Obesity in Children with Down Syndrome: Background and Recommendations for Management

Julie Murray, MSN, BA, RN, CPNP; Patricia Ryan-Krause, MS, MSN, RN, CPNP

Disclosures

Pediatr Nurs. 2010;36(6):314-319. 

In This Article

Laboratory Assessment

Laboratory evaluation will contribute to the assessment of the child with Down syndrome who is obese (see Table 2). As stated previously, thyroid function tests should be performed annually (AAP Committee on Genetics, 2001) due to the high incidence of hypothyroidism in children with Down syndrome. At this time, there are no specific recommendations for laboratory assessment of obesity in children with Down syndrome, but the protocols developed by Krebs et al. (2007) for the general pediatric population should be applied. When a child's BMI is between the 85th percentile and the 94th percentile with no risk factors, a fasting lipid panel should be ordered. However, if the child's BMI is between the 85th percentile and the 94th percentile with risk factors, such as family history of obesity-related illness, elevated blood pressure, or high cholesterol, the provider should order a fasting lipid panel, aspartate amino-transferase (AST) and alanine amino-transferase (ALT) levels, and a fasting glucose level (Krebs et al., 2007). When the child's BMI exceeds the 95th percentile, the previous tests should be ordered regardless of the family's risk factors (Krebs et al., 2007). If laboratory results and physical findings indicate possible diabetes mellitus, an oral glucose tolerance test measuring both glucose and insulin levels should be ordered (Krebs et al., 2007). A local obesity or endocrine clinic should be consulted if the provider is unsure which tests to perform or how to interpret abnormal results.

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