Mitchell ER. Psychological complications of pediatric obesity. Pediatr Clin North Am. 2011;58(6):1393-1401, x
142. Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007;120(suppl 4):S193-S228
143. Zeller MH, Modi AC, Noll JG, Long JD, Inge TH. Psychosocial functioning improves following adolescent bariatric surgery. Obesity (Silver Spring). 2009;17(5):985-990
144. Zeller MH, Modi AC. Predictors of health-related quality of life in obese youth. Obesity (Silver Spring). 2006;14(1):122-130
145. Anderson SE, Cohen P, Naumova EN, Jacques PF, Must A. Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosom Med. 2007;69(8):740-747
146. Eisenberg ME, Neumark-Sztainer D, Story M. Associations of weight-based teasing and emotional well-being among adolescents. Arch Pediatr Adolesc Med. 2003;157(8):733-738
147. Goodman E, Whitaker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics. 2002;110(3):497-504
148. Liem ET, Sauer PJ, Oldehinkel AJ, Stolk RP. Association between depressive symptoms in childhood and adolescence and overweight in later life: review of the recent literature. Arch Pediatr Adolesc Med. 2008;162(10):981-988
149. Dreyer ML, Egan AM. Psychosocial functioning and its impact on implementing behavioral interventions for childhood obesity. Prog Pediatr Cardiol. 2008;25(2):159-166
150. Zeller M, Kirk S, Claytor R, et al. Predictors of attrition from a pediatric weight management program. J Pediatr. 2004;144(4):466-470
151. Weitzman C, Wegner L; Section on Developmental and Behavioral Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Council on Early Childhood; Society for Developmental and Behavioral Pediatrics; American Academy of Pediatrics. Promoting optimal development: screening for behavioral and emotional problems. Pediatrics. 2015;135(2):384-395
152. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613
153. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a twoitem depression screener. Med Care. 2003;41(11):1284-1292
154. Gardner W, Murphy M, Childs G, et al. The PSC-17: A brief pediatric symptom checklist with psychosocial problem subscales. A report from PROS and ASPN. Ambul Child Health. 1999;5(3):225