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The prevalence of obesity in children and adolescents has been gradually increasing in recent years and has become a major health problem. Childhood obesity can readily progress to adult obesity. It is associated with obesity-related comorbidities, such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea, non-alcoholic fatty liver disease, and the risk factor for cardiovascular disease. It is important to make an accurate assessment of overweight and obesity in children and adolescents with consideration of growth and development. Childhood obesity can then be prevented and treated using an appropriate treatment goal and safe and effective treatment strategies. This article summarizes the clinical practice guidelines for obesity in children and adolescents that are included in the 8th edition of the Clinical Practice Guidelines for Obesity of the Korean Society for the Study of Obesity.

Background: Serum fibroblast growth factor 21 (FGF21) has been suggested to be a possible biomarker for early detection of metabolic syndrome and type 2 diabetes in adults. However, few studies have investigated the correlation between FGF21 levels and metabolic parameters in children. This study sought to evaluate the relationship between FGF21 and metabolic parameters in obese Korean children and adolescents. Methods: Fasting serum FGF21 and adiponectin levels as well as fasting insulin, glucose, transaminases, and lipid profiles were measured by enzyme-linked immunosorbent assays in 45 lean and 70 obese children aged 7-14 years. Independent t-test and multivariate correlation analysis were used to evaluate the relationship between FGF21 and metabolic parameters. Results: Serum FGF21 was significantly higher in obese children than in lean children. Serum FGF21 levels were positively correlated with insulin resistance index homeostasis model assessment (HOMA-IR) (r=0.355, P=0.004) and triglycerides (r=0.423, P<0.001) and were negatively correlated with high-density lipoprotein (HDL) cholesterol (r=-0.412, P<0.001). After adjustment for body mass index, triglycerides, HDL cholesterol and adiponectin, FGF21 levels showed a significant correlation with only HOMA-IR on multivariate linear regression analysis. Conclusion: Serum FGF21 levels were higher in obese children and significantly correlated with HOMA-IR. Therefore, FGF21 could be a biomarker for obesity-induced insulin resistance in children and adolescents as indicated in adults. [ABSTRACT FROM AUTHOR]

The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.