By Sandra Gibson Hassink MD
This convenient, useful advisor offers clinicians with a entire method of the clinical administration of obese little ones and teenagers. assurance starts off with the epidemiology, pathophysiology, and developmental elements of kid and adolescent weight problems and a advisor to assessment of overweight childrens. next chapters handle respiration, cardiovascular, endocrine, metabolic, orthopaedic, gastrointestinal, renal, and neurologic problems and comorbid stipulations in addition to psychological well-being concerns, acute obesity-related emergencies, and weight problems as a part of genetic syndromes. Pathophysiology is associated with scientific presentation, review, and therapy, and way of life matters are mentioned the place acceptable. Highlighted containers and algorithms support clinicians locate and digest info quickly.
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Additional info for A clinical guide to pediatric weight management and obesity
The influence of common polymorphisms in POMC, resulting in partial loss of function, on obesity phenotypes in less extreme individuals is unclear (46). Links to Obesity-Related Comorbidities Alterations in insulin sensitivity are hallmarks of the metabolic derangements due to obesity and the development of the major comorbidities of type 2 diabetes, dyslipidemia, and cardiovascular disease. Insulin-mediated glucose disposal by muscle varies almost 10-fold in healthy individuals, possibly explaining the variability of the impact of obesity on insulin resistance in each individual.
Weiss PAM, Scholz HS, Haas J, Tamusinno KF, Seissler J, Borkenstein MH. Long term follow up of infants of mothers with type I diabetes; evidence for hereditary and non hereditary transmission of diabetes and precursors. Diabetes Care. 2000;23(7):905–911. 2. Hales CN, Barker DJ, Clark PM, Cox LJ, Fall C, Osmond C, Winter PD . Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991;30:1019–1022. 3. Law CM, Barker DJ, Osmond C, Fall CH, Simmonds SJ . Early growth and abdominal fatness in adult life.
5592_LWW_Ch03pp018-029 9/22/06 7:33 AM Page 23 PATHOPHYSIOLOGY OF OBESITY 23 Leptin, produced in adipocytes, is correlated to the body’s total fat stores. Leptin regulates long-term energy balance in favor of conservation of fat mass (39). Melanocyte–stimulating hormone interacts at the level of the hypothalamus with a melanocortin receptor, MC4-R, to decrease food intake and increase energy expenditure (39). Appetite-stimulating (orexigenic) peptides such as agouti-related protein and neuropeptide Y are also expressed in the hypothalamus as a component of the CNS control of energy balance (39).
A clinical guide to pediatric weight management and obesity by Sandra Gibson Hassink MD